Patients with locally advanced lung cancer and very limited pulmonary function (forced expiratory volume in 1 second $[FEV1]{\leq}1L$) have dismal prognosis and undergo palliative treatment or best supportive care. We describe two cases of locally adv...
Patients with locally advanced lung cancer and very limited pulmonary function (forced expiratory volume in 1 second $[FEV1]{\leq}1L$) have dismal prognosis and undergo palliative treatment or best supportive care. We describe two cases of locally advanced node-positive non-small cell lung cancer (NSCLC) patients with very limited lung function treated with induction chemotherapy and moderate hypofractionated image-guided radiotherapy (Hypo-IGRT). Hypo-IGRT was delivered to a total dose of 45 Gy to the primary tumor and involved lymph nodes. Planning was based on positron emission tomography-computed tomography (PET/CT) and four-dimensional computed tomography (4D-CT). Internal target volume (ITV) was defined as the overlap of gross tumor volume delineated on 10 phases of 4D-CT. ITV to planning target volume margin was 5 mm in all directions. Both patients showed good clinical and radiological response. No relevant toxicity was documented. Hypo-IGRT is feasible treatment option in locally advanced node-positive NSCLC patients with very limited lung function ($FEV1{\leq}1L$).