Guest Cary(I can't log in) Posted July 3, 2003 Share Posted July 3, 2003 Does anyone no of treatments for NSCLC brain metasis, My father just had a seizure and they found a brain metasis. I know about the gamma knife, but what about any chemos. Sorry for my spellings I'm real stressed. I am leaving tonight to pick him up from his vacation in North Dakota. Cary Quote Link to comment Share on other sites More sharing options...
natalie Posted July 3, 2003 Share Posted July 3, 2003 Hi Carey- I would ask the doctor about IMRT treatment. I read an article about it in the paper a month ago. It is a radiation treatment that can be done multiple times. As I understand it, once there is a whole brain radiation, you can't do radiation again, but with the IMRT, you can radiate over and over again if needed and it seems to protect the healthy brain cells. There is also stereostatic surgery. Also, I think some chemotherapy breaks the blood brain barrier so the brain gets some treatment when the lungs are getting treated. I had one doctor say it did and another that said it didn't...so I can't be too sure. I would also ask them about treating the whole brain. They may opt to treat just that one lesion, but there could small lesions that are there that are too small to show up on the scans, so I would inquire the doctor about treating the whole brain too vs. spot treat. Here's some info on IMRT I found on the web... Now, technology is taking another huge leap forward. This time it is in cancer treatment. Not since the arrival of the powerful linear accelerators in the 1970s has there been such significant advancement in radiation therapy for cancer. lNTENSITY MODULE RADIATION THERAPY (IMPT): IMRT is the most sophisticated form of computer-delivered radiation therapy currently available. This innovative, three-dimensional conformal radiation treatment delivers highly focused radiation with minimal impact to surrounding tissues. Historically, the maximal dose that could be delivered to a tumor site has been restricted by the tolerance of nearby tissues. The precision of IMPT technology allows for more finite definition of the target zone, enabling a higher dose of radiation at the turner site with decreased probability of normal tissue toxicity. The Western Pennsylvania Hospital Is the only facility to provide IMRT in this region and was one of only six clinical sites in the world selected to develop this cutting-edge technology. This newly FDA-cleared technology promises enhanced outcomes and substantial coat savings compared to related technology. The Western Pennsylvania Hospital's Division of Radiation Oncology of the Department of Radiology together with The Western Pennsylvania Hospital's Center for Neuro-Oncology have participated In numerous IMRT studies that have resulted in significant advancements in the treatment of brain tumors. THE IMRT SYSTEM: The IMRT system consists of a computer planning technology that enables clinicians to precisely match a palliative radiation dose to the shape of a tumor target with minimal damage to sensitive structures around it. A rnultileaf intensity modulating collimator enables radiation oncologists to deliver the radiation beam exactly to the tumor sire. In the Division of Radiation Oncology at West Penn Hospital, the Peacock System is used as the IMPT delivery system. HISTORY Of IMRT: The Peacock System is the invention of Mark P. Carol, M.D., an expert in stereotactic neurosurgery and intensity modulated radiation therapy. Dr. Carol holds eight patents in neurosurgery, radiation therapy and cardiology. Although he developed the initial idea for the Peacock System in 1975, computer technology could not meet the needs of the idea at that time. Dr. Carol revisited the idea again in 1991, and in 1992 began working on a prototype. The FDA provided final clearance for the hardware system in 1996. In April 1996 the FDA approved the planning software. HOW IMRT WORKS: Conforma1 treatments are delivered rotationally in contiguous transverse slices. During rotation, the field shape and intensity of the beam are continuously varied. IMPT has the ability to shape the radiation beam to the target and modulate the intensity of radiation across the target. The process for the actual planning lakes several days, yet treatment takes no longer than it does for conventional radiotherapy. For planning, a series of 40 to 80 imaging studies are done on a CT scan. These are input into the Emend planning computer. The computer goes through the anatomy, marking as many targets and sensitive structures as necessary. Traditional forms of conventional radiotherapy require that the operator assign the weight of the beam, identify the target zone and then input the information into a computer system for calculation of the radiation dosages. With IMRT clinicians determine and input the optimal dosage for the tumor site into their system. The software simulates the radiation physics and then establishes the optimal treatment plan, including provision of the treatment parameters. During simulation, the planning computer calculates a series of up to 5,000 separate plans, The system is capable of automatically creating and implementing an optimized treatment plan that can target cancerous tissue in almost any size or shape at almost any anatomical location. It can also concurrently plan for and treat multiple targets with the same dose or can give each target a different dose, if desired. Once the optimal plan is selected the data are transferred onto a floppy disk that is inserted into the IMRT controller on the accelerator and delivers the treatment plan. During treatment, as the IMRT moves around the patient it keeps measuring the angle and adjusts the small vanes that shape the beam. USES OF IMRT: IMRT is particularly valuable for intracranial lesions. Because there is no limit to the size of tumor that can treated, IMRT may be used to treat large malignant tumors. It can also be used to treat multiple tumors, such as metastatic lesions, with a single treatment plan. IMRT is especially valuable for treatment of benign tumors, such as meningiomas end acoustic neuromas when the tumor is adjacent to a functional cranial nerve. Because IMRT conforms a high dose to the tumor and a lower dose to sensitive structures, IMRT therapy may also benefit patients who have already received the maximal allowable dose with conventional radiation therapy. Types Of Tumors Eligible for Treatment: Since 1994, patients have received treatments at The Western Pennsylvania Hospital for tumors of the brain, head and neck. Future applications will include treatment to the lower spine as well. Improvements in clinical conditions have been achieved without side effects that would have been expected with conventional radiation. These potential side effects include a compromise of visual function, mucositis, spinal cord dysfunction, and xerosomia (Dry mouth resulting from damage to the saliva-producing parotid glands). Many of the patients who have been treated had recurrent cancers or inoperable tumors and had already received the maximal amount of radiation deliverable by conventional means The use of IMRT, as delivered by PEACOCK, allows patients to receive additional radiation safely, in some cases prolonging survival and improving the quality of life. Patient Selection Criteria: Any patient with a radiation-sensitive tumor occurring anywhere in the central and peripheral nervous system may be a candidate for IMRT: The patient's age, the type of tumor, and the patient's prior history of radiation, eligibility for surgery, and general medical condition must also be considered Based on these factors, the decision is made on a case-by-case basis as to whether or not IMRT would benefit a patient. 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Rick Posted July 4, 2003 Share Posted July 4, 2003 Cary, I am sorry to hear the news... ! I have sent you a new password to login with... Quote Link to comment Share on other sites More sharing options...
Tiny Posted July 4, 2003 Share Posted July 4, 2003 Cary- I'm SO very sorry! Your dad will be in my daily prayers, and you and the rest of the family too. Quote Link to comment Share on other sites More sharing options...
Debaroo Posted July 4, 2003 Share Posted July 4, 2003 Cary, you might also want to look into Gamma knife...it sounds similar to the IMRT treatment, but is done in one session-a 3D MRI is used and three doctors plot out the dosages, including a nulcear physisist. My dad had it in January and it was successful. I posted a message in response to Alyssa in the orig. orig. General forum that is more detailed. Feel free to e-mail or private message me if you would like more information. The Gamma knife can be done as often as needed, my dad had 3 lesions treated with it...the tumors are killed in one session of a high frequency radiation that is targeted only at the tumors, the surrounding tissue is left untouched and the tumors are killed 100% with one treatment (98% of the time)...the tumors are then reabsorbed by the body at the same rate at which they grew. Please keep us posted as to how your father does. Take care and you are in my thoughts and prayers. Deb Quote Link to comment Share on other sites More sharing options...
lenr8 Posted July 4, 2003 Share Posted July 4, 2003 Iam havong gamma knife on kuly 10 the for a single braon met. The Dr's at IU explained to that the gamma knife is equally as effective as surgery with less risk and effects of surgery. I did see 2 neurosurgeons that day, all agreed on the gamma knife. Nothing about this is easy but seems to be easeier that surgery. Whole brain radiation will be the worst part to me. They said that there is a high re-occurrenceo f mets but to the brain agian but can also be re treated with gamma knife which is a one day event and will be causht earlier because theythen scan sooner. And they did tell me after whole brain it breaks the blood-brain barrier Quote Link to comment Share on other sites More sharing options...
Fay A. Posted July 4, 2003 Share Posted July 4, 2003 I don't think it is considered "standard of care" for brain mets, but INTRATHECAL CHEMOTHERAPY has been used for brain mets from other forms of cancer (breast cancer, lymphoma, and a few others). It's also used to treat people who have carcinomatous meningitis. I had a computer crash a few weeks ago and lost all of the data I had saved on the subject, so I cannot provide you with any links to information. You can do a search on excite and/or google. A pub med search would also give you more info. I am sorry that this has happened. You have my prayers for things to go well, no matter what treatment is used. Fay A. Quote Link to comment Share on other sites More sharing options...
Guest Cary(cant login) Posted July 5, 2003 Share Posted July 5, 2003 Well, I have some semi good news. My father is able to walk and talk again. he only has two mets in the brain (small 1 cm) and the whole problem was the extreme brain inflammation that was being caused by unknown sources. We finally got him home this morning and had him checked out and they said he is very lucky we caught them at such an early stage and should be easily treated. So the inflammation was in fact a blessing. Thank You all. Cary Quote Link to comment Share on other sites More sharing options...
Don Wood Posted July 5, 2003 Share Posted July 5, 2003 Carey, that is great news! Don Quote Link to comment Share on other sites More sharing options...
kimblanchard Posted July 5, 2003 Share Posted July 5, 2003 Cary This is very good news. My husband had stereotactic radiosurgery (X knife similar to gamma) and his tumor has almost disappeared with no side effects! Blessings to you, Peg Quote Link to comment Share on other sites More sharing options...
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