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Radiation Oncology Archive Questions

Below are Dr. Citron’s answers to Radiation Oncology questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.



Now displaying records 1 to 2 of 2.

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Q : 1

01/29/2012
In 2004, I received treatment for stage III breast cancer. I received chemo and radiation of my right breast, lymph nodes (right side) and right braechial plexus. I had pain in neck and shoulder after about third day of radiation, which my radiologist said was impossible. I had an MRI of that shoulder and I have AVN. Could radiation to that area have caused the AVN, neck pain on right side and around the veges nerve and pain between neck and shoulder?

In general, radiation to the right breast and lymph nodes is appropriate for stage III breast cancer, and because the brachial plexus is right in the same area as the lymph nodes, it generally is overlapped by the radiation. The brachial plexus can tolerate some radiation, and generally, the typical doses used in breast cancer are felt to be safe for the brachial plexus. Discomfort that occurs during the treatment course is more commonly due to inflammation that resolves after the treatment is finished. In terms of the AVN, radiation could affect the bone by decreasing the circulation in the tiny blood vessels that supply the bone. Generally, when the radiation fields for treatment of the lymph nodes are designed, the humeral head is excluded from the treatment field if that can be done without compromising the effectiveness of the treatment.


Q : 2

04/17/2011
My brother is 76 years old, has NSCLC and is undergoing treatment. I just read about the trilogy radiation therapy and would like to know if he should pursue this therapy instead of his current treatment. He has had about eight radiation treatments and six chemo.

Some details of lung cancer treatment depend on the stage of the lung cancer. If he is getting chemo and radiation, I assume he is stage II, III, or IV. In that case, radiation is generally given in small amounts five days per week, over a period of weeks, and the Trilogy machine would not generally have significant advantages over other machines. In stage I disease (just one small spot in the lung with no spread to lymph nodes or elsewhere), a specific technique of radiation can be used as an alternative to surgery, stereotactic body radiation therapy (SBRT). SBRT uses larger doses of radiation given over just a few treatments, and these larger doses of radiation cannot be administered by all machines. The Trilogy machine is one machine that can give these large doses per treatment. I am sorry I cannot be more specific about your brother's treatment without knowing the details of his case.


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