When a patient with stage IIIA NSCLC is treated with induction chemotherapy alone followed by surgery, and has a pCR, do you offer post-operative RT based on pre-chemo findings or omit due to complete response?
Would age or histology alter your decision if biospy proven N2 disease has a pCR after 4 cycles of chemotherapy?
Answer from: Radiation Oncologist at Academic Institution
This issue comes up regularly....the assertion being that if the mediastinal disease has been cleared with chemotherapy, there is no need for RT. However, studies have shown that local failure is still quite high even when a mediastinal pCR is achieved. In the SAKK trial (B Journal of Cancer 2006;94...