Author Topic: Tumor size and dose?  (Read 7437 times)

producer

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Tumor size and dose?
« on: April 30, 2012, 02:05:11 pm »
Hi, a question to the radiation 'experts' of our crew..

Is a 1cm tumor treated with the same  dose as a 2.5cm tumor? It sound like a smaller tumor would require less  beams or overall energy to kill or am i mistaken?



cheers

chris
Mosaic NF2  diagnosed march 2011.

9mm x 6mm x 6mm left VS

Cyberknife 3 day treatment completed May 2nd.

PaulW

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Re: Tumor size and dose?
« Reply #1 on: April 30, 2012, 04:03:56 pm »
The dose is typically 13 Gray to the tumour margin, if done in a single fraction regardless of tumour size.
This is how much radiation is absorbed by the tumour, not how much is transmitted through your head.

The total amount of radiation travelling through you is related to the tumour volume.

Think of how long it takes to heat a small cup of water in the microwave, versus a large bowl of water.

The radiosurgeon needs to boil the water if you like!
Small tumour = short time in the microwave.
Big tumour = Long time in the microwave.
Desired effect get the water to boiling point.

The boiling of the water is the 13 Gray bit...
The time in the microwave and the total amount of radiation you receive is not generally reported.
But its directly related to tumour volume.

Hope that makes sense?


 
« Last Edit: April 30, 2012, 04:06:46 pm by PaulW »
10x5x5mm AN
Sudden Partial hearing loss 5/28/10
Diagnosed 7/4/10
CK 7/27/10
2/21/11 Swelling 13x6x7mm
10/16/11 Hearing returned, balance improved. Feel totally back to normal most days
3/1/12 Sudden Hearing loss, steroids, hearing back.
9/16/13 Life is just like before my AN. ALL Good!

mk

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Re: Tumor size and dose?
« Reply #2 on: April 30, 2012, 04:25:23 pm »
Paul explained it well. To add to his explanation, I would add that the definition of one Gray is 1 Joule of energy/kg. Thus the larger the mass of the tumor, the more "energy" (i.e. joules) are absorbed.

Nowadays typical doses for single-session radiation are 12-13Gy. It has been shown that this provides optimum tumor control. However in the case of larger tumors the radiation oncologists may opt to deliver a lower dose, 11 or even 10 Gy, in an effort to avoid tumor swelling. In my case they used a dose of 11 Gy for a 2.8 cm tumor.

Marianna
GK on April 23rd 2008 for 2.9 cm AN at Toronto Western Hospital. Subsequent MRIs showed darkening initially, then growth. Retrosigmoid surgery on April 26th, 2011 with Drs. Akagami and Westerberg at Vancouver General Hospital. Graduallly lost hearing after GK and now SSD but no other issues.

Suu

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Re: Tumor size and dose?
« Reply #3 on: May 01, 2012, 03:14:34 am »
I don't know the answer to your question but want to wish you all the best of luck.

Cheers,
Suu
4cm Left side AN Translab August 18th 2010
Facial nerve not working
Nerve conduction Jan '11 Repeated 23rd May '11
SSD left side
5 ops in 6 weeks to fix CSF leaks
Tarsorrhaphy 9 Mar '11 Extended 26 Aug '13
Sling Thur 16 June '11
12/7 nerve graft 9 Feb '12

producer

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Re: Tumor size and dose?
« Reply #4 on: May 01, 2012, 08:11:09 am »
Thank you all.  Yes I think Paul really helped me understand with his great analogy!


I have today completed my 2nd of 3 CK session..   Both sessions have only lasted 20 mins each and my total dose will be 18Gy.

I have heard some people's fractionated sessions lasting up to 45 mins each so trying to understand why mine is such a short period.

thanks again


chris

« Last Edit: May 01, 2012, 08:13:20 am by producer »
Mosaic NF2  diagnosed march 2011.

9mm x 6mm x 6mm left VS

Cyberknife 3 day treatment completed May 2nd.

chloes mema

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Re: Tumor size and dose?
« Reply #5 on: May 01, 2012, 01:09:13 pm »
Loved PaulW's explanation.

Read this post to my husband.  When done reading, I said to him, "So why don't I just put my head in the microwave?"   ;D

Have to have some humor....

Karen
Diagnosed October 2011
Oct '11-9 X 6 mm left ear
Mar '12 - 1.25cm
Tinnitus, imbalance, and mild dizziness (ditsy)
My AN = Annoying Nuisance
Jan'12 W&W
May'12 CK completed
Oct'12 hemifacial spasms
Dec'19 It's back

producer

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Re: Tumor size and dose?
« Reply #6 on: May 01, 2012, 01:49:49 pm »
Microwave wont start unless door is closed Karen.. wouldve beat you to it!   ;D


chris
Mosaic NF2  diagnosed march 2011.

9mm x 6mm x 6mm left VS

Cyberknife 3 day treatment completed May 2nd.

PaulW

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Re: Tumor size and dose?
« Reply #7 on: May 01, 2012, 03:43:16 pm »
The bigger the tumour the more radiation it needs so the longer the treatment.
Just like the water in the Microwave.
Also I believe Stanford have recently installed the latest Cyberknife??
Treatment times have been reduced through the use of a variable iris collimator, which means the cyberknife can now change beam sizes without the robot having to change the piece of metal with a hole in it, that lets the xrays through.
Also improved programming has sped up treatment times.
10x5x5mm AN
Sudden Partial hearing loss 5/28/10
Diagnosed 7/4/10
CK 7/27/10
2/21/11 Swelling 13x6x7mm
10/16/11 Hearing returned, balance improved. Feel totally back to normal most days
3/1/12 Sudden Hearing loss, steroids, hearing back.
9/16/13 Life is just like before my AN. ALL Good!

MaryBKAriz

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Re: Tumor size and dose?
« Reply #8 on: May 01, 2012, 07:22:56 pm »
Such an interesting set of posts. Thank you for the question and answers.

Mary  8)
Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK

Suu

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Re: Tumor size and dose?
« Reply #9 on: May 02, 2012, 01:18:59 am »
Loved PaulW's explanation.

Read this post to my husband.  When done reading, I said to him, "So why don't I just put my head in the microwave?"   ;D

Have to have some humor....

Karen


I laughed till tears ran out of my good eye and then again when I read Chris' answer!  At my age it isn't good to laugh that hard without nearly wetting myself! 
Thanks.  :D :D :D
4cm Left side AN Translab August 18th 2010
Facial nerve not working
Nerve conduction Jan '11 Repeated 23rd May '11
SSD left side
5 ops in 6 weeks to fix CSF leaks
Tarsorrhaphy 9 Mar '11 Extended 26 Aug '13
Sling Thur 16 June '11
12/7 nerve graft 9 Feb '12

producer

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Re: Tumor size and dose?
« Reply #10 on: May 02, 2012, 08:45:27 am »
Glad to have put a smile on your face Suu..and a happy tear ;D


chris
Mosaic NF2  diagnosed march 2011.

9mm x 6mm x 6mm left VS

Cyberknife 3 day treatment completed May 2nd.

chloes mema

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  • Life is a special occasion.
Re: Tumor size and dose?
« Reply #11 on: May 02, 2012, 01:09:47 pm »
Glad to have put a smile on your face Suu..and a happy tear ;D


chris

Me, too Suu!

I still think I could've got the microwave to work, Chris.   ;D

Karen
Diagnosed October 2011
Oct '11-9 X 6 mm left ear
Mar '12 - 1.25cm
Tinnitus, imbalance, and mild dizziness (ditsy)
My AN = Annoying Nuisance
Jan'12 W&W
May'12 CK completed
Oct'12 hemifacial spasms
Dec'19 It's back

MDemisay

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Re: Tumor size and dose?
« Reply #12 on: May 02, 2012, 01:33:45 pm »
You guys are a laugh a minute!

I thought I was special at my inability to cry with both eyes, only crying with one. Guess I'm not as strange as I once thought, that's a good thing ain't it? ;D

Mike
1974 - Dr. Michelson  Colombia Presbyterian removal of 3 Arterio Venous Malformations
2004- Dr. Sisti  NY Presbyterian subtotal removal of 3.1 cm AN,
2012 - June 11th Dr. Sisti Gamma Knife (easy-breasily done)"DEAD IRV" play taps!
Research, research, research then decide and trust in God's Hands!

producer

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Re: Tumor size and dose?
« Reply #13 on: May 02, 2012, 03:37:03 pm »
I guess where there is will there is a way Karen!  lol

Surely youre not as strange as you thought prior to joining the forum Mike ;)


chris
Mosaic NF2  diagnosed march 2011.

9mm x 6mm x 6mm left VS

Cyberknife 3 day treatment completed May 2nd.