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Would you re-irradiate a spleen with increasing splenomegaly for a patient with myelofibrosis?

If a patient had a high dose of radiation to the spleen (10 Gy over 5 fractions) over a year ago but with increasing splenomegaly now, would you consider re-irradiation?
2 Answers
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Radiation Oncology · University Hospital Basel
Answered on

Would you care to elaborate a bit more on why such a dose was chosen during the prior treatment and what the result was?

Other than that, I would re-irradiate, however with a low dose, starting with fractions of 0.5-1.0 Gy every other day, and giving the spleen some time to shrink.

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Mednet Member
Mednet Member
Radiation Oncology · Marshfield Clinic - Rice Lake
Answered on

In patients for splenic re-irradiation, I generally look to the dose they had previously to determine the starting point for the current course, but given this patient's initial dose of 2 Gy/fx, I don't think I'd go with that approach.

I'd probably give 1 Gy/fx for five fx, treating daily, then wait...

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