Look, this is going to come down to stylistic differences and institutional patterns of care. I don't disagree with the way you describe treating these patients and in most situations would do the same. I'm just saying I've seen and done it both ways. However, if you want to continue to argue, then allow me to retort.
A) Concurrent carbotaxol followed by adjuvant carbotaxol is in generally seen by most as an inferior regimen, and is in my opinion used by med oncs to pump in more chemo.
B) There are plenty of adjuvant and neoadjuvant regimens that don't contain the taxane that is likely driving this uptick in pneumonitis. Also how do you know pneumonitis would be worse with SBRT? There was a randomized trial presented at the 2015 Astro Refresher in the lung session looking at SBRT (66Gy in 3fx) vs conventional (70Gy in 35fx) for T1-2N0 NSCLC demonstrating improved pneumonitis rates (34 vs 16%) in the SBRT arm. Why would the pneumonitis rate seen with carbotaxol be so magnified with SBRT vs conventional fractionation when there is less to begin with?
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Largest size you'd do SBRT for
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