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SCLC:
- CRT for limited-stage
- Palliative or ablative radiotherapy (SBRT) ( Omeroglu Simsek, 2020 ) | Postpone initiation of treatment by 4 weeks: -Post-Operative Radiotherapy (PORT) NSCLC - Prophylactic Cranial Irradiation (PCI) SCLC | Use less treatment sessions: - SABR as possible. - Hypo-F RT regimens ( Bakhribah et al, 2020 ) |
| Extensive-stage SCLC: PCI | - Stage I NSCLC: 45 - 54 Gy /3 frs or 48 - 50 Gy / 4 or 5 frs or 30 - 34 Gy /1 fr in select patients (SBRT/ablation) - Locally advanced NSCLC (stage III): 60 Gy / 24 frs or 55 Gy / 20 frs or up to 60 Gy / 15 frs (Hypo-F RT schedule) - Limited-stage SCLC: twice-per-day RT (cCRT) PCI for age < 75 yrs ( Singh et al, 2020 ) |
Extensive SCLC (PCI or palliative intent) | | Locally advanced (palliative): - 40 Gy / 15 frs - 39 Gy / 13 frs - 16 Gy / 2 frs ( Kochbati et al, 2020 ) |
SCLC, Extensive: - PCI - Consolidation thoracic RT in extensive-stage disease | Stage I-IIIB tumor operated: Short delay in RT if R0 resection | NSCLC, T1/2N0M0, medically inoperable; peripheral: -SBRT 30-34 Gy/single fr (T1 N0M0) -54 Gy / 3 frs in 1.5 weeks (Eligibility includes T1, 2 (<5 cm), T3 < 5 cm, chest wall involvement positive, no mediastinal or bronchial tree invasion) -48 Gy / 4 frs daily RT NSCL, T1/2N0M0, medically inoperable, central: - 60 Gy / 8 daily frs -70 Gy / 10 daily frs -50 Gy / 5 daily frs Stage III, Locally advanced NSCLC: -55 Gy / 20 frs with concurrent /sequential chemotherapy -60 Gy /15-20 frs NSCLC, advanced- inoperable, large for Palliative RT: 8 - 10 Gy/1-2 frs SCLC, localized: 40-42 Gy /15 daily frs ( Hinduja et al, 2020 ) |
| | Curative treatment for stage III NSCLC: Hypo-F in cCRT strategy (60–66 Gy / 22–30 frs and 50 Gy / 20 frs) Inoperable stage II-III NSCLC Limited stage SCLC Palliative NSCLC (spinal cord compression or SVCO) Early-stage NSCLC: SABR:30–34 Gy /1 fr to 48–54 Gy / 3 frs Central tumors: Hypo-F RT (50–60 Gy /15 frs) Inoperable early-stage NSCLC and operable NSCLC: SBRT Stage II NSCLC: definitive RT ( Stepanović and Nikitović, 2020 ) |
| Adjuvant RT (pathological N2 or R1 post-op): after chemotherapy or 3 months after surgery | Early-stage disease: SBRT for tumors <2.0 cm (a single fraction of 30 − 34 Gy) Adjuvant... |
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