I would go like that:
1. Estimate heatsink area needed. First, cut a piece of FR-4 the same size as your board. Solder DPAK in the middle, dissipate your watts, check the temperature. If the thing overheats, abandon the idea. If no, repeat with 1/2 of the area, then 1/3 of the area.
2. If the DPAK temperature is tolerable at 1/3, reroute the rest of the board to have that much copper for the heatsink. Should be doable.
All this can be done in less than a day for the price of US$5 for FR-4 plus your daily salary. BTW, is bottom side available? If yes, you can place vias under the tab, fill them with solder and have very good heat transfer to the bottom side.