Benefits of chemo along with radiation?

[Guest hearrean]

I know this will probably be a basic question, but in general, what is the benefit of having chemo along with radiation?

In my case, my (4) weekly treatments of chemo reduced my primary + (2) nodes by 50%. What happens when radiation is added vs. just having more chemo? Does it kill the tumor differently than chemo?

I ask this question because when I told the local Oncologist (not the MD Anderson one, but the local one who oversaw my previous chemo) that the MD Onc had said we now need to add radiation, he was surprised. He said he was surprised they suggested adding radiation vs. just continuing more chemo since I had such success in just 4 weeks of chemo.

Ken

[cat127]

One way to look at it is that chemo is a 'whole body' or systemic treatment and radiation is a targeted one, with the beams being aimed more directly at the tumor and identified lymph nodes. especially those nodes, as it is really important to sterilize them. I know with Kelly, the surgeon would not even consider surgery for her unless the chemo/radiation sterilized the nodes. I imagine that same thought holds true with 3a as well.

Now you will probably have seen the most drastic shrinking of the tumor in that first scan. Kelly's rad onc described it like this to us - it's sort of like a 500 lb man, those first 200 lbs come off easy, the last ones aren't so fast to come off.

Kelly saw +60% shrinkage in the primary tumor after 2 cycles, at the end of it all the size was smaller, but not another 60%. But they were hoping that the radiation and chemo together would have completely killed the primary tumor, leaving behind only scar tissue. We weren't that fortunate but you very well may be. In that case, the size on CT may only be a bit smaller, but then on PET it shows that the cells that are there aren't active.

Not sure if that helps you any or if it helps to say that there is definitely advantage to both treatment modalities. Why not attack with a tank and a machine gun!?

[john]

radiation as cat127 mentioned is for local control. Many recurrences occur locally so the radiation it to reduce the chance of a local occurence.

Chemo is systemic and will hopefully kill or stop any distant metastasis, but may not provide adequate local control.

I don't think chemo alone is sufficient from what I have read, but I am not a Dr

Are there any plans for surgery after the chemo? If this is the case make sure the surgeon is good because there can be complications caused by the chemo.

http://theoncologist.alphamedpress.org/ ... l/10/5/335

[blaze100]

Hi Ken, Chemo is like antibiotics - it becomes less effective with over use.

Your docs just want to give it the one-two punch and go for the knock out. I think it is good thing.

Barb

[cat127]

Below are Dr. West's words in a post to someone on his sight. It is, in his words, "well established" that the combination will increase the chance at a cure, so why your oncologist would even question the concurrent treatment is beyond me.

I'd just add to my comments that I agree with the oncologist that if someone is fit enough to pursue it, doing chemo concurrently with radiation will likely improve the cure rate compared with radiation alone. This is well established for stage III NSCLC, and I'd strongly suspect that earlier stage NSCLC will show the same trends but will have a higher cure rate than stage III disease.

[Tom K]

I can’t explain the science, but my doctors told me concurrent chemo-radiation my best chance for achieving a cure. 2 years later, I am still here to testify to their success.

[wendyr]

Ken, the protocol you're suggesting was used on my hubby. He had 33gy of radiation over 6 weeks along with reduced, induction chemo of carboplatin & paclitaxol. It was manageable and he got good results. They were also MD Anderson docs.

wendyr