Day 7 of a 28 Day Treatment

[rcaldw]

My treatments are being done in Houston, using the Novalis machine.  They are giving me 28 total treatments for a 2cm AN on my left side.  I guess this would be FSR, but not in 3, but in 28. (someone correct me if I'm wrong, please).  I finished day 7 today.  Other than a little fatigue, not great side effects at this point.  Anyone been through something similar and could give me a little more as to what I can expect?  They (the doctors here) are almost giving me the impression that other than a little possible hair loss and fatigue I might not have many side effects at all.

[Jeff]

Hello,
I believe this mode of treatment is called  intensity modulated radiation therapy(IMRT). You can read about it here http://www.irsa.org/imrt.html. My brother had treatment using Novalis 5 days a week for six weeks. He had some fatigue and dizziness. I am glad that you are doing well.
Best wishes,
Jeff

[rcaldw]

Jeff, do you have any knowledge as to whether this approach is more or less effective than GK or CK with respect to AN's?

[Jeff]

I am not well versed in the various modes of treatment, so I will let some of those who are more knowledgeable than me speak to your question.
Jeff

[jcinma]

Jeff,
I had 30 FSR treatments at Mass General Hospital in Boston. Didn't really have any side effects at all while I had the treatments.  A couple of months later I suffered from fatigue but nothing terrible.  I do have a small bald spot (smaller than a quarter) but I also had surgery so I am not totally sure which caused the spot. Maybe a combo from both.
Jane

[GM]

Wish you the best with your treatments...here's to evicting the little invader 

[Mark]

rcaldw,

Glad to hear that your treatments with the Novalis machine are going well.

I believe Jeff is correct that the process you are going through is considered IMRT and would typically be described as radiotherapy as opposed to radiosurgery, but I think that is more just semantics.

I'm not that familiar with IMRT and the only write up I found on it was from the CK society web site which I'll copy here

Shaped Beam Systems 
 
The recent development of IMRT or Intensity Modulated Radiation Therapy has added another dimension to multi-fraction radiation therapy. These linac-based technologies use computer-controlled "beam-shaping" to do a better job of conforming the radiation dose to the shape of the tumor or other lesion. This form of advanced radiation therapy can be utilized at virtually any location in the body. IMRT technology enables a mechanical device (called a multi-leaf collimator) that is typically attached to most modern medical linear accelerators, to dynamically reshape the outlines and intensity of the radiation field during cancer treatment. When combined with sophisticated planning software, IMRT fits the dose of radiation to a target much better than conventional radiation therapy, and thereby minimizes the volume of surrounding normal tissue that is injured by treatment. While it appears that IMRT may produce fewer side-effects than conventional radiation therapy, IMRT is not as spatially precise as radiosurgery. Because of this imprecision, a full course of IMRT treatment is typically administered over multiple treatment sessions (typically 20-30+). Common brand names include X-Knife (Radionics) and Novalis (Brain Lab).


Advantages of Shaped-Beam systems include:
The capacity to treat most regions of the body with IMRT
When coupled to an invasive stereotactic frame, precision targeting for brain tumors that approaches, but does not equal, that of the Gamma Knife or CyberKnife.
The capacity to more accurately target extracranial (non-brain) tumors than standard radiation therapy
An ability to deliver fractionated intracranial or extracranial treatment


Disadvantages of the Shaped Beam systems include:
The need for an invasive head frame (similar to the Gamma Knife) to assure treatment accuracy when used for brain radiosurgery (single fraction)
Less treatment accuracy when multiple fractions are used to treat areas of the brain where the use of an invasive head frame is impractical
A significantly lesser degree of targeting accuracy when treating extracranial tumors compared to brain radiosurgery
Treatment accuracy is degraded further when the target moves during radiation delivery from either natural breathing or patient movement

Best wishes for a great outcome!   

Mark

[philadelphia1]

I'm receiving similar treatement at Thomas Jefferson University in Philadelphia  for a small (<1cm) AN on my left side.  Novalis Brain Lab, 26 treatments.  My docs call it fractionated stereotactic radiotherapy (FSR).

I have 3 treatments to go -- very manageable side effects (minor dizziness, nausea early on, some fatigue/headache that seem totally related to the overall level of stress in my day).  No hair loss.  No real tumor swelling at this point, at least.

The overall stats quoted to me were very favorable (90%+ tumor control).  My doctor recommend FSR over GK to increase the odds of retaining my hearing -- which is still good.

It has been somewhat difficult to have so long a course of treatment, but now that I am near the end, I'm very glad I made the choices I did.  Of course, won't really know until I have had several MRIs as follow up.

Good luck with your treatment.

ML
Philadelphia