Post-chemo CT

[Vaan]

Hello to everybody!
My husband started his last chemo on 15 of June. I would like to know when is the appropriate time for CT scans in order to see the size of residual retroperitoneal mass

[jpboucher]

Hey Vaan,

Usually done 4 - 6 weeks after chemo completion.

All the best for you and your husband,

Jean-Philippe

[Vaan]

What we should consider chemo completion?? The end of 21 days which is the duration of the cycle or the end off five days where they give you the medicines? Some docs suggest to do ct scans two weeks after the chemo completion while others suggest 4 weeks.

[jpboucher]

That's a good question and some docs don't give the same answer.

In my experience, doctors consider the last bleo shot or the last EP shot to be "chemo completion".

You can say 2, 4 or 6 weeks but the timing of the CT scan depends on how the doctor will define chemo completion.

Hope that helps,

Jean-Philippe

[Davepet]

Considering that your docs are already leaning towards RPLND, longer is more likely to give the best chance of avoiding the surgery. It can take a while for the tumors to shrink post chemo.

Dave

[Vaan]

Thanks for your responses! I am really anxious about the appropriate timing for the follow up scans and for the RPLND surgery..
The completion of chemo was at 19/6 and the end of the 21 days cycle is at 5/7. His Dr said to do the scans at 18/7 (4 weeks from his last VIP chemo shot) and then we are going to schedule the PC- RPLND, if it is necessary. Taking into account that the surgery should be performed 4-6 week after chemo is it dangerous for a possible relapse if we couldn't manage to schedule the surgery in the two remaining weeks?

[jpboucher]

I don't think so.

Here are the odds of what's left after chemo :

- 70 % necrosis : no problem to wait
- 25 % teratoma : slow growing, so no problem to wait a couple of weeks
- 5 % active cancer : might be a problem if agressive tumor, but usually no problem if we're talking in term of weeks.

jp

[Vaan]

Thank you for your answer. I thought that the persentages were a bit different (45% Necrosis, 45% teratoma, 10% active cancer). Am I wrong?

[Chemin]

My son was given similar breakdown of percentages as jp mentioned. The ctscan was recommended to be done 4-6 weeks after last bleomycin.

[Vaan]

Thanks again for your helpful responses. Maybe the percentages depending on the tumor's synthesis..but I prefer the higher chance of necrosis!

[jpboucher]

Percentages have been taken off this meta-analysis of nearly 600 patients who have PC-RPLND : http://meetinglibrary.asco.org/content/107014-134

Jean-Philippe