kelleylynn129
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Posts:8
Hello everyone. I searched for info about whether gamma knife after recent WBR, would work and couldn't find any answer about my case. DX is stage IV NSCLC adenocarcinoma, non-operable with mets to brain, bones. Had 15 rounds of WBR 7 weeks ago. Had MRI of brain yesterday that DR today said the brain mets, too numerous to count have progressed and nothing more the Dr can do. Said maybe go to another hospital/center that has gamma knife and get their opinion. Will gamma knife work if the WBR didn't??
Thanks.
Grace
Forums
Reply # - September 14, 2012, 01:37 PM
Reply To: Is gamma knife still an option?
Wanted to add that had 3 rounds of alimta/carboplatin and still had progression in lungs and other areas.
thanks.
Reply # - September 14, 2012, 01:54 PM
Reply To: Is gamma knife still an option?
Hi.
I wanted to let you know of our experience with WBR and Gamma Knife. My husband had 2 mets to the brain, had 15 rounds of WBR which was followed by Gamma Knife. The combination seemed to be successful in taking care of these mets.
It is my understanding that Gamma Knife is used primarily on people when they have a low number of mets, I want to say 4 or less. I am sure that someone more knowlegeable than me will comment and be able to give you more information.
Good Luck to you.
Louise
Reply # - September 14, 2012, 02:17 PM
Reply To: Is gamma knife still an option?
Hello,
I'm sorry to hear about the progressing brain mets. Louise is correct, gamma knife is normally used when there are just several brain mets. Using it on numerous lesions, especially after WBR, can cause significant damage to healthy brain tissue. If there are a couple of lesions that are large and/or causing troublesome symptoms, gamma knife may help. Otherwise, your doctor may be able to suggest a chemo agent that may cross the blood/brain barrier and be effective. If you have an EGFR mutation, pulsed Tarceva, in which a higher dose of Tarceva is given at intervals such as 600 mg every four days, has shown some success and could also be tried. You can read a previous discussion of this topic here: http://cancergrace.org/forums/index.php?topic=9788.0
JimC
Forum moderator
Reply # - September 14, 2012, 07:13 PM
Reply To: Is gamma knife still an option?
I agree. Gamma knife is really not very feasible if there are a large number of new or progressing brain lesions after WBR. This isn't to say that you won't find someone willing to do it, but that's not the same as it being a good idea.
Sometimes we actually repeat WBR, which is not well studied and always something we're wary about doing. However, if there aren't good alternatives, it's something we've occasionally done. And today I actually saw a patient who is 4 years out (almost to the day) from her diagnosis with NSCLC and brain metastases that required a second round of WBR about 6 months after diagnosis.
Here's a little more discussion of the topic:
http://cancergrace.org/radiation/2008/12/07/reirrad-brain-mets-zg/
-Dr. West