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Topics:
Lung Cancer • Radiation Oncology • Thoracic Malignancies • Medical Oncology • Non-small cell lung cancer
When do you recommend induction chemotherapy prior to concurrent chemoradiotherapy for locally advanced NSCLC?
If you treat pre-chemotherapy volumes, is there a benefit to induction chemotherapy even in bulky disease. If so, how do you define disease that is too large?
Answer from: Radiation Oncologist at Academic Institution
I rarely recommend induction chemotherapy prior to definitive concurrent chemoradiation. This is because two randomized studies, LAMP (PMID 16087941) and CALGB 39801 (PMID 17404369) showed no survival benefit and added toxicity with induction chemotherapy compared to concurrent chemoradiotherapy alo...
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Answer from: Radiation Oncologist at Academic Institution
Agree. My first response was to say "never" but I would revise to "almost never". If you have a patient with a large tumor volume where your normal tissue dose is high and you feel likes its a high risk plan, I would not anticipate that you can make it significantly better after what is usually a ...