Treatment Decisions - 1252880

cards7up
Posts:636

As you know I first had SBRT then after a short time did chemo. Since I had no chest or lymph node involvement, would it have been feasible for me to have done both together? Had two tumors, one in each the upper and lower right lobes. I see most times that chemo/rads are done together only when there is chest and/or lymph node involvement. What if you were on chemo and you started progressing, would you stop chemo to start radiation on one problem area or continue with chemo and rads? Sorry if this sounds confusing. I'm confused tonight or just tired. Take care, Judy

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Reply # - January 21, 2013, 10:21 PM

Dr West
Posts: 4735

There is no real standard protocol in this situation. Because it's usually treatment in non-curative setting when someone is progressing, you usually want to minimize side effects as a real priority along with focusing on efficacy. Concurrent chemo/radiation is typically done for a curative setting of stage III NSCLC, but in the case of progression or starting as stage IV, it's probably more common to do sequential therapy because you don't have the potential benefit of an improved cure rate to justify the anticipated greater side effect challenges of concurrent chemo and radiation. Also, SBRT is just a few high radiation treatments, and there isn't any meaningful experience to ensure safety if chemo is given concurrently. Chemo/radiation administered concurrently is really only well studied when the radiation is spread out as daily treatments over several weeks.

I hope that answers your question.

-Dr. West

Reply # - January 22, 2013, 06:10 AM

cards7up
Posts: 636

If it's stage III with lymph node involvement, would you radiate the lung and the nodes along with chemo?
Take care, Judy

Reply # - January 22, 2013, 06:26 AM

Dr West
Posts: 4735

That would be the most common approach for initial treatment of stage III NSCLC with nodal involvement, provided a patient is felt to be likely to tolerate that safely.

-Dr. West

Reply # - January 22, 2013, 12:28 PM

cards7up
Posts: 636

But would you also radiate the lung tumor at the same time your radiating the nodes?
Take care, Judy

Reply # - January 22, 2013, 07:15 PM

cards7up
Posts: 636

Thanks Dr. West. I didn't realize that you can radiate the nodes and lung tumor and do chemo all at the same time. Learn something new every day. Take care, Judy

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