What if Perioperative Therapy for Non-Small Cell Lung Cancer Renders Someone Inoperable?

This case is really one of multiple “what ifs.” Patients who are medically inoperable (even after perioperative systemic therapy) and with stage III disease should be considered for consolidative/definitive chemoradiation. 1 Farley A Nelson B Neoadjuvant Chemoimmunotherapy for Initially Resectable Non-Small Cell Lung Cancer: Queen's Gambit or CheckMate?. Int J Radiat Oncol Biol Phys. 2024; 118: 585-586 Abstract Full Text Full Text PDF Google Scholar However, if additional chemotherapy is not possible, as in this debilitated patient, we could offer a hypofractionated course of radiation to 55 Gy/20 fractions, similar to a sequential therapy paradigm. If this patient has significant functional decline wherein any additional therapy is not possible, we would recommend surveillance with restaging scans at 2 to 3 months and re-evaluation for definitive therapy at that time.