Challenge accepted.

From the Canadian center that brought us all SABR-COMET, here is a practical review of challenging cases of lung stereotactic body radiation (SBRT) for non-small cell lung cancer (NSCLC). Scenarios include pre-existing interstitial lung disease (patient received 50Gy/5), the dreaded ultra-central location (60Gy/12), re-irradiation (54Gy/3 for a second time with a 3-year interval), and how to manage a large primary tumor in the setting of oligomets (55Gy/20 on a clinical trial). They ultimately conclude that the benefit of lung SBRT often outweighs the risk, even for such challenging cases, but is best done with input from multidisciplinary and rad onc peers. | Andruska, J Thorac Oncol 2021