rp25
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Posts:3
My treatment plan includes SBRT of a small metastasis (1 cm) considered to be "oligo".
However, due to targeted therapy, it has already disappeared.
I understand there might be microscopic disease left.
Assuming the oligo area is well defined, is SBRT still an option ?
The goal would then be to kill the disease on microscopic level at an early stage.
Thanks for any comments (pros and cons etc).
Forums
Reply # - May 7, 2016, 07:55 AM
More info might be helpful.
More info might be helpful. Type, stage and location. Have you had any other treatment?
Take care, Judy
Reply # - May 7, 2016, 08:09 AM
Hi rp25,
Hi rp25,
Welcome to GRACE. Congratulations on the good response to targeted therapy. Usually an oligometastatic nodule is treated when it's the only location not responding to treatment, while yours seems to have responded well. If that metastasis has "disappeared", I'm not sure how the radiation would be targeted. In addition, the goal of systemic treatment such as the targeted therapy you have received is to kill micrometastases wherever they may be found.
You haven't mentioned where this nodule is located, or how well the primary tumor has responded to treatment. Those might be factors as well. If the rest of the disease is under control, then SBRT might be an option if the targeting issue can be resolved. You can find the most recent GRACE podcast here, and it includes links to other posts on the subject.
JimC
Forum moderator
Reply # - May 7, 2016, 10:09 AM
Thanks Judy and JimC for your
Thanks Judy and JimC for your comments.
Stage IV, NSCLC, adenocarcinoma.
The plan was to start with targeted therapy and, if stable, add radiation therapy (now under consideration).
The primary tumor is located in the right lung. It has shrunk substantially but has not disappeared.
The metastasis was located on the lower part of a shank of the adrenal gland. So it might be possible to target the SBRT towards this area.
Reply # - May 8, 2016, 11:57 AM
Hi rp25,
Hi rp25,
That's great that the primary tumor has reduced in size so significantly. In that context, it seems reasonable to radiate the area of the adrenal metastasis, although of course it won't be possible to judge its efficacy, since apparently nothing appears there on the current scan.
Good luck!
JimC
Forum moderator
Reply # - May 8, 2016, 01:45 PM
Is the adrenal met still
Is the adrenal met still visible on the CT scan? As Jim mentioned, if it's not seen how would they radiate it? Take care, Judy
Reply # - May 9, 2016, 02:07 AM
Thanks Judy and JimC.
Thanks Judy and JimC.
My understanding is that you need to replace the met with another target. In this case, the met was located in a specific part of the gland. This part could be irradiated if it is a well defined structure (using image guided RT).