RPCI Uses "Dose-painted" Radiation Therapy to Improve Quality of Life for Anal Cancer Patients

Buffalo, NY - Most patients with anal cancer receive radiation as part of their treatment plan, but the anus is “a very sensitive area of the human body, almost like the fingertips,” notes Gary Yang, MD, Director of Gastrointestinal Radiation Medicine at Roswell Park Cancer Institute (RPCI). That’s of special concern, because radiation can burn the skin and cause other side effects that can bring treatments to a halt. “And if the patient has to take a break during treatment, you’re giving the tumor a break, too,” says Dr. Yang, who also serves on the National Comprehensive Cancer Network (NCCN) Esophageal/Gastric Cancers Guidelines Committees.

RPCI is among only a handful of centers in North America that use “dose-painted” intensity-modulated radiation therapy (IMRT) to precisely target anal tumors with high-dose radiation while minimizing the exposure of healthy tissue in the small bowel, bladder, external genitalia, skin and bone marrow.

“We can spare the anal sphincter so a patient doesn’t have to have a colostomy bag,” he adds. “With a combination of chemotherapy and dose-painted IMRT, 75% of patients should be able to avoid lifelong colostomy resulting from anal surgery. There’s better quality of life, and a better outcome, because there are no interruptions to treatment.”

While IMRT is used widely for treating other cancer sites, “it has not been implemented for anal cancer [at most institutions], due to the level of technology and support it requires,” says Dr. Yang. “You can have a top-of-the-line machine, but you also need highly experienced cancer specialists, dosimetrists, physicists and support staff working together to determine the best treatment plan.”

source: Roswell Park Cancer Institute

RPCI Uses "Dose-painted" Radiation Therapy to Improve Quality of Life for Anal Cancer Patients

Buffalo, NY - Most patients with anal cancer receive radiation as part of their treatment plan, but the anus is “a very sensitive area of the human body, almost like the fingertips,” notes Gary Yang, MD, Director of Gastrointestinal Radiation Medicine at Roswell Park Cancer Institute (RPCI). That’s of special concern, because radiation can burn the skin and cause other side effects that can bring treatments to a halt. “And if the patient has to take a break during treatment, you’re giving the tumor a break, too,” says Dr. Yang, who also serves on the National Comprehensive Cancer Network (NCCN) Esophageal/Gastric Cancers Guidelines Committees.

RPCI is among only a handful of centers in North America that use “dose-painted” intensity-modulated radiation therapy (IMRT) to precisely target anal tumors with high-dose radiation while minimizing the exposure of healthy tissue in the small bowel, bladder, external genitalia, skin and bone marrow.

“We can spare the anal sphincter so a patient doesn’t have to have a colostomy bag,” he adds. “With a combination of chemotherapy and dose-painted IMRT, 75% of patients should be able to avoid lifelong colostomy resulting from anal surgery. There’s better quality of life, and a better outcome, because there are no interruptions to treatment.”

While IMRT is used widely for treating other cancer sites, “it has not been implemented for anal cancer [at most institutions], due to the level of technology and support it requires,” says Dr. Yang. “You can have a top-of-the-line machine, but you also need highly experienced cancer specialists, dosimetrists, physicists and support staff working together to determine the best treatment plan.”

source: Roswell Park Cancer Institute

Novel Radiation Therapy to Treat Lung Cancer Used for the First Time in United States, at New York Hospital Queens

FLUSHING, N.Y., Dec. 17 /PRNewswire-USNewswire/ -- A 58-year-old man who lives in Corona, Queens came to the emergency room of New York Hospital Queens (NYHQ) with extreme pain and tingling in his left arm. Although he did not realize it at the time, he had lung cancer. Recently, he made medical history as the first patient in the United States to be treated for lung cancer through the use of radioactive pellets placed directly in the tumor, and today his recovery is going well. Known as brachytherapy, this treatment approach is commonly used to treat prostate cancer.

"Although the patient came in because of pain in his arm, it was not due to an injury. It was discovered that the cause was a Pancoast tumor, a tumor in the lungs that affects the arms and shoulders but rarely causes symptoms, such as cough or shortness of breath, typically associated with the lungs," according to Dattatreyudu Nori, M.D., chairman, Radiation Oncology.

The patient was treated with high dose chemotherapy and then underwent treatment with external beam radiation. Although he did have some positive response, the tumor was still present. Because of the location of the tumor, the NYHQ physicians knew that additional conventional treatment could endanger surrounding critical structures including nerves and vessels, and could affect the other organs of his body.

With the options becoming limited, Dr. Nori, along with colleague Paul C. Lee, M.D., the hospital's vice chairman of cardiothoracic surgery, decided to perform a surgical resection of the tumor and then implanted the tumor bed with radioactive Cesium 131 pellets -- in a new type of brachytherapy procedure. Brachytherapy involves the implantation of radioactive seeds into the tumor site to kill the remaining cancer cells after surgical resection, while limiting the damage to healthy tissue. Brachytherapy has been successful in treating prostate cancer, but had never been used to treat this form of aggressive lung cancer.

source: PR Newswire

European Radiotherapy Pioneers Deliver First Varian RapidArc™ Treatment for Rectal Carcinoma Patient

GHENT, Belgium, Dec. 15 /PRNewswire-FirstCall/ -- Ghent University Hospital in Belgium, among the first hospitals in the world to pioneer radiotherapy treatments using arc therapy, has carried out its first treatment using fast and efficient RapidArc radiotherapy technology from Varian Medical Systems (NYSE: VAR). A 56-year-old male rectal carcinoma patient was treated in just 75 seconds, over four times faster than possible using conventional fixed-beam treatments.

"This treatment would have taken more than five minutes using conventional intensity-modulated radiotherapy and such time-savings are very important both for the wellbeing of the patient and the efficiency of the hospital," said Professor Marc van Eijkeren, head of Ghent University Hospital's Department of Radiation Oncology. "We were able to achieve an increase in dose to the tumor while using far fewer monitor units of radiation to achieve this. Indeed, there was threefold reduction in monitor units used, which is helpful in tissue sparing and increasing patient comfort."

"We are a busy university hospital and we are under constant strain to deliver advanced IMRT treatments within our standard 15 minutes treatments slots," he added. "With RapidArc, that will no longer be a problem as we will be able to offer advanced conformal treatments to more patients while reducing our treatment slot times."

source: Varian

New Study Questions True Favorability of Rare Breast Cancer Type

ScienceDaily (Dec. 12, 2009) — In a large review of breast cancer patients with mucinous carcinoma, researchers at The University of Texas M. D. Anderson Cancer Center have identified an association between this rare type of breast cancer long-associated with a favorable prognosis and multiple tumors undetected by mammography or ultrasound.

The study, presented December 12 at the CTRC-AACR San Antonio Breast Cancer Symposium, is the first to observe this negative association and should caution those caring for mucinous breast cancer patients that more, not less, therapy, as well as additional screening may be needed for a select group of these patients, said George Perkins, M.D., associate professor in M. D. Anderson Department of Radiation Oncology and the study's first author.

Mucinous breast cancer, also known as colloid carcinoma, is a rare type of invasive breast cancer formed by mucus-producing cancer cells. Perkins estimated that the disease accounts for approximately two percent of all breast cancers diagnosed. The prognosis for mucinous carcinoma is thought to be better than for the more common types of invasive breast cancers."

"While mucinous breast cancer is thought to be a disease with a favorable prognosis, our study is the first to identify it as one associated with significant multifocal presentation -- a potentially unfavorable aspect with a subtype long thought to be extremely favorable," said Perkins.

source: Science Daily Release

TomoTherapy Introduces Radiation Oncologist Training Program

MADISON, Wis – December 8, 2009 – TomoTherapy Incorporated (NASDAQ: TOMO) announced today that it has expanded its Institute of Learning curriculum to include a course for radiation oncologists. The course, which is being offered in partnership with Monmouth Medical Center of Long Branch, N.J., is designed to introduce physicians to the fundamentals of the TomoTherapy® platform and its use in a clinical setting.

The radiation oncologist course on TomoTherapy technology is collaboratively taught by physicians Mitchell Weiss, M.D., and Sang Sim, M.D., along with physicist Jack Yang, Ph.D., all of whom are members of Monmouth’s radiation oncology team and have been using TomoTherapy technology since 2008.

“Hosting this type of program allows us to share our TomoTherapy experience with others, so they can smoothly transition to the TomoTherapy platform,” said Dr. Weiss. “At the same time it allows for collaboration and for the opportunity to learn from each other.”

The new training course was piloted in November 2009 at Monmouth Medical Center. Four physicians from TomoTherapy treatment centers around the world attended the three-day course focused on peer-to-peer learning. According to James Coster, M.D., a radiation oncologist with US Oncology, Inc., affiliate Kansas City Cancer Center, the new program addresses an important need. “From expanding what I consider an appropriate range of applications to improving treatment planning strategies, the M.D. training course was extremely valuable to me as a new user,” said Dr. Coster. “Instruction like this should accelerate one’s ascent up the learning curve for this unique technology.”

source: TomoTherapy

Published Study Highlights Advantages of SAVI Breast Cancer Radiation Therapy

ALISO VIEJO, Calif.--(BUSINESS WIRE)--The SAVI™ applicator for breast brachytherapy is a safe, effective therapy for breast cancer, according to a newly published study in a peer-reviewed journal. The study showed that SAVI’s unique design provides fewer complications, excellent cosmetic results, outstanding dosimetry and increases the number of women eligible for breast brachytherapy.

The study was conducted by researchers at the Moores UCSD Cancer Center and published in the October-December 2009 issue of the prestigious Brachytherapy journal.

Researchers found that radiation exposure for healthy tissue was “exceedingly low” because of the multi-catheter design of SAVI. No serious complications were reported, including no symptomatic persistent seromas, no persistent edema or breast pain. There was one case of asymptomatic fat necrosis reported at the 18-month follow-up mammogram. There were no local recurrences of cancer.

The study was a retrospective review of the first 30 patients to receive treatment with SAVI at the Moores UCSD Cancer Center. The median follow-up for the subjects was 12 months.

“Great progress has been made in breast brachytherapy technology,” said lead author Catheryn Yashar, M.D. “With SAVI, we seem to have a device that overcomes some of the most significant drawbacks of other methods. The device’s versatility means that many more women can take advantage of the convenience of breast brachytherapy, and be confident in its safety and results.”

source: Business Wire

Polymer Therapeutic Protects Gut From Radiation Damage, Infection After Cancer Treatment

A non-absorbed, oral co-polymer therapy under development by Midway Pharmaceuticals demonstrated the ability to protect against damage to healthy gastrointestinal tissues and to prevent lethal bacterial infections in animal models of radiation damage. The results suggest the compound, a high molecular weight co-polymer of polyethylene glycol (PEG), may provide a new way to prevent serious GI side effects of radiation in patients receiving fractionated radiotherapy for abdominal cancers or in accidental exposures to harmful radiation.

The new results are published online and in the December issue of the American Journal of Physiology by John Alverdy, MD, Director, Center for Surgical Infection Research, University of Chicago, Pritzker School of Medicine and colleagues at the University of Chicago, and University of Arkansas for Medical Sciences and Surgical Service. Dr. Alverdy is a founder of Midway Pharmaceuticals, an emerging specialty pharmaceutical company that is developing the polymer commercially for GI diseases, cancer supportive care and other indications.

source: Medical News Today

Brain Tumor Cells Made More Responsive to Radiation

ScienceDaily (Dec. 3, 2009) — Duke University Medical Center researchers have figured out how stem cells in the malignant brain cancer glioma may be better able to resist radiation therapy. And using a drug to block a particular signaling pathway in these cancer stem cells, they were able to kill many more glioma cells with radiation in a laboratory experiment.

The work builds off earlier research which showed that cancer stem cells resist the effects of radiation much better than other cancer cells.

The Duke team identified a known signaling pathway called Notch as the probable reason for the improved resistance. Notch also operates in normal stem cells, where it is important for cell-cell communication that controls cell growth and differentiation processes. The study was published in late November by Stem Cells journal.

"This is the first report that Notch signaling in tumor tissue is related to the failure of radiation treatments," said lead author Jialiang Wang, Ph.D., a research associate in the Duke Division of Surgery Sciences and the Duke Translational Research Institute. "This makes the Notch pathway an attractive drug target. The right drug may be able to stop the real bad guys, the glioma stem cells."

source: Science Daily Release