One Dose, One Time Early Stage Breast Cancer Treatment
19th September 2013
One Dose, One Time Early Stage Breast Cancer Treatment Comes to New Zealand
A team of Auckland breast cancer specialists is bringing an innovative one dose, one time treatment for women with certain types of early-stage breast cancer to New Zealand.
Focus Radiotherapy, a New Zealand clinician-owned specialist radiation therapy service is introducing the new treatment option using the Zeiss Intrabeam intraoperative radiotherapy (IORT) system to the Southern Cross Hospital, North Harbour Auckland and intends to make it available to women across the country.
The new treatment means a reduction in radiation treatment time for the patient; minimised exposure to healthy tissue and organs, such as the ribs, lungs, heart and opposite breast; no treatment delay for patients who must also undergo chemotherapy as part of their breast cancer treatment; and same day treatment with no hospitalisation required.
One of the founders of Focus Radiotherapy, Auckland Breast Surgeon Dr Erica Whineray Kelly says: `This may be an excellent therapy option for women having breast-conserving surgery, also known as a lumpectomy. We are the first and only centre in New Zealand offering this revolutionary treatment. The Intrabeam system is used to deliver a prescribed dose of radiation during breast conserving surgery. The goal of this approach is to destroy remaining cancer cells, helping to prevent the possibility of recurrence – and in most cases – eliminating the need for weeks of radiation treatments. Women who have been diagnosed with early-stage breast cancer should talk with their doctor about whether this treatment is right for them.’
Chairperson of the Breast Cancer Aotearoa Coalition (BCAC), Libby Burgess, says Intrabeam is a wonderful innovation for women with low-risk early breast cancer: ‘The delivery of surgery and radiotherapy during a single operation will eliminate weeks of daily trips to the clinic, allowing women to avoid ongoing stress and inconvenience and return to their normal lives much faster.
‘The precise targeting of radiation to the area that the tumour was removed from will avoid unnecessary radiation to healthy tissue. I’m delighted to see this option being offered to New Zealand women’, Ms Burgess says.
Currently only women who have early-stage breast cancer, have negative lymph nodes and are 50 and older may be candidates for Intrabeam. The clinically documented treatment delivers a single fraction of radiotherapy in 20-30 minutes during the time of lumpectomy. Other forms of radiation therapy can require three to six weeks of treatment.
‘With this new less-invasive treatment, the small spherical tip of a miniaturized radiation device is inserted into lumpectomy incision, Dr Whineray Kelly explains. ‘The therapy is delivered while the patient is still asleep from the lumpectomy. No additional surgery is needed, and both treatment time and radiation exposure are reduced. This can contribute significantly to helping patients get back to their lives more quickly.’
Localizing the radiation inside the breast is effective because this is where cancer is most likely to recur. The international TARGIT research group has been investigating this new method of delivering radiotherapy for breast cancer in which the treatment can be delivered at the time of surgical lumpectomy since 1988. The results of the trial show the overall number of recurrences of the cancer was very low (1).
Dr Whineray Kelly adds: `Radiotherapy delivered at the time of surgery is an exciting advancement. By delivering radiation intraoperatively, primarily the tumor bed is targeted, therefore patients benefit from less ‘scatter radiation’ to the lungs and heart, and fewer cosmetic problems with the breast.’
Intrabeam can also be used for a boost treatment during surgery and to deliver a prescribed dose of radiation therapy in conjunction with whole breast radiation.
How INTRABEAM Works
Step 1. INTRABEAM IORT is delivered during the lumpectomy procedure, immediately following tumour removal
Step 2. After the surgeon has removed the tumour, the radiation oncologist positions the INTRABEAM applicator in the area of the breast where the tumour was located.
Step 3. Low energy radiation is delivered locally to the targeted tissue in the tumour bed, minimizing healthy tissue exposure to radiation.
Step 4. After 20-30 minutes of radiotherapy, the applicator is removed and the surgeon then closes the incision.
Benefits of INTRABEAM
• A reduction in radiation treatment time for the patient
• Minimized exposure to healthy tissue and organs, such as the ribs, lungs, heart and opposite breast
• No treatment delay for patients who must also undergo chemotherapy as part of their breast cancer treatment
• Same-day treatment with no hospitalisation required
• No travel required to a radiotherapy centre for up to six weeks of daily treatment
1) Vaidya JS, Joseph DJ, Tobias JS,
Bulsara M, Wenz F, Saunders C, et al. Targeted
intraoperative radiation therapy versus whole breast
radiation therapy for breast cancer (TARGIT-A trial): an
international, prospective, randomised, non-inferiority
phase 3 trial. The Lancet 2010; 376: 91 - 102
Vaidya et al. “Targeted intraoperative radiation therapy for early breast cancer: TARGIT-A trial – updated analysis of local recurrence and first analysis of survival”. San Antonio meeting 2012, S4-2.