My husband was diagnosed with sclc with mets to liver January 2015. He had 4 rounds of carboplatin/etoposide with a very good response after 2 rounds, not much more after 4. He received 10 days of PCI and chest irradiation. After 6 weeks his CT showed lung and lymph node stable with progression in the liver. As we prepared to begin 2nd round chemo with topotecan we did a brain MRI to satisfy requirements for a clinical trial. One 3mm lesion was noted. We did not expect that so soon after PCI. Now we are having gamma knife this week for that lesion. My question is can WBR be used down the road after PCI and gamma knife and if so, how long must one wait before doing so. We don't know when this lesion appeared since no MRI was done since early 2015.
Mon, 08/03/2015 - 08:24
Welcome to GRACE. The question of whether to repeat WBR is one that must be carefully considered, due to the risk of cumulative damage to healthy brain tissue. It may depend on the pace of disease progression elsewhere in the body, as well as how recent the first course of WBR was.
The subject is discussed in this post by Dr. Goldberg: http://cancergrace.org/radiation/2008/12/07/reirrad-brain-mets-zg/
And when my wife and I faced a similar decision, Dr. West, Dr. Weiss and I had a good discussion which you can read here: http://cancergrace.org/forums/index.php?topic=9910.0
Good luck with GK and topotecan.
Mon, 08/03/2015 - 13:41
Jim, thank you for your quick response. The two links were most informative. I might add that my husband is 61 years old with no significant impairment at this time. We hope to put forth a good fight. I'm sorry we all must deal with these issues.
Thu, 08/06/2015 - 18:30
Just an update on my husbands situation. We showed up for gamma knife and the MRI showed no lesion. It was gone. They concluded that a tumor must have been present before PCI and the PCI itself was therapeutic causing a shrinking lesion which was picked up 2 weeks ago. By the time gamma knife was scheduled, it was gone. Strange, but welcome turn of events.
Thu, 08/06/2015 - 19:51
That is wonderful! So glad not to have a treatment I'm sure.
Fri, 08/07/2015 - 08:09
That's great news. And it's true that the full effects of radiation can take quite a while to become fully evident. Congratulations!