One large "zap" for painful bone metastases is enough

[Tall_Allen]

pcnrv.blogspot.com/2019/08/...

If your radiation oncologist is planning on delivering more than one, ask why. Note: He is reimbursed by the number of treatments he gives.

[whatsinaname]

I had complained about severe pain in the tumor on my right skull which was also growing in size (from three PSMA PET-CT scans). The pain level was 8/10, pretty bad.

I eventually decided to get my skull radiated after consulting 2 RO's in Bombay. Both insisted that IMRT in 10 fractions was preferable to SBRT in 3 sessions. The reasons given were that 1) it was technologically challenging to administer SBRT to the skull and could damage the stem cells leading to cognitive impairment. IMRT was much easier to administer and 2) SBRT was far more toxic than IMRT ie the side effects could be far worse. I went with their decision. Today is my tenth and last radiation session and am happy to state that my pain has almost completely vanished. The first cancer treatment that has succeeded for me, thus far

Cheers, Everyone !!!

[j-o-h-n in reply to whatsinaname]

Great News.... keep up the good work.........

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 08/03/2019 8:08 PM DST

[whatsinaname in reply to j-o-h-n]

Thank you very much, j-o-h-n !!!

[HOPEFULSPOUSE]

WOW - 🤢

[Magnus1964]

This is some great information, thanks.

[TNCanuck]

Allen, what are your thoughts on the "one zap" approach in using it on one spine lesion that is asymptomatic --- as part of debulking?

[Tall_Allen]

This was for pain palliation, but it's probably true for prevention of spinal compression (possibly in conjunction with kyphoplasty). So far, those are the only known benefits to treating mets on the spine. ASTRO guidelines call for a single zap for that purpose.

[SPEEDYX]

I would think multiple radiation treatments could lead to possibility of more side effects too.

[Tall_Allen in reply to SPEEDYX]

No significant differences in toxicity (nausea, vomiting, fatigue, dermatitis, and fracture)

No significant differences in quality of life

[SPEEDYX]

👍