Can a patient receive IMRT while taking target madicine Geftinat? - 1256902

Hello jznj, welcome to Grace. I'm sure you will find the answers you look for here, providing they exist. Unfortunately there are many questions left without straight answers. What I do know about early stage nsclc is that it's curable without surgery. Though I believe the proven research has been with radiation and standard chemo.

I will ask a doctor to respond to your questions. Until then I'd suggest you look through some of these links listed in the link below. Some have to do with the role of EGFR tki's (like gefitinib) for people with non metastatic lung cancer.

This is a long list all the short videos (below are some links picked from this list) http://cancergrace.org/general/2013/02/20/iaslc-vids/

These are from that list and on the subject of early stage cancer and molecular testing. I stopped posting about half way through the list so there may be more.
http://cancergrace.org/lung/2013/02/24/wakelee-markers-in-early-stage-n…
http://cancergrace.org/lung/2013/03/04/riely-molec-markers-in-early-sta…
http://cancergrace.org/lung/2013/03/11/kelly-molec-markers-in-early-sta…

Here is a list of posts on curable unresectable nsclc. Mostly stage III though your mom fits into the subject if she isn't able to have surgery.
http://cancergrace.org/lung/tag/unresectable-locally-advanced-nsclc/
and this is a good place to start in that list,
http://cancergrace.org/lung/2012/11/18/quick-video-intro-to-locally-adv…

I hope for all the best for your mom,
Janine

Patients who are in the range of 80 are appropriately treated in an individualized way, so there isn't a clear "best" way to approach her care.

In general, we favor local therapy, whether surgery or radiation, for patients with localized disease -- surgery typically being the leading consideration, or radiation in patients who either refuse or aren't great candidates for surgery.

Whether to include gefitinib (Iressa, or gefitinat in some parts of the world) with radiation is a matter of judgment, as there isn't real evidence to speak to this situation. My inclination is to not administer the targeted therapy concurrent with radiation in such a situation, but there's no right or wrong answer here.

Good luck.

-Dr. West

I hope the treatment is successful. Keep a close eye on her or try to have someone close. There isn't any real info about what to expect from these 2 treatments together.
I suppose, though this is purely layman supposition and what I'd do if my husband were in the same position I would watch and act quickly for typical radiation side effects such as esophagitis, pneumonitis explained here, http://www.mayoclinic.com/health/pneumonitis/DS00962
and be proactive with tarceva side effects like rash etc.

The waiting is really difficult but you can't really know the results of radiation because there needs to be about a 3 month period after radiation treatment ends to settle the area down from all the activity. This is a primer on chest radiation. http://cancergrace.org/radiation/2012/03/29/not-black-or-white/#more-14…

All the best,
Janine

P.S. Dr. Sequist responded via email to say when she got to the email Dr. West had responded and she very much agreed with his comments. It's good to have a 2 comments from such exceptional minds even (or is that especially) when they agree with one another.