Hi, I have started a series of five cyber knife sessions to a lone tumor deep in my sub pectoral muscle that caused a fracture in rib #2 - right side. These sessions are being done on my week off from my chemo regiment of Carbo/Taxol/Avastin - starting cycle two in a week (on Wed, last cyber knife on that Mon). I have seen concerns about mixing radiation and Avastin. The chemo was scheduled prior to Cyber Knife. I have concerns about bleeding issues that I have heard about from mixing Avastin and radiation. I have no history of bleeding but want to know how concerned I should be with this. I plan on talking to my doctor but wanted to know if there are any studies I can reference showing the risks or is it not a big issue due to location of the radiation?
Thank you in advance,
Ronda
Background: Diagnosed September 2011 with a pancoast tumor with horners syndrome. NSCLC - Adenocarcinoma, originally staged 3B. I have been tested for mutations and have none. Did concurrent radiation and chemo (Cisplatin/Etoposide) for six weeks. Followed up with an additional cycle of chemo. Declared NED for a short time. July 2012 new tumor discovered close to original one. Tried carbo/alimta without success. Now on Carbo/Taxol/Avastin but was having platelet issues so schedule was off and had tumor growth. Carbo dosage has been reduced for this round in hopes of keeping my platelets up. I have only one defined tumor at this point and nothing elsewhere - yippy.
Reply # - February 17, 2013, 09:05 AM
Reply To: Cyber Knife and Avastin
That's a very good question, but I don't think there's any answer out there, and it would depend very greatly upon the exact area the radiation is treating. I don't know of any published experience Avastin (bevacizumab) given concurrent, or nearly concurrent, with stereotactic radiosurgery/Cyberknife, but I believe that many oncologists, both general oncologists and lung cancer specialists, would share your concern about potential complications from the effects that Avastin has on wound healing, including potentially (?especially) after Cyberknife.
I would say the key issue is whether the radiation would be in the vicinity of any risky structures, and the location of where you're describing as a target for radiation sounds like it will be away from any especially high-risk anatomic structures.
-Dr. West
Reply # - February 17, 2013, 09:17 AM
Reply To: Cyber Knife and Avastin
Thank you so much for your prompt reply. I do feel better now. The exact location is upper mid to right area, rib # 2 roughly 3" from my center (not sure what it's called but where the ribs meet in the middle, sternum maybe :)). I will report back what my onc says but I am leaning on being safe and requesting we drop the Avastin. Nobody can tell if the chemo is working anyway, the only spot I had when we started back in August is the same one they are radiating now, at least there is nothing new so maybe....
Thanks again,
Ronda