Short-Course Versus Standard Chemoradiation in Rectal Cancer

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KWT
Posts: 3214
Joined: Thu Jul 11, 2013 7:22 pm

Short-Course Versus Standard Chemoradiation in Rectal Cancer

Postby KWT » Sat May 16, 2015 1:49 pm

food for thought for those entering this phase of the hijacking. I had a five day course of radiation at stanford and the hardest thing about it was coughing up the hotel charge :shock:
No, really just diareah once and a little fatigue when I went climbing a week later.
For me I avoided the month long ordeal that most have. I can only think of one other person here who did the short course, Ehut? Anyway it would be a good thing bringing it up to your docs because they probably won't mention it.

http://www.ncbi.nlm.nih.gov/pmc/article ... po=26.4706

http://www.sciencedirect.com/science/ar ... 9611000233
Last edited by KWT on Sat May 16, 2015 3:20 pm, edited 3 times in total.

PainInTheAss
Posts: 668
Joined: Tue Jul 02, 2013 3:08 am

Re: Short-Course Versus Standard Chemoradiation in Rectal Cancer

Postby PainInTheAss » Sat May 16, 2015 2:47 pm

I seem to remember that Green Monkey did the short course. I think I saw someone else refer to it on a blog, too. Maybe the short course radiation machine is a billion dollars and hospitals would rather use the six week machine they still have that cost $500 million, or whatever. I mean, where do you junk a radiation machine when you buy an upgrade? Sell it to a third world country hungry for US technology? My cancer center had a newer machine at one facility that did more targeting of radiation so they sent me there for chemorad but it was still 6 weeks. I don't think they have the short course anywhere here in Arizona.
47yo single mom of 4 (24, 21, 18, 16) at Dx
6/13 - RC T4b IIIc 5LNs on PET CEA 5.4
8/13 - Finish chemorad
10/13 - APR/hyst+ovaries/perm colostomy 2/12 nodes+
6/14 - Finish Xelox 6 rds
1/15 - CT clear CEA 0.2
10/15 - CT/MRI clear CEA 0.7
4/16 - CT clear
10/16 - CT/MRI clear CEA 0.6
5/17 - PET clear? Follow up MRI to verify inflammation

KWT
Posts: 3214
Joined: Thu Jul 11, 2013 7:22 pm

Re: Short-Course Versus Standard Chemoradiation in Rectal Cancer

Postby KWT » Sat May 16, 2015 3:24 pm

Well, I'm not so sure that the machine is any different, but how would I? I just figured they adjust the dose?

Ehut
Posts: 230
Joined: Wed Sep 26, 2012 4:24 pm
Location: Algonquin, IL

Re: Short-Course Versus Standard Chemoradiation in Rectal Cancer

Postby Ehut » Sat May 16, 2015 3:29 pm

That's right Kenny, I had the short course also. For me, the decision was based on my liver's good response to pre-surgery chemo. The concern was the liver would be untreated for 6 weeks during standard course radiation, so we wanted to take advantage of the healthier liver right before surgery. From what I understand, this is the more common route in Europe. The Mayo doctors gave me the choice, and I don't regret it.
Dx 12/11 rectal stage IV w/ 6 mets to liver, age 35
4 cycles FOLFOX 12/11 to 2/12
short course radiation 2/12
rectal/liver resection 3/12, temp ileostomy
8 cycles FOLFOX/FOLFIRI 4/12 to 8/12
ileostomy reversal 10/12
port out 10/13
NED for 8+ years and counting!

jjlist
Posts: 654
Joined: Fri Jan 21, 2011 11:56 pm

Re: Short-Course Versus Standard Chemoradiation in Rectal Cancer

Postby jjlist » Sat May 16, 2015 7:00 pm

What's the difference with short or long. Is the amount of radiation the same? Or is it just administered at differnt measured amounts per session?
age 56
11/16/09 DIAG low rectal tumor ST II T3N0M0
12/21/09 chemopump radiation
3/18/10 suregry colo-anal anastomosis, no nodes,.
4/29/10 Abcess infection
6/3/10 started 12 folfox sessions completed 10.
1/11/11 ileostomy takedown

peanut_8
Posts: 2340
Joined: Sun May 25, 2014 1:31 pm

Re: Short-Course Versus Standard Chemoradiation in Rectal Cancer

Postby peanut_8 » Sat May 16, 2015 7:03 pm

If I had known about the short course option, I would have been happy to travel to Stanford for it. Thanks for bringing this to our attention, KT.
peanut
female, diagnosed Jan 14, RC stage 2a, age 56
MSS
April 14, 28 chemo/rad with Xeloda
June 14 adjuvant Xeloda 6 rounds
currently NED

justin case
Posts: 4269
Joined: Sun Sep 04, 2011 8:26 am
Location: Katy, Texas

Re: Short-Course Versus Standard Chemoradiation in Rectal Cancer

Postby justin case » Sat May 16, 2015 7:34 pm

I did the long course of radiation. I had 3 rounds of FOLFOX, before radiation. Standard radiation comes with Xeloda or 5 FU. I was lucky, mine included oxiloplatin.
I was very tired of my side effects.
I had surgery, and after surgery, I opted for the short course of 5FU.
I switched oncs, and I had an option.
She knew I just fired an onc, because he wanted FOLFOX, with erbi and iri, for final chemo. I was a stage 2a.
I was offered 1week of 5FU , 1 week off, and 1 final week of 5FU, by push injection.
The other option which I took was, a push of 5 FU, once a week for 6 weeks, 2 weeks off,
then a push of 5FU for the next 6 weeks. I was low on iron also, so once a week I got infused with iron.
the total sessions were one and a half hours per week.
That is my version of short term chemo, 12 infusions in 14 weeks. I couldn't get the time off to do it in 3 weeks, nor after surgery, could I afford to take three more weeks off work.
There are options other than standard protocol, that are just as effective!
Michael
7/11 diagnosed Stage 2 colon and rectal cancer
chemo/rad
lar/temp ilio
Reversal & port removal
21 round of chemo Folfox 9tx, 5fu 12 tx
Last treatment July 2012

jjinmd
Posts: 88
Joined: Thu Dec 18, 2014 9:24 am

Re: Short-Course Versus Standard Chemoradiation in Rectal Cancer

Postby jjinmd » Sat May 16, 2015 9:40 pm

I did short course too, but that ended up that way because I did the 4 rounds of folfiri/avastin for the liver mets first. It certainly was not their "standard" approach...seemed to me that we were making decisions as we went along. My doc said the difference for them in the decision was that they were going for node sterilization rather than tumor shrinkage (because I had a clinical complete response in the primary tumor). Even a week was rough - rougher than the folfiri in my opinion.
42 year old Mom of two
7/14 Stage IV rectal cancer; CEA 70
4 rounds FOLFIRI/Avastin; 5 days radiation
11/14 TME, Liver resection, Temp Ileo - cPR
6 rounds FOLFOX
4/15 CT = NED
5/15 Ileo reversal
7/15 CEA = 2.1

Ehut
Posts: 230
Joined: Wed Sep 26, 2012 4:24 pm
Location: Algonquin, IL

Re: Short-Course Versus Standard Chemoradiation in Rectal Cancer

Postby Ehut » Sat May 16, 2015 10:13 pm

Radiation dose per session of short course is about double, but the overall dosage ends up being about half.
Dx 12/11 rectal stage IV w/ 6 mets to liver, age 35
4 cycles FOLFOX 12/11 to 2/12
short course radiation 2/12
rectal/liver resection 3/12, temp ileostomy
8 cycles FOLFOX/FOLFIRI 4/12 to 8/12
ileostomy reversal 10/12
port out 10/13
NED for 8+ years and counting!


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