Can radiation be repeated for lung cancer in same site after exactly 5 years

[Venu]

  My Dad has a left lung cancer in lower lobe. First diagnosed in 2016 and treated with a couple of chemotherapies and radiation therapy done in March/April 2017( (55Gy in 22 fractions, Equivalent to 60 Gy). And Since February 2019(the last 3 years) my dad has been using Nitendinab tablets(Europe medicine) and his health has been stable for the last 3 years. Recently CT and PET  scan reports showed an increase in tumor size in the same site and the tumor size is 47X43X40 mm (6 months before it was 31x28x35 mm).   So he did a liquid Biopsy lung panel test and got KRAS G12A  positive. Looks like no targeted therapy available for this mutation. Doctors in one hospital suggested chemotherapy and doctors in another hospital suggested Radiation therapy(IMRT). Not sure which one to choose. Can you please let me know if there is any targeted therapy available?  Or which one to go with chemotherapy or Radiation? Also Can the radiation be repeated for lung cancer in the same site? Please advise.   

[Justin1970]

Hi venu

Sorry to hear your news about your dad I was diagnosed last August with lung cancer and had radical chemoradiotherapy done which started at the end of October it was given with curative intent and the tumor in my lung and lymph nodes did shrink, I also have kras and was told there is something I can take at a later date if its needed but I will have to try and find out what it was they offered, someone will come on the site to offer better advice soon, I'm sure they will do the best for your dad so please stay strong and positive 

All the best Justin 

[LouT]

Venu,

Sorry to hear about your dad's progression.  I believe the best person to speak to about repeating radiation would be a Radiation Oncologist.  They specialize in this treatment and can take your father's particular case into consideration when making a decision about whether or not a repeat treatment would be effective.  Remember what may not be right for another patient could be appropriate for a repeat treatment in your father's case.  You'll likely be hearing from others soon as well, some may even have experience with same-location repeat treatment.  In the meantime Lungevity has a section on radiation therapy and it can be found here.

Please let us know what you decide.

[Tom Galli]

Venu,

Welcome here.

To your questions: is there a targeted therapy to treat KRAS G12A and can IMRT radiation be used after fractional general radiation? Our knowledge base--Lung Cancer 101-- cites only one KRAS mutation that responds to targeted therapy, KRAS G12C. Here is that information source. On radiation, IMRT is a precision form of radiation that may be a possible treatment method after fractional general radiation. But as Lou suggests, a radiation oncologist would need to make that determination. 

Stay the course.

Tom