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RT at OU for another time
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02/12/2011 01:46
David26

not registered

02/12/2011 01:46
David26

not registered

Re: German/American protocols

Larry, thanks for posting the German protocols. Below is what I copied from this board about 7 months ago.


from wach

The limit for any specific area is 30 Gy. You can have your hand radiated 5 times if the radiated areas don't overlap but you shouldn't radiate the same are with more than 30 Gy.

another poster

The protocol Dr. T is using for me is 2 gys per day for 10 days, for a total of 20 gys. As someone mentioned above, Dr. T said that if needed he could re-treat an area with another 20 gys. I told him that I had heard you shouldn't use more than a total of 30 gys on an area. His response (at least as I understood it) was that because the daily dose he gives is lower (2 gys v. the more customary 3 gys), 40 gys on his protocol is biologically equivalent to 30 gys under the 3 gy per day protocol. His 40 gys would be administered over the course of 20 days (2 weeks in a row, then a few months break, then another 2 weeks in a row). In comparison, the standard protocol is 30 gys administered over the course of 10 days (1 week, then a few months break, than another week).

So, my understanding from what he said is that administering a lower dose over a longer time period allows you to administer more gys with the same level of risk.

another

I had treatment at VCU Massey Cancer Center with Dr Weiss for Dupuytren's in both hands. The protocol was 1 treatment for 7 days in a row (not including the weekend and includes two cycles of treatment.

newman

Professor Seigenschmiedt Essen was running two protocols -total dose 21GY and 30 Gy.He has been recording and evaluating the results now for some years. Another protocol used in Germany is 2 daily treatments of 4Gy which is repeated at 2monthly intervals. Total of 4 sessions -Total 32 GY. In my case one of my hands received 15 Gy which stopped the progression. Flojo mentions she received 18 Gy. which would enable her to have an additional RT if needed. Finally radiotherapy works best in the early stages on the nodules before contraction. Regards.

from wach

RT can make a growing (proliferating) nodule to slow down its growth, in favorable cases even stop it for many years. It does not work preventive, i.e. it can't exclude that you get a new nodule sometimes later in the same or a close by area.

The total accumulated dose should not exceed 30 Gy in any specific area. That's just heuristical, not a hard limit, 35 Gy probably wouldn't make much of a difference but at the same time the overall guide line is to minimize the dose in any RT treatment in order to minimize the risk. So, if you have 15 Gy applied and have the impression that it stopped the disease you still can have another 15 Gy later should you either find out that it didn't stop it or should you get a new nodule in the same area.

To me that seems to make sense and I had been doing that myself in two RT areas. By the way, this kind of thinking is fairly new. In the past 30 Gy were the standard and initially some clinics had even experimented with 50 Gy. The research of Seegenschmiedt and others proved that 20 and 30 Gy don't make that much of a difference. Personally I believe that 15 Gy might do the job in many cases, too. Proving that is elaborate because you need to treat a sufficient amount of people and have follow up reviews of their development for several years. Not many clinics have the money to fund this.

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