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Cyberknife after conventional radiotherapy
skg82
Posted: Thursday, July 10, 2014 7:34 AM
Joined: 7/10/2014
Posts: 3


My father, age 71, had adenocarcinoma stage IIIA in 2010, RUL with adjuvant radiation and chemotherapy with NED at present. January 2014 PET/CT revealed 1.8cm nodule at the surgical margin of the adeno surgery. Went for middle lobectomy but had wedge resection due to tumor invasion to mediastinal pleura and chest wall. Biopsy revealed it was a second primary: squamous. PET/CT did not show invasion findings before surgery and radiation oncologist did not want to intervene after surgery where surgeon left surgical clips because no volume was identified through imaging. June 2014 PET/CT reveals 7cm x 3cm mass. Surgery is not an option for possible pneumonectomy. He received 5040 cGY in 2010. Under these circumstances, is cyberknife or SBRT an option? Thanks in advance for your response.
radsrus
Posted: Thursday, July 10, 2014 3:47 PM
Joined: 10/10/2008
Posts: 4435


Yes, but with masses that size the control rate is lower

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


skg82
Posted: Thursday, July 10, 2014 5:26 PM
Joined: 7/10/2014
Posts: 3


Thank you for your response. Would there be any concerns regarding reirradiation at the same spot where he received 5040cGY in 2010? Would carbo/taxol chemo after Cyberknife be advised to further control rate? We are experiencing some resistance from the radio oncologists to treat previously irradiated area but if surgery is not an option, we are running out of alternatives more so when his recurrence appears to be local through PET/CT imaging. Thanks!
radsrus
Posted: Friday, July 11, 2014 2:17 AM
Joined: 10/10/2008
Posts: 4435


There is always some concern about a previously irradiated area, but it should be manageable. Have to leave the chemo question to the medical oncologists. If your local folks don't want to treat, look around. Where do you live?

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


skg82
Posted: Friday, July 11, 2014 4:48 AM
Joined: 7/10/2014
Posts: 3


Hi! We're in Puerto Rico where there's only one CK machine and one doctor trained for it. We have an appt next week to see him and we'll go from there. If he chooses not to intervene, we will be looking for second opinions in the mainland. Thank you for your response!
 

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