Yes, BOT can be persistent, and not always easily treatable. I have persistant cancer,,for unknown reasons, which can be many, including being chemo and radio resistant from hypoxia, other reasons too. MSKCC was doing PET scanning with hypoxia testing, I believe one member here had it in a clinical trial prior to treatment, which may have increased or lessened treatments based on findings. I don't know what it would do in our situation, but there are medications that may or may not help decrease hypoxia resistance, but from what I read, nothing worthwhile yet, without side effects. I had High Dose IORT, High Dose Intraoperative radiation treatment, during a neck dissection, and proton treatment with carboplatin next, about two months later, as part of the treatment package. Last year it was with IMRT, so I understand saving Protons as a future option, if needed. MSKCC does IORT also, being my doctor started it there in the 90's, and can be used in basically any location, usually with prior radiation. This is what they do1. doing a surgical dissection, 2. IORT 3. a flap during the same surgical procedure, and 4.more external beam radiation after that in 4-6 weeks depending on healing, but not always do it based on pathology, prior treatments.


Take care.