SBRT Radiation of Lung - 1293588

teddy
Posts:9

What are the possible side effects of 15 SBRT treatments of a right paramediastinal lung mass? How long should the radiation effects last and what are some suggestions to ease the effects?

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catdander
Posts:

Hi Teddy,

Normally SBRT is just given over 1 to 5 sessions on tumors that are usually small but can be as large as 5 to 7 cm. Is it possible radiation was given by external beam?

Since SBRT is a higher concentration of radiation the healthy tissue in its path receives more radiation than would external beam so the possibility of side effects would be higher. What specific side effects depends on the path. Sometimes esophagitis becomes a problem and may begin a week or so after being radiated. Chest radiation can cause pneumonitis and can take up to several weeks to show up. In my husband's case he has permanently lost a lot of muscle tissue in the shoulder girdle from radiation to a pancoast tumor.

There are steps one can take to lessen effects of esophagitis such as eating soft blandish foods and taking prescription numbing agents for the throat (magic mouthwash) if it's difficult to swallow these symptoms should begin to heal a couple of weeks after the end of treatment.
Pneumonitis can become a dangerous side effect that needs quick treatment usually with steroids. So it's important to let the oncology team know of new or worsening symptoms. They should also be able to tell the patient or care giver of possible symptoms to watch out for and have you prepared to mitigate the symptoms.

Here is a post from one of our radiation oncology contributors, http://cancergrace.org/radiation/2012/01/18/sbrt-and-optimal-candidates/
There are newer posts and videos on sbrt but you should note that they are focused on trials that include smaller tumors up to about 3 cm.

I hope this helps.
Best of luck,
Janine

teddy
Posts: 9

The exact terminology used was SBRT/IMRT/VMAT of daily sessions for 15 consecutive days on a right lung paramediastinal mass measuring 3.5 x 6.1 cm.

catdander
Posts:

Both imrt and vmat are types of sbrt.
SBRT/IMRT/VMAT may mean that a hybrid of imrt and vmat was used. It's only been a few years since enough data was collected to be confident that sbrt was more effective than external beam on small tumor less than 3 cm without causing more harm. We're just now beginning to understand how imrt and vmat work on larger tumors. There does seem to be a lot of promise. A downside from the little I just read seems to be worry that sbrt on larger areas such as one large or several smaller sites could pose a greater risk of a secondary cancer than external beam, though only time will tell.

This is a small study of less than 100 people. In this study (and another in last link below) people with nsclc were given treatment over a 2 week period.
Under "Other Adverse Events" Most patients had at least one of these symptoms/adverse events. (It's important to note that a lot of these symptoms happened because these people have lung cancer and would probably have had the symptoms without radiation treatment.)
dysphagia, difficulty swallowing
dyspnea, difficulty breathing
pleural effusion
pulmonary fibrosis
wheezing
pneumonitis
fatigue
atelectasis, lung collapse
https://clinicaltrials.gov/ct2/show/results/NCT00750269?sect=Xa83fe0&te…

This is a link to clinicaltrials.gov that have results posted. There are 6. At least 2 of which include people with with stage II nsclc. A tumor 6 cm is at least a stage II.
https://clinicaltrials.gov/ct2/results?term=sbrt&type=&rslt=With&age_v=…

All best,
Janine