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Just curious, in limited stage small cell patients with PET negative and mediastinoscopy proven disease free mediastinum does anyone ever skip on mediastinal irradiation? There is a tiny Dutch study that skiped mediastinal nodes in PET neg LS patients with few mediastinal failures. We generally treat most everyone BID and it makes sense that leaving the mediastinum alone in select patients could reduce esophageal toxicity. Some of our senior faculty are weary of doing so since truly limited stage patients are so rare they don't want to blow a curative opportunity. Thoughts?