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NSCLC — SCE Medical Oncology MCQ

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HardLung CancerNSCLCSCE Medical Oncology

A 1.7 cm peripheral second primary NSCLC is staged cT1bN0M0 in a patient who previously had an ipsilateral lobectomy. Formal cardiopulmonary assessment concludes that any further lung resection is contraindicated, but radical radiotherapy is feasible. What local treatment should be offered under NICE NG122?

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Correct answer: A — Stereotactic ablative radiotherapy as curative-intent radical radiotherapy

For stage 1 to 2A N0M0 NSCLC when any surgery is contraindicated or declined, NG122 says to offer SABR. Conventional or hyperfractionated radical radiotherapy is used if SABR itself is contraindicated. Prior lobectomy does not automatically preclude curative radiotherapy, while ablative procedures require separate selection and palliative dosing would undertreat a curable localised cancer.

Reference: NICE NG122 lung cancer: radical treatment for stage 1 to 2A NSCLC (Current NICE guidance, accessed August 2026): https://www.nice.org.uk/guidance/ng122/chapter/Management