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Can radiation be used again after failure
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07/13/2013 22:19
lauriw 
07/13/2013 22:19
lauriw 
Can radiation be used again after failure

Hi everyone, I have been reading everything that I can to find out who has had something close to the conventional Prof S. protocol for RT and then had new disease in the radiated field and gotten more radiation. I had the standard 5 Days X 3g in two sessions for both hands in 2010. About 12 weeks ago I got a new nodule in the middle of my right hand, the worst of the two in the beginning, and there is already a very large cord. The nodule seems to have receded as the cord has grown. I have talked to my radiologist here is Des Moines about retreating with radiation. He is concerned it would be too toxic. I have read that some of you have had areas retreated in parts of your hand that have had the earlier protocol. If so, what treatment were you given and what were the results. I believe I have read that Prof S has retreated some of you, is there anything at all published about being given more radiation, a lower dose maybe? Lori, I read that you said your Dr. would retreat. What would he give you? My Dr. says if I can find him some documentation for how to do more radiation safely he would consider doing it again to this hand. Can anyone help me?
lauriw

07/14/2013 01:30
callie 
07/14/2013 01:30
callie 
Re: Can radiation be used again after failure

I asked that exact question to my doctor, "could the area be retreated next year if necessary"? The answer was "yes", the area could be retreated. My age was 66 at the time of irradiation. That might have a bearing on the answer, but it might not. I had the same dosage as you received.

07/14/2013 07:00
spanishbuddha 

Administrator

07/14/2013 07:00
spanishbuddha 

Administrator

Re: Can radiation be used again after failure

ProfS will only do an additional 15Gy in specific circumstances (usually aggressive cases).

07/14/2013 13:55
lori 
07/14/2013 13:55
lori 
Re: Can radiation be used again after failure

Hi Laurie,

Dr. C. said he would do a retreatment, but it would be at a reduced rate of 15gy.

Lori

07/14/2013 17:10
lauriw 
07/14/2013 17:10
lauriw 
Re: Can radiation be used again after failure

Lori, what does your Dr. Base that on? Do you knowcanyonecwho has been treated again? Lauri

07/15/2013 13:51
lori 
07/15/2013 13:51
lori 
Re: Can radiation be used again after failure

Lauri,

the last time I saw him (my 6 month check up) , I asked him if it came back in this exact same region could he retreat. He looked at my hand for several moments and said yes with a lower dosage. I did not ask him why, what methodology he was using or anything else. I did discuss the fact that the forum found it questionable. He understood this but felt that my hand could be retreated. It could be due to the fact that my hand showed so much positive response and that response was quick to show. It could be due to the fact that I had little side affects. Who knows....my guess was he made the decision based upon my hand and that this decision might be case specific. I am sorry I know this does not help you with your decision.

Lori

07/15/2013 15:19
Lanod 
07/15/2013 15:19
Lanod 
Re: Can radiation be used again after failure

lauriw:
.....About 12 weeks ago I got a new nodule in the middle of my right hand, the worst of the two in the beginning, and there is already a very large cord.......
lauriw

Lauriw, sorry to hear that you have recurrence in your irriated right palm.

In an earlier post you told us that you had no contrcature in your right hand at the time of RT. Can you advise as follows:

- for how long was your DD diagnosed prior to RT
- how did you know that the DD was active at the time of RT?

In Prof. S's 2012 paper he suggests that 7% of patients develop progression within the irradiated area at a follow-up time of an average of 8 years (approx). However, he suggests that only 3.5% of patients who were treated at the no contraction stage (i.e. Stage N) went on to a further stage, by the follow up time.

Lanod

07/15/2013 17:32
lauriw 
07/15/2013 17:32
lauriw 
Re: Can radiation be used again after failure

Lanod, thanks for the note! I had DD for over a year before I had my first set of radiation treatments. I had it in both hands and it was growing at a very fast rate. I had radiation on both hands just over two years ago, have had no contracture on either hand. Earlier this year I noticed a nodule on my right hand, the worst of the two, and it has now developed into a prominent cord below my middle finger. I tolerated RT very well, my Dr says that there is some athrophy ( don't know how to spell that word) under the skin on both palms, but other than that I am in good shape. He is worried about retreating with radiation because of damaging the tissue and skin. I am thinking just a week of 5gy would maybe work but he wants documentation or some kind of protocol that has worked without too much toxicity to the hand. I want to do everything that I can to avoid contracture. You said there was a paper in 2012 by Prof. S. where did you find that?? Are you suggesting that Prof S. does not think radiated hands will contract when new nodules and cords develop? Also, I knew my DD was active in 2010 because of the itchy crawly feeling and how fast new nodules and cords were developing.
I look forward to hearing back from you!!!
Lauriw

07/15/2013 20:41
LubaM. 
07/15/2013 20:41
LubaM. 
Re: Can radiation be used again after failure

I had RT Nov. '09 to treat my left hand that was a stage N (no contracture)... there were multiple nodules at the base of the fingers, lots of dimpling in the palm and the disease was active based on itching, burning/crawling sensation and an increase feeling of tightness. Three years after RT I developed a cord that pulled my small finger with a contracture at the PIP joint.

07/15/2013 21:27
lauriw 
07/15/2013 21:27
lauriw 
Re: Can radiation be used again after failure

Luba, did you ever talk to you Dr. about doing radiation again and if so what was his/her response? Have you had the contracture treated?
lauriw

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