Real-Time System Used in Conjunction with Brachtherapy to Fight Cancer

The multidisciplinary team of urologists, surgeons, radiation oncologists, radiation physicists from Kimmel Cancer Center (at Thomas Jefferson University and Thomas Jefferson University Hospital (Philadelphia, PA, USA) and others involved in using the device are hoping that the new federal Food and Drug Administration- (FDA)-approved technology will make an already good system even better, adding scientific precision to a treatment that currently relies mainly on physician experience and skill.

While the system, which is made by Nucletron, a technology company based in Veenendaal, The Netherlands, is only being used for imaging and planning purposes so far; it ultimately will help with the actual placement of the seeds.

"The device is a step above the traditional technique because it makes use of a more sophisticated approach that allows for a coordinated, real-time imaging-based implantation of seeds,” Richard Valicenti, M.D., associate professor of radiation oncology at Jefferson Medical College of Thomas Jefferson University, commented about the Nucletron device.

Patients have two options for treatment for localized, low-risk prostate cancer confined to the prostate: surgery or radiation therapy. In brachytherapy, tiny pellets--seeds--approximately the size of a grain of rice surround the prostate, giving off radiation that travels only a few millimeters to kill nearby cancer cells. The seeds are carefully placed inside the cancerous tissue and positioned to effectively attack the cancer. Brachytherapy has been proven to be very effective and safe, providing a good alternative to surgical removal of the prostate, while reducing the risk of certain long-term side effects, such as impotence. The seed radioactivity decays with time, while the seeds stay within the treatment area.

"This new approach is automated, so what normally takes us many steps to do we can do very quickly,” Dr. Valicenti said, noting that brachytherapy is highly operator-dependent. It gathers the imaging information--the dimensions of the patient's prostate--and downloads this into a computer system, where it is quickly processed.

The clinicians, radiation physicists, and other specialists then specify the parameters of treating the cancer, such as how much dose to give the prostate, how much extra dose to give to the area of the tumor and the positions in which to give the radiation, all in less time than previously possible with standard techniques, according to Dr. Valicenti.

"Up until recently, we would produce a plan in the outpatient setting that we hoped to recapitulate in the operating room,” explained Adam Dicker, M.D. Ph.D., professor of radiation oncology at Jefferson Medical College. "But there was always the concern that what we saw initially might not match the situation later.”

The system provides a multidimensional view of the prostate and the "ability to process and accumulate more precise information, constantly updating and readjusting the treatment plan.”


Related Links:
Kimmel Cancer Center
Nucletron