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Has anyone gone through the 30gy DART therapy, what is recovery like?

Posted by jagsromp @jagsromp, Jan 21 8:36am

I was diagnosed with HPV tonsil cancer SCC. Did TORS surgery with neck dissection. All margins clear but tumor had PNI-peri neural involvement. They are recommending DART 30gy chemo/ radiation treatment. Has anyone gone through DART 30gy. 2 week treatment? What is recovery like? Swallowing, pain, salivary issues, losing taste buds etc, very nervous trying to make decisions to do therapy or not….

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jfh1970 | @jfh1970 | Jan 25 4:33pm

P.S. If you are having serious throat pain this early in treatment it may be thrush. That happened to me on the same timeframe.

Ask a doc to check. Nystatin worked fast and got me back on track. The bad pain didn’t return until the end of treatment (that was the radiation effect).

Gagging from phlegm was my biggest challenge. Losing all taste is awful too, but I’m three months out now and it’s probably 80% restored.

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woodsy1 | @woodsy1 | Jan 25 6:02pm
In reply to @jfh1970 "@woodsy1 Two weeks Cisplatin, then four more weeks of CarboTaxol (the former was damaging my hearing..." + (show)
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@woodsy1
Two weeks Cisplatin, then four more weeks of CarboTaxol (the former was damaging my hearing so we switched)

28 total proton beam sessions for a total of 56 Gy.

Yes, NavDX test prior to treatment and then again at about 4.5 weeks. Came back at zero allowing me to stop treatment at six weeks of proton/chemo instead of the standard eight (per the DART 2.0 trial design).

I did not have surgery first as my lymph node spread was extensive and up against my carotid artery.

Strongly suggest you continue treatment as long as possible. Best to go through this only once. Also, if it spreads to your lungs (as this diagnosis typically does) it will be considered incurable and further treatment will only be to extend life. We are lucky that P-16+ SCC is exceptionally sensitive to this method of treatment.

Again, good luck. Hang in there!

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@jfh1970
Thanks for sharing all that. I wasn't a candidate for surgery either, similar circumstance
with the lymph node and a 3.5 cm tonsil tumor. No doubt larger by the time I got into treatment 3 mos later after diagnosis.
The NavDx test is available and might have blood drawn for that next week if the VA insurance will cover it.
Find that out tomorrow. you are 3 months out now good luck with the PET scan hope you are clear after all that !
Getting the IMRT photon therapy here so pretty concerned about swallowing issues , other
long term ailments and quality of life if the treatment continues much longer,
I am intrigued by a MSK study showing 2 chemo cycles and 30 gy is effective for non surgical
H&N HPV pos. patients .
https://www.mskcc.org/news/low-dose-radiation-possible-game-changer-treating-hpv-positive-head-and-neck

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jfh1970 | @jfh1970 | Jan 25 8:01pm
In reply to @woodsy1 "@jfh1970 Thanks for sharing all that. I wasn't a candidate for surgery either, similar circumstance with..." + (show)
Profile picture for woodsy1 @woodsy1

@jfh1970
Thanks for sharing all that. I wasn't a candidate for surgery either, similar circumstance
with the lymph node and a 3.5 cm tonsil tumor. No doubt larger by the time I got into treatment 3 mos later after diagnosis.
The NavDx test is available and might have blood drawn for that next week if the VA insurance will cover it.
Find that out tomorrow. you are 3 months out now good luck with the PET scan hope you are clear after all that !
Getting the IMRT photon therapy here so pretty concerned about swallowing issues , other
long term ailments and quality of life if the treatment continues much longer,
I am intrigued by a MSK study showing 2 chemo cycles and 30 gy is effective for non surgical
H&N HPV pos. patients .
https://www.mskcc.org/news/low-dose-radiation-possible-game-changer-treating-hpv-positive-head-and-neck

Jump to this post

@woodsy1 I know photon produces significantly more side effects than proton, but it is equally as effective with this disease.

Suggest you do everything possible to stick it out. When eating becomes nearly impossible, try to sleep more. You’ll be tired anyway and the days go by faster that way.

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woodsy1 | @woodsy1 | Feb 5 7:06am
In reply to @jfh1970 "P.S. If you are having serious throat pain this early in treatment it may be thrush...." + (show)
Profile picture for jfh1970 @jfh1970

P.S. If you are having serious throat pain this early in treatment it may be thrush. That happened to me on the same timeframe.

Ask a doc to check. Nystatin worked fast and got me back on track. The bad pain didn’t return until the end of treatment (that was the radiation effect).

Gagging from phlegm was my biggest challenge. Losing all taste is awful too, but I’m three months out now and it’s probably 80% restored.

Jump to this post

@jfh1970

Good call on the Thrush because that came on strong starting about the 3rd week.
Never had that before and thought those white spots in my mouth and throat were just the effects from chemo/radiation but the Doc diagnosed it properly.
Getting that resolved now.
That is great news you are recovering fairly well from treatments and cancer free to boot !

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