nsclc,stage4, brain surgery, cyberknife, chemo, now on Avastin - 1247465

sunshine43056
Posts:1

Hi, I am writing about a loved one Doyle who was diagnosed Aug 2011 with Lung Cancer which had spread to his brain, He had sugery to remove the mass on Aug 23 followed by cyberknife 3treatments in Oct The lung mass increased in size between surgery and beginning of chemo. He then had also has 6 treatments of carboplatin and taxotere, with xgeva. He has been on Avastin as a maintence for a few months and so far it seems to be working well (also still recieving xgeva ). His lastest scan of his brain done last month showed no reoccurrance, his last scan on chest area on 8-2-12, showed no change in irregular right lobe mass measing 3x3.6 cm. ( was 2.5 ) When first found, There has been a increase in diameter of the left paratracheal lymph node from 12.7 to 16.7 mm., there has been a increase in size of the right hilar lymph node from 11.70 mm. in diameter to 12.5 mm. There has been a increase in size of the subcarinal lymph node from 8.8 mm. to 14.1 mm in diameter. Scattered bilateral lung parenchymal nodules unchanged. The oncologist mentioned yesterday he might want to use cyberknife again but this time on his lung mass, if he can do it while still recieving Avastin, What do you know about this, Is it being used now, what are possible side effects or problems with this? Would appreciate any info you can give. I am praying he can have the cyberknife becauce it has worked well with the brain area. Thank you for any help you can give.

Forums

catdander
Posts:

Hi sunshine, I'm sorry your friend is going through such a difficult process.
I found this post (linked to below) by Dr. Pennell regarding avastin and radiation. I don't know how "cyber knife" would relate so I'm going to contact a doctor who I think will have some observations on the topic.

Unless Doyle is having symptoms from the growing tumors they don't sound like there is much change in each; just a few mm. I'd question if that was enough for a change in treatment. (I'm not a med. pro.)

http://cancergrace.org/lung/2009/11/17/avastin-radiation-and-tracheoeso…

You should hear back from one of our doctors within 12 hours.
Good luck to your friend,
Janine
forum moderator

Dr West
Posts: 4735

There is really no significant data on cyberknife for chest tumors with concurrent Avastin (bevacizumab). As Janine correctly noted, there is some reason to be cautious about possible complications with wound healing when radiation and an anti-angiogenic therapy are given concurrently. It's not well studied, and what little work has been done suggests potential danger.

At the same time, in the setting of known metastatic disease, the value of cyberknife for one chest lesion when there are actually several areas growing, though slowly, is very questionable. I must confess that I don't think there's a good rationale to do that at all.

-Dr. West