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Old 11-04-2009, 06:38 AM   #1
Lani
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less brain swelling with multiple session Cyber/gamma knife treatment

This paper concerned a primary benign brain tumor--unclear whether will hold for breast cancer brain mets as well, but food for thought and perhaps something to ask Rad Onc

Less brain swelling occurs with multiple sessions of SRS for common brain tumor

CHICAGO – Treating a common brain tumor with multiple sessions of radiation appears to result in less brain swelling than treating the tumor once with a high dose of radiation, say researchers from the Lombardi Comprehensive Cancer Center at Georgetown University Hospital.

Benign brain tumors known as meningiomas are often treated with a single, high dose of radiation using stereotactic radiosurgery (SRS). At Georgetown, SRS is conducted using CyberKnife. A single SRS treatment leads to good tumor control; however, post-treatment swelling (edema) is a common and potentially serious complication.

In a study presented today at the 51st Annual Scientific Meeting of the American Society for Radiation Oncology in Chicago, the Georgetown researchers say there appears to be a safer option.

"Like the single dose, delivering lower doses of radiation in three, four or five CyberKnife sessions leads to good control," says Georgetown's Christopher Lominska, MD, lead author of the study and chief resident in radiation medicine. "The multiple sessions have the added bonus of causing less edema."

For the study, researchers reviewed the records of 81 patients treated at Georgetown from April 2002 to April 2008. "Edema tended to occur less often in the patients who received multiple SRS treatments," Lominska says. "Three, four or five treatment sessions with the CyberKnife appear to result in a low edema rate equivalent to conventional radiation therapy which often involves 30 treatment sessions. That means SRS with CyberKnife allows good tumor control with fewer side-effects, and in less time than conventional therapy."
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Old 11-04-2009, 08:59 AM   #2
hutchibk
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Re: less brain swelling with multiple session Cyber/gamma knife treatment

I have had 6 different tumors pinpoint targeted with IMRT 3D Conformal Stereotactic Radiosurgery over 5 days each... and never has one ever had edema.

As I have said, my Rads Onc has worked with both the IMRT Varian Trilogy machines he currently uses and previously with Cyber brand. He prefers IMRT for many reasons and I believe one reason is that the multiple days of treatment over the one day of treatment have consistently yielded him prefrerred results... such as less edema.

Just one girl's experience.
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Brenda

NOV 2012 - 9 yr anniversary
JULY 2012 - 7 yr anniversary stage IV (of 50...)

Nov'03~ dX stage 2B
Dec'03~
Rt side mastectomy, Her2+, ER/PR+, 10 nodes out, one node positive
Jan'04~
Taxotere/Adria/Cytoxan x 6, NED, no Rads, Tamox. 1 year, Arimadex 3 mo., NED 14 mo.
Sept'05~
micro mets lungs/chest nodes/underarm node, Switched to Aromasin, T/C/H x 7, NED 6 months - Herceptin only
Aug'06~
micro mets chest nodes, & bone spot @ C3 neck, Added Taxol to Herceptin
Feb'07~ Genetic testing, BRCA 1&2 neg

Apr'07~
MRI - two 9mm brain mets & 5 punctates, new left chest met, & small increase of bone spot C3 neck, Stopped Aromasin
May'07~
Started Tykerb/Xeloda, no WBR for now
June'07~
MRI - stable brain mets, no new mets, 9mm spots less enhanced, CA15.3 down 45.5 to 9.3 in 10 wks, Ty/Xel working magic!
Aug'07~
MRI - brain mets shrunk half, NO NEW BRAIN METS!!, TMs stable @ 9.2
Oct'07~
PET/CT & MRI show NED
Apr'08~
scans still show NED in the head, small bone spot on right iliac crest (rear pelvic bone)
Sept'08~
MRI shows activity in brain mets, completed 5 fractions/5 consecutive days of IMRT to zap the pesky buggers
Oct'08~
dropped Xeloda, switched to tri-weekly Herceptin in combo with Tykerb, extend to tri-monthly Zometa infusion
Dec'08~
Brain MRI- 4 spots reduced to punctate size, large spot shrunk by 3mm, CT of torso clear/pelvis spot stable
June'09~
new 3-4mm left cerrebellar spot zapped with IMRT targeted rads
Sept'09~
new 6mm & 1 cm spots in pituitary/optic chiasm area. Rx= 25 days of 3D conformal fractionated targeted IMRT to the tumors.
Oct'09~
25 days of low dose 3D conformal fractionated targeted IMRT to the bone mets spot on rt. iliac crest that have been watching for 2 years. Added daily Aromasin back into treatment regimen.
Apr'10~ Brain MRI clear! But, see new small spot on adrenal gland. Change from Aromasin back to Tamoxifen.
June'10~ Tumor markers (CA15.3) dropped from 37 to 23 after one month on Tamoxifen. Continue to monitor adrenal gland spot. Remain on Tykerb/Herceptin/Tamoxifen.
Nov'10~ Radiate positive mediastinal node that was pressing on recurrent laryngeal nerve, causing paralyzed larynx and a funny voice.
Jan'11~ MRI shows possible activity or perhaps just scar tissue/necrotic increase on 3 previously treated brain spots and a pituitary spot. 5 days of IMRT on 4 spots.
Feb'11~ Enrolled in T-DM1 EAP in Denver, first treatment March 25, 2011.
Mar'11~ Finally started T-DM1 EAP in Denver at Rocky Mountain Cancer Center/Rose on Mar. 25... hallelujah.

"I would rather be anecdotally alive than statistically dead."
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