Personalized Radiation Therapy During - Instead of After - Surgery
New York, NY — In 2012, NewYork-Presbyterian Hospital became the first hospital in New York City to offer Intraoperative radiotherapy (IORT) to women with certain breast cancers. IORT represents an effort to reduce the chance of a recurrence, shorten the duration of conventional postoperative external radiation, and reduce the risk to healthy tissue associated with external radiation. Since then, NewYork-Presbyterian/Columbia University Medical Center has been finding new ways to use individualized, internal radiation delivered in the operating room immediately after a cancer tumor is removed.
Now, physicians at NewYork-Presbyterian/Columbia are expanding these pioneering efforts by offering IORT for other types of cancer in the abdomen and pelvis. Unlike that in the breast, the tumor bed in the abdomen and pelvis may not be as clearly defined after surgery, and several sites at risk for recurrence may need to be treated.
Earlier this year, in the hospital’s first case of using IORT for a cancer other than breast cancer, a woman with recurrent colon cancer in the pelvic cavity needed to have treatment to separate areas of her body. The surgeon, Ravi Kiran, MD, the Kenneth A. Forde Professor of Surgery (in Epidemiology) and chief of colorectal surgery at NewYork-Presbyterian/Columbia, removed the tumor, but could not cut too close to vital blood vessels and other organs. Because of the limitations of surgery, and because the patient had already received a high lifetime cumulative dose of radiation therapy in previous treatments, Dr. Kiran and Clifford Chao, MD, the Chu H. Chang Professor of Radiation Oncology and chair of radiation oncology at NewYork-Presbyterian/Columbia, decided to use IORT to “mop up” any leftover tumor cells. Dr. Chao used a flat radiotherapy applicator to deliver radiation to areas close to blood vessels along the pelvic wall and a spherical applicator to treat a region lower in the pelvic cavity. “We also used a protective wrap, or draping, made of material that shields organs like the bowel or blood vessels from scatter radiation,” Dr. Chao said. Continue>
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