High Dose High Risk Radiation

Portal Forums Radiation Oncology Chest Radiation High Dose High Risk Radiation

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February 1, 2015 at 5:39 am  #1268335    


My dad has a non small cell squamous tumor on the upper left lobe of his lung. This is the second flare up in the area after a previous radiation treatment (33) with a follow up of chemo. The new flare up is close to a main vessel in the Lund that the oncologist says that there is a 1 in 10 chance of rupture within the first month after treatment. The plan is to do 8 high dose treatments with high risk side affects. Loss of left arm function, dead tissue that will have to be eventually surgically removed, and the blood vessel rupture being the worst. We are having difficulty deciding to go with the high risk because of the vessel risk. Other option is 15 low dose and chemo follow up. Have you heard of this vessel rupture? I guess we are facing taking risks to buy more time, which may end life earlier if the vessel ruptures, or low dose low risk and having less time. Or my dad is considering doing nothing because the end result is the same regardless. If he does nothing, we were told that the cancer will most likely rupture the vessel when it invades that area…it is quite close already. I was just wondering if you have heard of this happening, decision making is very difficult at this moment.

Thank you for your time-

February 1, 2015 at 6:30 am  #1268336    
JimC Forum Moderator
JimC Forum Moderator

Hi Christina,

Welcome to GRACE. As you’ve learned, radiation near a major blood vessel is always risky, but as Dr. Loiselle has said:

“As a radiation oncologist, interpreting risk profiles of lung irradiation and applying them in individual patient circumstances is often a gray area of balancing risk and benefit, rather than a set of black and white maximum dose thresholds.” – http://cancergrace.org/radiation/2012/03/29/not-black-or-white/#more-1410

Since these decisions are so individualized, unfortunately that means that your dad’s doctors are best equipped to provide a good evaluation of the risks of each choice. That being said, the chemo option after radiation may also be very helpful and may help extend his life. His doctors may feel that radiation is needed first in order to prevent the tumor from invading the blood vessel, but if they feel that he will be able to have chemo not too long after the radiation, that would be an important factor in my choice were I or my loved one facing this decision. I wouldn’t view this as a situation in which the “end result is the same” either way.

Best wishes for success in the upcoming treatment, whichever path you choose.

Forum moderator

Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

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