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and treatment of prostate cancer |
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two states throughout the United States to treat our patients |
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types of cancers we specialize in treating and the most common procedures for each |
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techniques and the continuously improving technologies used in prostate brachytherapy |
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Southwest Oncology Centers is pleased to announce the acquisition of the Xoft electronic brachytherapy system, which can be operated at either our Scottsdale or Glendale office. This system uses a miniature linear accelerator, which can be introduced into the cavity of an afterloading device, to produce a low energy X-ray beam. An afterloading device is a hollow plastic tube which can be inserted into a natural cavity such as the vagina, or a surgical cavity like the space present after performing a lumpectomy for early breast cancer. It can also be applied to the surface of the body in the treatment of shallow skin cancers. The Xoft device can be moved in and out of the afterloading device to produce symmetric or asymmetric dose delivery at a predetermined distance from the surface of the device. Each treatment generally will require less than 15 minutes to perform.
At the present time this system can be used with a variety of inflatable ellipsoidal or spherical balloon catheters to deliver Accelerated Partial Breast Irradiation (APBI) of selected early breast cancers. APBI consists of giving two treatments per day, separated by 6 or more hours over a 5 day period. The ultimate local cancer control rates and cure rates with APBI have been demonstrated to be comparable to the more conventional 6 week course of once per day, 5 days per week treatment of the entire breast, for selected cases of women who have undergone a successful lumpectomy and a lymph node sampling procedure. The Xoft balloon catheters also contain multiple small tubes which can be used to remove liquid, called seroma fluid, which can accumulate in the lumpectomy cavity, and limit the usage of the Mammosite APBI device which, in turn utilizes a single radioisotope source to deliver the radiation. Since X-rays are produced by the Xoft system only when the power source is turned on, and these X-rays are of a much lower energy than the Gamma rays emitted by radioisotope sources, most of the radiation is absorbed within the breast. Somewhat less radiation will reach the skin than would occur with radioisotope therapy, and women treated with APBI using the Xoft system do not have to be isolated in a room which has been shielded for radioactivity. A flexible leaded pad placed directly over the treated breast provides adequate shielding of personnel or family members who might be present during a treatment, which conceivably could take place in a comfortable examination room with windows.
Some women are not good candidates for APBI using either electronic or isotope brachytherapy because the shape of their lumpectomy cavity is too irregular or too close to their skin. If they would otherwise be good candidates for APBI, many of these women can still be treated image guided intensity modulated helical Tomotherapy, again using two treatments per day, separated by 6 or more hours over a 5 day period. We have treated several women in this fashion with minimal side effects.
The Xoft system can also be place in a variety of cylindrical plastic afterloading devices, which can be temporarily inserted into the vagina. This is a useful treatment for certain stages of endometrial, or uterine cancer, following a hysterectomy, or removal of the uterus by a Gynecologic Oncologist. Depending upon the size, location, and microscopic appearance of an endometrial cancer, some women are at particularly high risk of recurrence in the vagina or underneath its surface. These women are usually treated with a series of 3 – 6 intracavitary radiation treatments over 2-5 weeks. Once again, a flexible leaded pad placed directly over the genital area provides adequate shielding of nearby personnel and the treatment conceivably could occur in a comfortable examination room.
The Xoft system has also been adapted to treat superficial skin cancers, which are located in areas such as the eyes, ears, nose, and lips, where surgical removal could result in a permanent cosmetic deformity. In this case the radiation source is maintained at a fixed distance from the surface of the cancer , and treatments are given on a daily basis for 5-7 weeks.
Both Dr. Sapozink and Dr. Grado have extensive experience in the use of High and Low Dose Rate brachytherapy of Gynecological malignancies using radioisotope delivery systems. They look forward to using electronic brachytherapy for Gynecological applications because of the potential improvement in ease of use and patient safety. Dr. Sapozink has also supervised over one hundred APBI treatments and hopes that electronic brachytherapy in this setting may expand the number of women who would be candidates for this procedure, and improve the comfort of women who ultimately undergo it. Both Drs Grado and Sapozink have extensive experience treating skin cancers with other techniques as well.
