What is your preferred dose and fractionation schedule for a patient with a stage III non-small cell lung cancer, whose comorbidities preclude chemotherapy, but has good enough performance status to warrant an attempt at longer-term local control?
What dose is preferred for central stage III NSCLC without chemotherapy? Do you recommend higher dose hypofractionated RT or conventional RT?
Answer from: Radiation Oncologist at Academic Institution
This is a very good question. I'd say the answer to this one is evolving! Typically the patients who cannot tolerate either sequential or concurrent chemotherapy for locally-advanced NSCLC are quite frail and/or have comorbidities that are significant. The results using radiation alone for Stage II...
Answer from: Radiation Oncologist at Academic Institution
There is really no practical standard of care in this situation. The vast majority of folks in our institution are able to get sensitizing doses of paclitaxel/carboplatin even if PS 2 , so we don't treat many stage III patients with RT alone. I do use hypofractionated schedules , and the regimen dep...
Answer from: Radiation Oncologist at Community Practice
RTOG's older study where 6960 was given at 120 BID has been used successfully to control locally advanced disease. We have seen excellent response and long term local control.