脑癌患者，家住Fremont，需要去UCSF做放疗吗？

老爸glioblastoma,脑部手术在Fremont Washington hospital做的，接下来的放疗也约了本院的Bogdan Eftimie来做。但看了他的专长是不在脑部。Dr. Eftimie earned his medical degree at Loma Linda University, his internship and residency at Loma Linda University and his fellowship at the University of California San Diego. His clinical interests include gastrointestinal, lung, melanoma and benign hematology.

我在想有没有必要带老爸去UCSF 给专门的 neuro- oncologist 看一下。不太清楚放疗是不是找最好的放疗专家才好。

请问大家有经验吗？谢谢。

最好约脑专家，gbm的标准化疗药没几个，选择很少，可以约gbm专家给治疗方案，然后治疗在本地医院进行化疗

最好找一下second 和third opinion。UCSF和斯坦福都有second opinion program。oncologist和radiation oncologist都看一下比较好。
再看看是不是要上keto diet，据说对脑癌很有效。
祝福。

Bless

回复 1楼maroonfan的帖子

GBM 找neurooncologist 看，不要图省事

最好约脑专家，gbm的标准化疗药没几个，选择很少，可以约gbm专家给治疗方案，然后治疗在本地医院进行化疗
poke 发表于 1/2/2020 2:51:08 PM

请问脑专家的英文是什么？ 谢谢。

最好找一下second 和third opinion。UCSF和斯坦福都有second opinion program。oncologist和radiation oncologist都看一下比较好。
再看看是不是要上keto diet，据说对脑癌很有效。
祝福。
piggie1981 发表于 1/2/2020 2:51:40 PM

oncologist 也有很多细分的吧。是哪一个啊。

这个是脑手术以后的MRI 结果。大家给看一下，是啥情况？

FINDINGS:

CEREBRUM:There has been resection of the complex cystic mass from the

medial aspect of the posterior right parietal lobe. There are

postoperative residuals measuring approximately 3.5 by 2.7 x 3.5 cm.

There is a small additional component extending to the cortex in the

posterior superior aspect. There is intrinsic increased signal

intensity along the periphery of the lesion as well as susceptibility

artifact consistent with products of hemorrhage. No specific

abnormal enhancement of the surgical margin is demonstrated to

suggest residual tumor. There is persistent surrounding white matter

edema with persistent mass effect on the posterior aspect of the

right lateral ventricle. There is mild edema of the right parietal

lobe. There is no shift of midline structures. No other abnormal

areas of enhancement are demonstrated.

CEREBELLUM:No edema, hemorrhage, mass, acute infarction, or

inappropriate atrophy.

BRAINSTEM:No edema, hemorrhage, mass, acute infarction, or

inappropriate atrophy.

CSF SPACES:No dilatation of the ventricles is demonstrated. No

extra-axial fluid collections are identified..

SKULL:There is a right posterior parietal craniotomy with overlying

scalp swelling.

SINUSES:Limited views demonstrate no significant mucosal thickening

or fluid.

ORBITS:Limited views are unremarkable.



CONCLUSION:

Status post resection of a complex cystic mass from the medial

posterior right parietal lobe. The surgical cavity is smaller than

the previous lesion. There is a small area of surgical extension to

the posterior superior cortex. There is hemorrhage and surgical

residual along the margin of the surgical cavity but no focal

abnormal enhancement is demonstrated to suggest residual tumor.

There is persistent edema of the adjacent white matter with mass

effect on the posterior aspect of the right lateral ventricle. There

is mild edema of the right parietal lobe but no shift of midline

structures.