Proton Therapy: After primary thoracic radiation

[MyWifeSCLC]

Found some information on using proton therapy to primary lung cancer site after 1st-line thoracic radiation. Has anybody heard of this?

I thought that any radiation to an area already irradiated (ie. 30 days thoracic radiation) should not receive additional radiation. My wife's onc referred her to a proton therapy location to discuss PCI. I asked a whole bunch of questions about the primary cancer.  There's something called pencil beam that supposedly only hits the cancer and next to nothing anywhere else.

Is this anything like SBRT? 

We are meeting (consult?) with a proton therapy radiologist next Tue to discuss a number of things. Should have more info then but was hoping others on here might have already heard some things.

Steve

[Tom Galli]

Steve,

Yes I've heard of it and yes I know of a survivor who had proton radiation about a year after 30 days of conventional thoracic fractional radiation.  His situation involved a recurrence within the area affected by original radiation but on the edge of the radiated area. So the radiation oncologist and physicist agreed the treatment could safety be administered. SBRT was a consideration but his doctors settled on proton therapy because they could precisely control the area to be radiated.

The biggest problem was convincing his insurance to pay for proton therapy. There was a multitude of messages and phone calls before insurance decided to approve the therapy. It worked. But unfortunately a year later, another recurrence at the base of his throat was resistant to chemo and unable to be radiated. He had Squamous cell, NSCLC, not quite as nasty as small cell but almost. 

Stay the course.

Tom

[MyWifeSCLC]

Met with Proton Therapy radiologist yesterday. It was the best consult we've had since my wife's pulmonologist gave us his considerable expertise on the subject of SCLC. Too bad my wife's current oncologist and radiologist didnt communicate in the same manner as the pulmonologist and now the Proton Therapy radiologist.

The PT radiologist indicated that they could perform all the same radiation techniques that were available with "photon" treatments. However, insurance companies rarely pay for any 1st-line treatment using PT and especially my insurance co. BCBS of TX. From what I researched and heard from the PT radiologist, I'm a huge believer in Proton Therapy. I told him that we had another consult with another radiologist (not Proton Therapy). He knew the radiologist and said he was excellent and we couldn't go wrong with him. He tactfully steered us to the other guy due to the very high cost of PCI or HA-PCI which is what we were seeing him for.

By the way, he does do hippocampus avoidance, as well as, the other radiologist my wife is seeing tomorrow. Finally confirmation that HA-PCI is done outside of clinical trials. Also, by the way, the radiologist we are seeing tomorrow is in charge of the local facility participating in the national clinical trial on HA-PCI.

The Proton Therapy radiologist told us to come and see him if my wife's primary cancer progressed. Proton Therapy would reduce radiation to surrounding tissue that had already received 30 days of accumulated "standard" radiation.

Steve

[Tom Galli]

Steve,

Great to read you've finally had a satisfying and informative physicians consultation. 

Stay the course.

Tom