Using Shaped-Beam Technology, New Study at University of Rochester Cancer Center Takes Aim at Liver and Breast Cancers
URCC First in U.S. to Use New Brain Tumor Technology for Other Cancers
October 04, 2000
The University of Rochester Medical Center is the first facility in the U.S. to begin using new Shaped Beam Surgeryä called Novalisä on cancers involving the liver and breast. The University is the first to use the revolutionary technology -- originally designed for precision treatment of tumors in the brain -- on cancers in other areas of the body.
The Novalis shaped-beam technology, a form of stereotactic radiosurgery, is a non-invasive radiation treatment that sends shaped beams of targeted ionizing rays into a specific area of the body, destroying and shrinking only cancerous or abnormal cells within the tumor. With Novalis, the beam is shaped to mirror the exact size and dimension of the tumor.
The two studies - one focusing on liver cancer and one on breast cancer that has spread to other parts of the body (metastatic cancer) - will enroll between 150 and 200 patients each and are attempting to control these cancers that are often fatal. The liver study, will involve those patients with advanced forms of liver cancer - either originating within the liver or metastatic - who have not responded to chemotherapy treatment or have never received chemotherapy. The breast cancer study, which is in the final stages of approval, will involve those patients with cancer that has already spread from the breast to other parts of the body, but have fewer than five metastases (tumors) throughout the body.
An estimated 41, 200 will die in the year 2000 from breast cancer. And, of the more than 77,000 deaths each year from breast and prostate cancer, approximately 50% are associated with some form of metastatic liver cancer.
"We're changing our whole approach to treating cancer that's spread to the liver by focusing our efforts and the shaped beams of our radiation directly at the metastatic tumors itself," said Dr. Paul Okunieff, chair of the Department of Radiation Oncology and co-director of the Robert J. Flavin Shaped Beam Surgery Center at the University of Rochester Medical Center.
Dr. Okunieff is also former chief of Radiation Oncology at the National Cancer Institute (NCI). "In many cases, it's the cancer that has spread from elsewhere that proves fatal, not the original cancer. With this new approach, we're hoping to stop it from continuing on its deadly path - especially in the liver."
Shaped-Beam Technology Gives Doctors at URCC New Hope
According to Dr. Okunieff, preliminary studies conducted at the University of Rochester have indicated that focusing treatment on metastatic tumors in the liver using stereotactic radiosurgery has produced extremely promising results, citing cases in which tumors in the liver treated with radiation have been eliminated, with no reoccurrence of the cancer months or even years after treatment. Prior to the treatment with stereotactic radiosurgery, Dr. Okunieff said some patients showed signs of cancer growth despite the use of chemotherapy. Therefore, Dr. Okunieff's study protocol will use a combination of chemotherapy to treat micro-metastases within the body (those tumors too small to be detected by conventional imaging techniques) and shaped-beam surgery to stop the growth of larger tumors, especially those fatal ones located in the liver.
"We feel that using both chemotherapy in conjunction with the Novalis shaped beam radiosurgery will give us a 'one-two punch' that will knock out the cancer permanently," Okunieff said.
Novalis: Shaping A New Era in Tumor Treatment
Traditional radiosurgery devices use a series of circular beams which are aligned together and directed at the tumor. However, due to the irregular or asymmetrical shapes of most tumors and lesions, overlaps in the circular radiation beams could affect healthy organ tissue surrounding the tumor. This can pose serious limitations because destroying even a relatively small amount of organ tissue at the edges of a patient's cancer can effect the ability of the organ to perform the essential functions needed. Shaped-beam surgery enables physicians to conform the radiation to the exact and precise dimensions of the tumor, helping to ensure that only the diseased cells of the tumor receive the specified doses of radiation.
"We can now bring the pinpoint precision needed to treat brain tumors to other parts of the body, and that's an important milestone for us. It means that we can now focus on an entire range of cancers that are attacking the body," said Robert J. Maciunas, MD, Chair of the Department of Neurosurgery at University of Rochester and CO-Director of the Robert J. Flavin Shaped Beam Surgery Center.
Shaped-beam surgery with Novalis uses precise, detailed computer-generated images that mirror the exact shape and size of the tumor. Each beam of radiation can then be shaped to conform to the exact dimension of a patient's tumor - specifically targeting and treating diseased tissue while leaving neighboring healthy liver tissue unharmed. The flexibility of the new Novalis system also allows doctors to "fractionate" the radiation directed at the tumor, or deliver small doses of radiation each day over the course of several days of treatments. This enables the radiation oncologists to treat large tumors or lesions and lower the risk of complications and side effects.
The University of Rochester Cancer Center was one of the first designated centers of the National Cancer Institute when the War on Cancer was declared by the Nixon administration in 1974. It is the major resource for diagnosis and treatment of cancer in the Greater Rochester and Finger Lakes region - offering comprehensive care for all forms of cancer in both adults and children. The University of Rochester Cancer Center is among a small handful of centers in the U.S. to introduce Novalis technology.
Novalis is a product of BrainLAB AG, a leading innovator in the development and distribution of medical equipment and software systems for the field of neurosurgery and radiosurgery. With headquarters in Munich, Germany, BrainLAB has more than 200 employees worldwide. In 1996, BrainLAB formed a strategic partnership with Varian - an international electronics company and world leader in radiotherapy equipment that designs, manufacturers, and markets high technology systems and components for applications in worldwide markets - to develop Novalis. Varian is a world leader in the design and production of equipment for treating cancer with radiation