Surgical Radiation to the Liver

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C Dixon
C Dixon Member Posts: 201
edited March 2014 in Colorectal Cancer #1
When I went in for my post op check for my liver resection, my surgeon said that there were microscopic crc cancer cells found in what was left behind of the right lobe. One of the lesions was close to the blood supply for the left lobe, so he could only get so close. Anyway, Duke has recommended surgical radiation (not sirshpheres) to get at these cells and finish them off as I have been on both Folfox and Folfiri.

I was wondering if anyone has had radiation to the liver and what your experience was like.

Thanks,

Catherine

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  • Sundanceh
    Sundanceh Member Posts: 4,392 Member
    #2
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    CyberKnife?
    Could this be CyberKnife treatments or Stereotactical Radiation?

    I've done CyberKnife on the liver to help cut out the remaining tumor that RFA could not reach. It worked very well. 3-5 treatments of intense radio surgery using intense radiation.

    If this is an option, then it is very solid and can be very effective.

    I was hoping for the stereotactical radiation on my lungs, but do not appear to be a candidate, so I have no experience with this, but I did read it and it is promising as well.

    Craig
  • pepebcn
    pepebcn Member Posts: 6,331 Member
    #3
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    Catherine on Monday l will visit
    my radiologist to discuss about when to start my radiation, l will keep you informed, are you on chemo right now? lm in the same scheme you are or where so similar situation, Keep in touch!
    Pepe.
  • pepebcn
    pepebcn Member Posts: 6,331 Member
    #4
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    Sundanceh said:

    CyberKnife?
    Could this be CyberKnife treatments or Stereotactical Radiation?

    I've done CyberKnife on the liver to help cut out the remaining tumor that RFA could not reach. It worked very well. 3-5 treatments of intense radio surgery using intense radiation.

    If this is an option, then it is very solid and can be very effective.

    I was hoping for the stereotactical radiation on my lungs, but do not appear to be a candidate, so I have no experience with this, but I did read it and it is promising as well.

    Craig

    Craig what about toxicity to the liver
    specially if you are on chemo too?
    Best!
  • C Dixon
    C Dixon Member Posts: 201
    #5
    Options
    Sundanceh said:

    CyberKnife?
    Could this be CyberKnife treatments or Stereotactical Radiation?

    I've done CyberKnife on the liver to help cut out the remaining tumor that RFA could not reach. It worked very well. 3-5 treatments of intense radio surgery using intense radiation.

    If this is an option, then it is very solid and can be very effective.

    I was hoping for the stereotactical radiation on my lungs, but do not appear to be a candidate, so I have no experience with this, but I did read it and it is promising as well.

    Craig

    I don't really know.
    I just read about Stereotactical and it sounds like just what he described but I go for 5 1/2 weeks and the information about SBRT talks about having only 3 - 5 sessions. I do have to go for a special hour long CT and then a simulation from which they will take 10 days to plan how to go about it.

    I do remember the doc saying that there are all kinds of names for the treatment based on from whom the equipment is bought: Gamma, Cyber and so on. The only thing at Duke that they don't have is the Proton beam.

    I wonder if mine is going to take longer because it is not an actual tumor but a side of the liver. I guess these are questions for next week.

    Thanks,

    Catherine
  • C Dixon
    C Dixon Member Posts: 201
    #6
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    pepebcn said:

    Catherine on Monday l will visit
    my radiologist to discuss about when to start my radiation, l will keep you informed, are you on chemo right now? lm in the same scheme you are or where so similar situation, Keep in touch!
    Pepe.

    No Chemo Yet
    But the doc said I would be taking Xeloda during the treatments to enhance the radiation. I don't know what they will put me on after that. Probably back to Folfox or Xelfox.

    Catherine
  • Sundanceh
    Sundanceh Member Posts: 4,392 Member
    #7
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    pepebcn said:

    Craig what about toxicity to the liver
    specially if you are on chemo too?
    Best!

    Good Question
    Pepe

    I was not on chemo at the time of my procedure, so I don't know the definite answer here. From reading Catherine's reply, it sounds like they are wanting to do both to enhance the treatments, so I can only gather that they have no issues in administering both at the same time.

    Catherine: mine is going to be 5-6 weeks as well, so it sounds like the new stuff is out for me as well. My understanding is this is external beam radiation, that they can "shape" to target the area in questions, while sparing surrounding tissue.

    I'll be so interested in hearing what happens with you - you can teach me:)

    -Craig
  • C Dixon
    C Dixon Member Posts: 201
    #8
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    Sundanceh said:

    Good Question
    Pepe

    I was not on chemo at the time of my procedure, so I don't know the definite answer here. From reading Catherine's reply, it sounds like they are wanting to do both to enhance the treatments, so I can only gather that they have no issues in administering both at the same time.

    Catherine: mine is going to be 5-6 weeks as well, so it sounds like the new stuff is out for me as well. My understanding is this is external beam radiation, that they can "shape" to target the area in questions, while sparing surrounding tissue.

    I'll be so interested in hearing what happens with you - you can teach me:)

    -Craig

    I think this is what I will be having.
    I would think yours is similar. All places like to claim they are the only ones but.......
    Do you think this is just regular radiation with a bunch of "fancy" talk? When do you start and how is your recovery coming?

    Gated Therapy

    Treatment to tumors located in the thoracic and abdominal regions, such as lung and liver, is always a challenging task because of respiratory organ motions. Traditional approach is to expand each treatment field to ensure the entire tumor volume is included in the radiation filed. To minimize radiation damage to extra normal tissues due field expansion, Duke has adopted respiratory control techniques to synchronize the radiation beam with tumor motion. With this technique, the treatment margin added to accommodate the organ motion could be reduced to minimize the radiation dose to normal tissues. Advanced technologies are used to achieve this goal, such as the use of Varian RPM system to monitor respiratory pattern, On-Board Imager to verify target motion, and electronic portal imaging system to verify real-time radiation delivery.

    IMRT

    Tumors to be treated are often surrounded by normal structures. The dose tolerances to the normal critical organs are one of the limiting factors to radiation dose prescribed to tumor. With the IMRT technique, one will be able to shape the radiation dose to the target and then minimize the dose to critical organs. Therefore, the expected dose could be prescribed to tumor while limiting the radiation damage to the normal tissue within the tolerance. The IMRT involves complicated treatment planning process (called inverse planning) and a dedicated delivery process using dynamic multi-leaf collimator (MLC). A comprehensive quality assurance program specific for both machine and individual patient was very critical and was developed at Duke to ensure the quality treatment of IMRT. We use latest Varian Eclipse inverse planning system and Clinac 21EX machine with120-leaf MLC to delivery fine radiation dose to the target.

    IGRT

    Image-guided radiation therapy (IGRT) is a process of using various imaging technologies to locate a tumor target prior to a radiation therapy treatment. This process is aimed to improve the treatment accuracy so that the need for large target margins which have traditionally been used to compensate for errors in localization. As a result, the amount of healthy tissue exposed to radiation can be reduced, minimizing the incidence of side effects. At Duke, physicians applied advanced imaging techniques using CT, MRI, PET/CT, and SPECT to accurately delineate treatment target. Recently, Duke Physicians are able to use state-of-art in-room on-board imaging and cone-beam CT technologies to visualize the treatment tumor three-dimensionally prior to the delivery of radiation beam. IGRT is complementary to IMRT. IMRT is used to improve the radiation delivery precision and IGRT is used to improve the radiation delivery accuracy.

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