only 7% shrinkage after chemo and radiation

Portal Forums Radiation Oncology Chest Radiation only 7% shrinkage after chemo and radiation

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December 17, 2017 at 3:25 pm  #1293645    


I was diagnosed with stage 3b NSCLC (T1N3M0) in March 2017. T1N3M0
I have gone through 2 rounds (12 days) of chemo Cisplatin/etoposide and 33 days of radiation. but saddly, I got only 7% shrinkage after 3 months as at Nov. 1, 2017. Hope it will continue to shrink.
Left supraclavicular node is slightly smaller measuring 0.7 cm, prior 0.8 cm. Left para-aortic lymph node is slightly smaller and measures 1.3 cm, prior 1.5 cm. The right para-oesophageal lymph node is smaller measuring 0.7 cm, prior 0.9 cm.
My upper lobe image 35 is slightly smaller and measures 1.4 x 1.2 cm, prior 1.5 x 1.1 cm.
I will be followed up every 3 months (with blood test, Xray) by my oncologist. CT scan on chest and spine after 6 months.
I will be on CRIZOTINIB if LC worsen.
Does anyone here have any idea of my small % of shrinkage? Does it mean my chance of NED is not encouraging.?

December 17, 2017 at 5:34 pm  #1293646    
JimC Forum Moderator
JimC Forum Moderator

Hi jkkwok1,

Welcome to GRACE. I’m sorry to hear that so far you’ve only seen 7% shrinkage, and I hope that you do continue to get further reductions in the size of your nodules. The full effect of radiation treatments can take quite a while to become fully evident, so there is that possibility.

Since crizotinib has been suggested as the next treatment if there is disease progression, I assume that your cancer cells have been tested for certain genetic abnormalities, which has revealed an ALK rearrangement. Crizotinib is specifically designed to target cancer cells bearing the ALK rearrangement, and such targeted therapies can be extremely effective.

Although that means that NED (no evidence of disease) is still a possible outcome, you should be aware that many patients manage to keep their cancer stable for long periods of time before switching to another therapy. In the case of ALK inhibitors such as crizotinib, there are next-generation inhibitors that can be effective should crizotinib cease working. In addition, there are other standard chemotherapy options, plus immunotherapies to which you might turn. Finally, the pace of research and introduction of new treatments is moving faster than ever, so by the time you might need a new treatment, there may be something new available.

Good luck with your follow-up scans, which I hope will show continued shrinkage or stable disease.

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:

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