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Trilogy Archive Questions

Below are Dr. Regine’s answers to Trilogy 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 15 of 17.

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Q : 1

Are you currently using Triology to treat prostate cancer? If so, for how long has it been used? Is it considered better than Cyberknife treatment alone?

Yes, we have, for about two years. It is more versatile than the Cyberknife in terms of capabilites and is considered a newer generation linear accelerator-based system. My office number is 410-328-2326 if I can be of further assistance.

Q : 2

What has your experience been in using Trilogy for patients with Stage IV pancreatic cancer? (This particular patient is very healthy and has excellent performance status, except for the tumor.) Are there any published reports or clinical trial results on use of Trilogy for this type of cancer? Many thanks!

Not a major indication for stage 4 pancreas cancer with liver mets. However, for those who have localized disease to the pancreas only and are unresectable, we are using it and reducing acute treatment side effects. We hope to present this experience at our national meeting later this year.

Q : 3

Can Trilogy be utilized to treat a Squamous Cell Carcinoma of the tongue?

Absolutely. We do so every day here. Please call my office if I can be of further assistance.

Q : 4

Is the Trilogy linear accelerator being used to treat cancer of the larynx/vocal folds? If not, why not? It seems that there would be less collateral damage. Thanks!

It can be, but may not be necessary, depending on the associated clinical scenario.

Q : 5

I have cholangiocarcinoma, resectioned 3 years ago. Have had two treatments of chemo ablations. Taking Nexavar, which is hard on me. Am I a candidate for your high tech Cyberknife?

We offer a newer, latest generation imaged-guided radiation therapy (IGRT) solution known as the Trilogy, made by Varian Medical Systems, the world leader in radiation therapy technology. We can review your medical history and imaging if interested. My office number is 410-328-2326.

Q : 6

Can Trilogy be used for an inoperable non-cancer soft tissue tumor? It is located in the neck on the top of the spine.

Yes. After review of the patient and imaging, it may be a consideration, particularly in this area.

Q : 7

My husband has already had treatments for his lung cancer which metastases to his brain. Due to the location of the tumor (deep in the brain) he was treated with Stereotactic Radio surgery. Then, after that he had whole brain radiation. After 4 ½ months from his treatments, another MRI scan confirmed that the tumor was growing around the rim of the previously treated tumor. Could he still be a candidate for your treatment, even though he has had radiation and chemo?

Need to make sure he is not simply experiencing MRI "changes" we sometimes see after radiosurgery (should be reviewed and confirmed with the docs who did the radiosurgery). Otherwise we generally do not re-treat the same area with radiosurgery.

Q : 8

Is the Trilogy method feasible for treating ovarian cancer?

It depends on much more information, like where the cancer is and in the context of what other treatments have/are to be planned.

Q : 9

I have been diagnosed with a 7mm nodule in my lung. I am having a PET scan done very soon. Would I be a candidate for the Trilogy if the nodule is malignant?

It all depends on what it is and all options should be kept open, including the possibilty of surgery. It should come down to what is bestfor you as recommended by an experienced multidisciplinary team such as the Thoracic team we have here. I can be reached at 410-328-2326 if I can be of further assistance. The Trilogy unit is the latest radiation technology solution.

Q : 10

Are you able to have Trilogy treatment along with chemotherapy? My father is diagnosed with tricellular bladder cancer. His bladder has been removed. He is currently undergoing chemotherapy treatments with Taxol and will be changing to Gemzar.

Yes, but it ultimately depends on the area being targeted as well as type and dosing of associated chemotherapy.

Q : 11

Can Trilogy be used on lymph nodes in the neck and thoracic region? I have 7 lymph nodes with miniscule cancer. I had breast cancer in 2004 and had 37 treatments on the IMRT machine.

Possibly, especially if the lymph nodes to be treated are within the area of your previuos radiation.

Q : 12

Is Trilogy treatment an option for ovarian cancer?

It depends on the patient and the associated tumor circumstances.

Q : 13

Please compare Trilogy to cyberknife for prostate cancer, i.e. number of treatments rate of success, etc.

Assuming getting standard course of external radiation, which very likely should be the case, the advantage of Trilogy over Cyberknife is that Trilogy is able to make use of both KV or conebeam CT for daily image guidance. Cyberknife can only make use of KV.

Q : 14

Is Triloy Therapy used for Renal Cell Cancer in the lungs? Five years ago, the major tumor and kidney was removed and the patient received high dose IL-2. This shrunk the lesions in the lungs, then they started to grow and he was given a lower dose of IL-2, which sustained growth for approximately 3 months. Now one of the lesions is starting to grow substantially. I am anxious to get therapy options.

Trilogy, with its Stereotactic Body Radiation Therapy (SBRT)component, is a definite possibility depending on your overall disease and performance status. SBRT is increasingly used for treating metastatic lesions to the lung/liver.

Q : 15

I was wondering if this treatment would be available for Stage IV Gallbladder cancer. The tumor is unresectable, the patient is a 47-year-old female. She has went through several clinical trials and even tried a chemo "cocktail." She also has peritoneal, ascites and a few lesions on her liver. Could the gallbladder tumor be destroyed by Trilogy?

Given all that you described, while the Trilogy may destroy the gallbladder tumor, it may likely not be helpful overall, given the extent of the rest of her disease.

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