#72983 04-13-2008 08:22 PM | Joined: Feb 2008 Posts: 341 Platinum Member (300+ posts) | OP Platinum Member (300+ posts) Joined: Feb 2008 Posts: 341 | Ok - I typically pride myself on being rather intelligent and self-sufficient, but search on this forum makes my head spin around like in the Exorcist  . I have tried going through advanced and using quotes and +, etc. but it never fails I get 8 - 15 pages each time and they aren't about what I am looking for. Most recent example - I am looking for others who have had the radiation boost at the end. So tonight I tried searching for IMRT boost or radiation boost, then I tried it with quotes, then with the +. I don't get anywhere on a couple of the ways and the other ways I need another hour+ to read them all. I think this may be why so many people re-ask the question(s) rather than utilize the search. Anyway - maybe a brief education post in the FAQ section on searching would be helpful. Or it could just be that I have Dan's chemo brain 
Michelle, CG to husband (45), DX 2/08 Stage IVa Adenocarcinoma Salivary Gland (T2N2bMO) Parotidectomy & ND 2/08, Tumor margins not clear, 4 of 30 nodes positve for cancer, TX IMRT 39x, cisplatin 7x (completed 5/1/08), PEG (4/22 - 7/9), No port. Currently in remission!
| | | | Joined: Jun 2007 Posts: 10,507 Likes: 7 Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) | Administrator, Director of Patient Support Services Patient Advocate (old timer, 2000 posts) Joined: Jun 2007 Posts: 10,507 Likes: 7 | Michelle:
Starting with about the last 10 radiation treatments the time was increased. When we got to the last 5 it was 45 minutes on the table. Starting out it was 20 minutes. All that for probably only a couple minutes of being zapped. Maybe it was a gradual build up but I didnt notice it til the last 2 weeks. Or maybe its cuz I was feeling the worst then and it was such a struggle to go for tx.
ChristineSCC 6/15/07 L chk & by L molar both Stag I, age44 2x cispltn-35 IMRT end 9/27/07 -65 lbs in 2 mo, no caregvr Clear PET 1/08 4/4/08 recur L chk Stag I surg 4/16/08 clr marg 215 HBO dives 3/09 teeth out, trismus 7/2/09 recur, Stg IV 8/24/09 trach, ND, mandiblctmy 3wks medicly inducd coma 2 mo xtended hospital stay, ICU & burn unit PICC line IV antibx 8 mo 10/4/10, 2/14/11 reconst surg OC 3x in 3 years very happy to be alive | | | | Joined: Nov 2002 Posts: 3,552 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Nov 2002 Posts: 3,552 | It's a tough subject to find and has never been properly defined. Here are some links" http://www.ro-journal.com/content/1/1/40http://linkinghub.elsevier.com/retrieve/pii/S0196070900202433"Acceleration of Radiation Dose: Another strategy in the treatment of head and neck cancers is to administer radiation therapy at more frequent and intensive doses. Patients with cancer of the head and neck may benefit from higher doses of radiation therapy that are administered twice daily compared to standard therapy consisting of lower doses administered once a day. However the current standard therapy is to administer radiation only once a day. One of the largest clinical trials of the past 2 decades involving the treatment of head and neck cancer showed that the risk of a local cancer recurrence may be reduced in patients with locally advanced head and neck cancer by using increased frequency and doses of radiation therapy. In this study, over 1,000 patients with locally advanced head and neck cancer received radiation therapy either once daily or twice daily. Higher doses of radiation were delivered to the group of patients receiving treatment twice daily, whereas standard doses of radiation were delivered to the group of patients receiving treatment once daily. Two years following treatment, 56% of patients receiving radiation treatment twice daily were free of cancer recurrence, compared with 46% of patients who received radiation once daily. (please note some in many cases the radiation dose frequency is simply done by adding a few more days and /or increasing the daily fractionalized dose rate higher then 1.8 Gy - my comments) Research indicates that accelerated boost radiation therapy can also be effective in elderly patients with cancer of the head and neck who are healthy enough to tolerate this more aggressive treatment. In one study, accelerated boost radiation therapy was administered to 45 patients, age 70 or older, with cancer of the mouth, throat, or larynx. The results were compared to a similar group of patients who were younger than 70 years of age. Among the older patients, 68% lived 3 years or longer after treatment, compared to 62% for the younger patients. The local cancer was controlled in 73% of the older patients and 68% of the younger patients." Full link: http://patient.cancerconsultants.com/CancerTreatment_Head_and_Neck_Cancer.aspx?LinkId=53927Another link: http://www.medscape.com/viewarticle/518831The last link has some interesting onformation on Amofostine as well. Please note that some of these links are a few years old. There is no substitute for going to a Comprehensive Cancer Center. This whole subject will make your head spin!
Gary Allsebrook *********************************** Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2 Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy) ________________________________________________________ "You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
| | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | Senior Patient Advocate Patient Advocate (old timer, 2000 posts) Joined: Sep 2006 Posts: 8,311 | Michelle,
Not sure I know what you mean by boost? Most of us that got the rad, got close to or the max amount of rad which I was told is about 70 Gy. Now as Gary points out some CCC's are trying different ways to reach that max by doing twice dailys the whole time or the last few weeks or only on Fridays or even cutting the delivery weeks in half. At Moffitt, almost 2 years ago (yeah), I just got a pretty much even dose each day but the last few weeks they spent all of the rad time on the 2 most potential areas. When I taught the class with Dr Trotti (my RO)a few months ago at Moffitt I know he spent a while telling the med students that they were beginning to use different accelerated radiation methods on H & N patients.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | Joined: Feb 2008 Posts: 341 Platinum Member (300+ posts) | OP Platinum Member (300+ posts) Joined: Feb 2008 Posts: 341 | Thanks for all that effort Gary - I'm going to have to take a minute and absorb all that in.
David - my use of the word "boost" means that the last 10 treatments Dan will receive are to be targeted directly at the tumor area and not in the broad area he has been having. Does that make sense?
I'm just worried if he is getting 1.8 per day and it's being spread around a large field - if he gets that in a small field does that mean much more intensity to that area?
My curiousness is related to a)does this different way help with success and b)does this mean his burns are going to get that much worse in that area?
Oh - our MO said Amifostine wouldn't be used in our case because it is primarily used to protect salivary glands and we're trying to "kill" the salivary gland because that's where Dan's cancer is. He said there are no studies that show how it works with salivary gland patients so he didn't want to try it.
Michelle, CG to husband (45), DX 2/08 Stage IVa Adenocarcinoma Salivary Gland (T2N2bMO) Parotidectomy & ND 2/08, Tumor margins not clear, 4 of 30 nodes positve for cancer, TX IMRT 39x, cisplatin 7x (completed 5/1/08), PEG (4/22 - 7/9), No port. Currently in remission!
| | | | Joined: Nov 2002 Posts: 3,552 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: Nov 2002 Posts: 3,552 | IMRT is never spread around a large area - it is always specifically targeted. at midpoint they will often take a CT and make adjustments to the treatment plan programming. They will also target known areas of interest, nodes, other tonsil (AKA bilateral radiation - if applicable of course), etc. In Dan's case they will hit the area without the clear margins for sure. We don't see much adenocarcinoma around here, mostly SCC and a very few melanoma cases so your RO is still the best person to ask.
It's all a little mysterious honestly. My tumor had completely vanished at the 3 week point and they radiated me for the full time anyway.
Gary Allsebrook *********************************** Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2 Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy) ________________________________________________________ "You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
| | | | Joined: Feb 2008 Posts: 341 Platinum Member (300+ posts) | OP Platinum Member (300+ posts) Joined: Feb 2008 Posts: 341 | I guess what I mean by a large field is his whole neck and right side. Whereas if I understand the last treatments will be even more focused.
It is mysterious!!! I've got it on my list to ask the RO tomorrow.
Michelle, CG to husband (45), DX 2/08 Stage IVa Adenocarcinoma Salivary Gland (T2N2bMO) Parotidectomy & ND 2/08, Tumor margins not clear, 4 of 30 nodes positve for cancer, TX IMRT 39x, cisplatin 7x (completed 5/1/08), PEG (4/22 - 7/9), No port. Currently in remission!
| | | | Joined: Feb 2007 Posts: 1,940 "OCF across the pond" Patient Advocate (1000+ posts) | "OCF across the pond" Patient Advocate (1000+ posts) Joined: Feb 2007 Posts: 1,940 | Robin had conventional (radiotherapy) not IMRT and for the first 5 weeks he had both sides of his neck/mouth targeted,and th floor of his mouth/throat.At the end of week five he was recalibrated,had anothe simulator session and a new mask as he had lost so much weight,and then started a round of punishing booster sessions which were accompanied by some sort of electrodes attached as well.Theses sessions lasted for much longer (15 mins instead of 6 mins),and they absolutely floored him,which wasn't that hard as the first 20 sesions pretty well burned him to a crisp and fried the inside of his mouth as well.
My understanding was that they pinpointed the actual tumour sites and concentrated the treatment for a short while,rather than just zapping the whole area.
it was tough but like everything else sweetie you will get through it
love liz
Liz in the UK
Husband Robin aged 44 years Dx 8th Dec 2006 poorly differentiated SCC tongue with met to neck T1N2cM0 Surgery and Radiation.Finished TX April 2007 Recurrence June/07 died July 29th/07.
Never take your eye off the ball, it may just smack you in the mouth.
| | | | Joined: Feb 2008 Posts: 341 Platinum Member (300+ posts) | OP Platinum Member (300+ posts) Joined: Feb 2008 Posts: 341 | Thanks Liz!! I know you've been keepin a low-profile lately and you have been in my daily thoughts. Thank you for taking a few minutes to send me some info and encouragement.
Michelle, CG to husband (45), DX 2/08 Stage IVa Adenocarcinoma Salivary Gland (T2N2bMO) Parotidectomy & ND 2/08, Tumor margins not clear, 4 of 30 nodes positve for cancer, TX IMRT 39x, cisplatin 7x (completed 5/1/08), PEG (4/22 - 7/9), No port. Currently in remission!
| | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | Senior Patient Advocate Patient Advocate (old timer, 2000 posts) Joined: Sep 2006 Posts: 8,311 | Michelle,
As I said or at least attempted to, my rad Tx plan called for targeting 5 areas at first and by the last 2 weeks the beam was only directed at 2 spots, those being the BOT where my primary was fond and the left side of my neck where I had at least 2 positive nodes. By your definition I guess that's a boost.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
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