| | Joined: Jan 2013 Posts: 1,294 Likes: 1 Patient Advocate (1000+ posts) | OP  Patient Advocate (1000+ posts)
Joined: Jan 2013 Posts: 1,294 Likes: 1 | Just came across this document from ncbi about "boost". There is a method that does alter the dosing from fraction to fraction and targets areas in varying amounts. I'm no expert here but it seems logical that the changing dose over the standard 35, 7 week timeframe can indeed be a factor in why radiated areas seem to be more/less impacted over treatment. http://www.ncbi.nlm.nih.gov/pubmed/14644486http://www.ncbi.nlm.nih.gov/pubmed/23824134
Last edited by donfoo; 12-24-2013 02:03 PM.
Don
Male, 1955
Great health except C
Dec '12
DX: BOT SCC T2N2bMx, Stage 4a, HPV+, multiple nodes
1 tooth out
Jan '13
2nd tooth out
Tumor Board -induction TPF (3 cycles), seq CRT
4-6/2013
CRT 70gr 2x35, weekly carbo150
ended 5/29,6/4
| | | | | Joined: Jul 2012 Posts: 3,267 Likes: 4 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Jul 2012 Posts: 3,267 Likes: 4 | There are quite few different radiation delivery techniques besides the standard fractionization. Even with standard fractions, I don't think it's the same delivery over the course of the 7 weeks of treatment. One reason is radiation declines in tumor kill rate after 25 treatments or 5 weeks, due to tumor regeneration, oxygenation, and more is needed to kill the tumor, and that why you see treatments for 6 and 5 7 weeks that are shorter in durstion, and more effective in some studies, and hardly any for 8 weeks, which more is not better. How this is done in fractions, volume, percentage, other, I don't know. Only the wizard does  Altered fractionization Concomitant boost Split course Hyperfractionization Hypofractionation Others
10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs
| | | | | Joined: Jul 2012 Posts: 3,267 Likes: 4 Patient Advocate (old timer, 2000 posts) | | Patient Advocate (old timer, 2000 posts)
Joined: Jul 2012 Posts: 3,267 Likes: 4 | Interesting video how the linear accelerator works: http://m.youtube.com/watch?v=jSgnWfbEx1A
10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs
| | | | | Joined: Jan 2013 Posts: 1,294 Likes: 1 Patient Advocate (1000+ posts) | | OP Patient Advocate (1000+ posts)
Joined: Jan 2013 Posts: 1,294 Likes: 1 | Thanks for the video link. Look about 6 minutes into your video and about 2 minutes into the this one http://www.youtube.com/watch?v=eZS6DVGBx0kThis describes what fascinated me about the whole thing. I would see those leaves dynamically reshape constantly and it was the beam being shaped to hit the target in the manner specified in the planning system. The link I provided is from 10 years ago so there has been refinement for sure but the underlying principles still apply. One thing is the newer units are continuous sweeping and do not stop at all around or click so I suspect the dose is now able to be given all the time as it sweeps around. The processors are much faster now so they can keep up with all the real time calcs that previously was a go-stop-reposition-go-stop affair. Of course that is all a big guess on my part. lol
Don
Male, 1955
Great health except C
Dec '12
DX: BOT SCC T2N2bMx, Stage 4a, HPV+, multiple nodes
1 tooth out
Jan '13
2nd tooth out
Tumor Board -induction TPF (3 cycles), seq CRT
4-6/2013
CRT 70gr 2x35, weekly carbo150
ended 5/29,6/4
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