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Brain Mets Again


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My sister had a brain tumor removed last January with whole brain radiation after - she had 10 treatments, one a day for 5 days, weekend off and then 5 more.

She just had an MRI and it shows there are two mets - one new one and one that was there before, but is growing again. The doctor referred her to another doctor who specializes in spot radiation.

I always thought that once you had whole brain radiation that it wouldn't go back to your head. Does anyone have any similar experience or any input.


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Guest Piermarie

When they treated my mother's brain lesions, they told us that whole brain radiation alone for the 4 areas would reduce the chance of recurrence by 50-60%. Then, if we added the stereotactic radiosurgery (aka gamma knife), it would change that percentage down to less than 10%. So, we obviously took the latter route as opposed to doing only WBR by itself. She had that done in August and her last scans have shown only one to be still there but it is "dead" and shrinking per the radiologist. Not sure what qualifies you for the stereotactic or if anyone with mets can have it done post-WBR. She had no symptoms initially with the mets to the brain, the scan was done as a routine check for mets and they found it. Hopefully, her next scan (due in March) will let her join the empty head club!!!!

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I think this drug has been approved recently

for brain met - Xcytrin. Also temozolamide has been used (not sure if it is approved)

I believe WBR has to be limited because the affects of radiation are cumlative. Like the previous post said maybe SRS (stereotactic radiation)

can work

http://www.docguide.com/news/content.ns ... 22004973DC


Recurrent Brain Metastasis

Phase II dose study of Thalidomide in recurrent brain metastasis

Eligibility: Recurrent brain metastases following completion of radiation therapy. Not a candidate for gross total tumor resection or for radiosurgery. No concurrent chemotherapy (except hormonal therapy for breast cancer).

Protocol: Thalidomide is administered daily until tumor recurrence or chemotherapy is started


stereotactic radiation

http://www.mayfieldclinic.com/publicati ... I96009.pdf

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I see I wasn't signed in with my first post. oops

Thank you for your replies. My sister has an appointment with the nuerosurgeon who took out her first tumor to see if the 2 new ones are removable.

She has also been referred to another doc who specializes in spot radiation. Would spot radiation be "gamma knife"? I will be sure to ask when we go see him.

Has anyone ever had to make this choice? What would you choose? From what I have read, gamma knife would appear to be the best option, but I guess I'd like to hear from you what your opinion is.

Thanks again,


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More info from hopkins. I can't tell you what the best option is but there are options. People on the board have had good success with gamma knife from what I have read on here.

From the article below ....


For multiple metastases, whole brain radiotherapy followed by stereotactic radiosurgical "boost" has shown higher rates of "intracranial control" when compared to whole brain radiotherapy alone. "

http://www.hopkinsmedicine.org/radiosur ... inmets.cfm

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Hi Kelly,

Sorry to hear of your sisters brain mets. :( I am presently going through it now! I was dx'ed on 12/18 with two small brain mets after being cancer free for 2 and 1/2 years and am presently finishing my 17th of 20 WBR treatments. :roll:

I went through the same questions as you and got 3 opinions. I am doing Whole Brain Radiation as a preventative and hopefully curative measure. Meaning if any more mets are developing we should kill them before they do and also to kill the 2 that I have. This seems to be the present "standard protocol" as a starting point. As others have said sterotactic Radiosurgery, or Gamma Knife is the next line of treatment and from what I got it's also becoming pretty standard. I will be re-scanned in Mid- March and a determination will be made at that time if it's required. If so, I will also go through Gamma Knife ( spot radiation), which from what I am told has a > 80% cure rate. After, that there also additional options of Chemo drugs that are penetrating the brain barrier, however this is a ways away right now.

John, has some good sites there for you to look at, Also, feel free to send me a PM if you have specific questions.

Good luck to you and your sister, and you'll be in my thoughts and prayers.

God bless and be well

Bobmc- NSCLC- stageIIB- left pneumonectomy- 5/2/01

MRI's taken 12/18/03 - 2 brain mets found- named em Frick & Frack

PET taken 1/5 - hot spot in mediastinum May be cancer??

"Absolutely insist on enjoying life today!"

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