Positive margins

Has anybody had a positive survival outcome after having positive bone margins after mandibulectomy for stage 4 ssc?
If so, can you tell me what treatment protocal was used? for example, rads/erbitux, rads/chemo?
Thanks,
P.

Comments

  • longtermsurvivor
    longtermsurvivor Member Posts: 1,842 Member
    Of course there are

    Of course there are survivors.  Think about it for a moment.  There were survivors, and a lot of them, when chemotherapy wasn't used at all, only radiation.  Positive margins merely means there is tumor left at the margin.  There were also survivors who didn't have a debulking surgery at all, just rads.  Respectfully, these are mixed questions.  There is no defininitive answer to the question of which chemo cocktail is better.   And there are plenty of survivors given the circumstances you just quoted.

    be well.  Best regards,

     

    Pat

  • josh r.
    josh r. Member Posts: 264 Member
    Keeping the Faith

    Hi P.

    Like "Long-Time-Survivor" said we are out here and we are not hiding. I was diagnosed with stage 4 throat cancer in July of 1991 and finished chemo-rads in November of 1991 and thank my Higher Power, my family, friends, the doctors and their staffs every day that I remain NED. The treatment was relatively new at the time so I can only imagine, thru our brothers and sisters here, how much more advanced the treatments are today. You have a lot of "teamates" right here pulling for you. All the best josh r.

  • hwt
    hwt Member Posts: 2,328 Member
    josh r. said:

    Keeping the Faith

    Hi P.

    Like "Long-Time-Survivor" said we are out here and we are not hiding. I was diagnosed with stage 4 throat cancer in July of 1991 and finished chemo-rads in November of 1991 and thank my Higher Power, my family, friends, the doctors and their staffs every day that I remain NED. The treatment was relatively new at the time so I can only imagine, thru our brothers and sisters here, how much more advanced the treatments are today. You have a lot of "teamates" right here pulling for you. All the best josh r.

    Vetorama

    Sorry to hear about your situation. January 2012 I had my left mandible removed and replaced with my fibula and titanium. They had clear margins with the surgery but I had 2 or 3 positive lymph nodes out of about 27. I had raditiation and Cisplatin in May. Have had one PET and two CT w/contrast since all NED. I read Mayo in Rochester has a new technique which does not involve the fibula. I would research that. 

  • vetorama
    vetorama Member Posts: 16
    hwt said:

    Vetorama

    Sorry to hear about your situation. January 2012 I had my left mandible removed and replaced with my fibula and titanium. They had clear margins with the surgery but I had 2 or 3 positive lymph nodes out of about 27. I had raditiation and Cisplatin in May. Have had one PET and two CT w/contrast since all NED. I read Mayo in Rochester has a new technique which does not involve the fibula. I would research that. 

    CRT

    Thank for the replies. There are so many cocktails out there, hard to judge. How was the RT/Cisplatin for you? I know everyone is different.

    Your time to start RT/Cisplatin seemed like a long time post surgery, was it?

    I read an article about a trial that used a combo of RT.erbitux and docetaxal that had reall good results. Anybody have any thougts?

    Thanks

  • longtermsurvivor
    longtermsurvivor Member Posts: 1,842 Member
    vetorama said:

    CRT

    Thank for the replies. There are so many cocktails out there, hard to judge. How was the RT/Cisplatin for you? I know everyone is different.

    Your time to start RT/Cisplatin seemed like a long time post surgery, was it?

    I read an article about a trial that used a combo of RT.erbitux and docetaxal that had reall good results. Anybody have any thougts?

    Thanks

    Yup

    RTOG 0234 was a randomized phase 2 adjuvant [postoperative] trial in about 200 patients with poor prognostic features that compared weekly cisplatin plus cetuximab [100 patients] vs weekly docetaxel plus cetuximab [100 patients]. The idea was to develop a second treatment option that could be offered instead of bolus cisplatin with radiation. That trial is very interesting. There was a significant improvement in survival among patients in the docetaxel-plus-cetuximab group, which is very intriguing. The full trial report has not been published yet but the abstract has been reported.[22]
     

    Note:  I have not seen the abstract, but here is the protocal.  You can click on links within it if you want the details.

    http://www.rtog.org/ClinicalTrials/ProtocolTable/StudyDetails.aspx?study=0234

  • vetorama
    vetorama Member Posts: 16

    Yup

    RTOG 0234 was a randomized phase 2 adjuvant [postoperative] trial in about 200 patients with poor prognostic features that compared weekly cisplatin plus cetuximab [100 patients] vs weekly docetaxel plus cetuximab [100 patients]. The idea was to develop a second treatment option that could be offered instead of bolus cisplatin with radiation. That trial is very interesting. There was a significant improvement in survival among patients in the docetaxel-plus-cetuximab group, which is very intriguing. The full trial report has not been published yet but the abstract has been reported.[22]
     

    Note:  I have not seen the abstract, but here is the protocal.  You can click on links within it if you want the details.

    http://www.rtog.org/ClinicalTrials/ProtocolTable/StudyDetails.aspx?study=0234

    RTOG 0234

    This is exactly the treatment choice i would like to have. I will see if my medical oncologist will go with this and whether my insurance company will pay. Very significant with positive margins. Wish me luck:)