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Another one of my dumb Questions--PCI


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Ok, so they do PCI for small cell, but why not for NSCLC? Also if they do this radiation for a place where mets are more likely to occur, why not do it on the liver and/or adrenals which seem to me to be places that mets are also more likely to occur? I can see why not for bone, since that would be like full body radiation, lol!

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I just wrote about this elsewhere, and I don't pretend to know a lot about this, but I'm happy to share with you what I've been told so far.

As to the "why not?" on NSCLC, I really don't know, other than that I'm told the benefits/results are quite small with that type, whereas with limited SCLC, the benefits are significantly larger. In fact, when I talked to my Radiation Oncologist this morning, he told me that of his limited stage SCLC patients, those with the longest and best survival have had this treatment. He also told me that if I were his sister, he'd be hopping up and down on me, insisting I have it.

From what the Radiation Oncology folks have told me, they learned from treating children with leukemia that cancer cells sometimes "hide out" in the brain -- they call it a Sanctuary Site -- and come back to wreak havoc later on. So, they developed some protocols for prophylactic (preventive) treatment, and after some time passed and studies were done, the improvement in survival with this treatment were significant. Chemo doesn't go through the brain like it does the rest of the body, and he says that recurrence happens most often in the brain, so it makes sense to do this, I think.

I'm told it's a lower dose radiation and you have fewer treatments, but those here who have had it will have to tell you about that. I'm sure it may vary as well, depending on the individual, as will the side effects.

Again, please don't take this as definitive information, it's just a compilation of what I've been told about this so far.


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I am not sure, but funny you mentioned it, b/c I asked the oncologist on Wed about it. I said i read on my websit about whole brain radiation, he said that is for SCLC.

I am not sure wny not for NSCLC, but maybe b/c they don't do surgery on small cell? Hmmm.

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Jane, I'll try to get this right:

PCI stands for Prophalactic (sp?) Cranial Irradiation.

Now, I'm pretty sure SCLC is rarely operated on because it is so fast growing, it would be like chasing ping pong balls around your body, but since it responds to well, generally, to chemo and radiation, they are much more effective at ridding the body of SCLC than surgery.

Why PCI for SCLC and not NSCLC? Hmm, I think that's been addressed on this website before. But part of the reason may be the behavior of SCLC - it generally will mets to the brain fairly predictable and because it does respond so well to radiation? Not sure, maybe someone can find the thread again.

Karen C.

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Apparently there is a trial going on now to see if PCI is beneficial to NSCLC patients as far as extending life.

I still wonder why it isn't possible to do preventative radiaiton on adrenals and liver. I think they think that chemo is supposed to work for that, but wouldn't radiation be less toxic?


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