Cyberkife or proton therapy on a lymph node?

[evlin75]

Would like any opinions or experience regarding treatment to a supra-clavicle lymph node. It has gone down in size some since the treatments with Abraxine but is still present. The plan is to do the biopsy and then try something to reduce the size.
Thanks for any opinions or ideas.
Ev

[Jackie07]

Hi Ev,

Below is the abstract of a comparison of different radiation treatment for head and neck cancer/tumor. You might want to get 2nd/third opinions if you are not sure about your doctor's choice.

Anticancer Drugs. 2011 Aug;22(7):596-606. doi: 10.1097/CAD.0b013e328340fd2b.
New techniques in radiation therapy for head and neck cancer: IMRT, CyberKnife, protons, and carbon ions. Improved effectiveness and safety? Impact on survival?
Thariat J1, Bolle S, Demizu Y, Marcy PY, Hu Y, Santini J, Bourhis J, Pommier P.
Author information
Abstract
The objective of this study was to assess the comparative effectiveness of intensity-modulated radiation therapy (IMRT), conformal and two-dimensional radiation therapy, proton beam, and carbon ion therapy in terms of tumor control and survival on the one hand and adverse events and quality of life on the other in irradiated head and neck cancer patients. A search of the literature was performed. At a given time, innovative techniques in radiation therapy may appear superior to routine irradiation techniques and clinical trials may therefore be considered unethical. IMRT, because of its superiority in terms of dose distributions and potential to preserve the salivary glands, has gradually replaced two-dimensional and conformal irradiation in routine use. The PARSPORT phase III trial is one among the rare trials to randomize two-dimensional and conformal irradiation against IMRT. It showed a 50% reduction in late xerostomia. Similarly, the relevance of clinical trials to prove the superiority of protons compared with photons is highly controversial. Although the expected benefit of particle beam therapy on dose distributions, local control, and quality of life seems sufficient for routine use without phase III trials, it should be noted that new toxicity profiles might be seen as was the case for IMRT (posterior alopecia, anterior mucositis, uncertainties of integral dose, and secondary cancers). Prospective clinical and medico-economic assessment, possibly in phase II trials, is therefore critically needed along with stringent quality assurance programs. Technological advances in radiation therapy clearly provide a benefit for patients despite the lack of level I evidence.

[Jackie07]

And here's a thread where several members have shared their experience dealing with the same condition: http://her2support.org/vbulletin/sho...aclavicle+node It's a dated thread, but you can get more information from each member's signature/treatment history.

Sending you good vibes.

[evlin75]

Thanks Jackie,

I will give Susan this info. It seems the nodes are common and not easy to shrink and stay removed.
She would have to travel and stay to receive the proton so it would have to be a LOT better to make the inconvenience worth while.
She had a series of radiation treatments but they only made it angry and inflamed but did noting to reduce the size.
Lots of thanks for your help.

Ev

[Cat]

My understanding is that proton therapy is more pinpointed and used when near something vital. I had proton on a node next to my aorta. They were at the time using it on brain and prostate mostly. I'm sure that has changed since. I had cyberknife following brain mets removal to clean up any last bits.
Proton therapy for me was 2 weeks (m-f) plus 2 or 3 visits for set up etc. Cyberknife was 2 visits for set up and 3 treatment days.
Good luck,
Cathy

[evlin75]

Thanks Cathy,
The latest decision now seems to be to do cryosurgery. Maybe because of the previous failed radiation. I am not totally sure but I understand the freezing type removal can be repeated if it does not completely remove the node the first try.
At least this is available locally and she will not have to travel a distance to receive the treatment. The proton machines are expensive and not available everywhere. They are getting a new one at her local treating facility that will be available in early 2015.
Thanks again,
Ev