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Dec. 12, 2001 |
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Delivering high-dose radiation directly to kids' tumors COLUMBUS, Ohio -- Dec. 12, 2001 (Cancer Digest) -- Placing high doses of radiation directly in contact with malignant tumors for a short time during surgery shows promise in treating certain childhood cancers. After removing the bulk of the tumor through surgery, the physicians apply radiation via a thin tube that can be directed to the hard-to-reach the tumor site. The radiation treatment itself lasts 15 to 20 minutes. The catheter is then removed and the wound is stitched. Healthy tissues surrounding the tumor are temporarily moved an inch or two away from the tumor during the radiation treatment in order to reduce the exposure of these tissues to the radiation. Eleven of 13 children in an Ohio State University study remained cancer-free an average of four years after treatment with the technique called intraoperative high-dose-rate brachytherapy (IO-HDRBT). Dr. Subir Nag, chief of brachytherapy and professor of clinical radiology at the Comprehensive Cancer Center at Ohio State says 10 of the surviving children were treated during advanced stages of their diseases. "Most of the children in the study likely would have died if we hadn't used this treatment," said Subir Nag in a press release. The technique is particularly useful in children whose small size can sometimes prevent surgeons from using other methods to completely remove tumors located in hard-to-reach areas of the body, such as the base of the skull and the sides of the pelvis and the abdomen. It's especially useful in treating children, . The research appears in a recent issue of the International Journal of Radiation Oncology, Biology, Physics. Nag and his colleagues treated 13 children, ages 2 to 14, during a seven-year period. Each child had cancer of a soft tissue, such as rhabdomyosarcoma (a cancer of muscle tissue) and chondrosarcoma (a cancer of the cartilage). All children were treated with the high-dose brachytherapy in conjunction with radical surgery, chemotherapy and external beam radiation therapy (a treatment that targets the tumor through layers of healthy, normal tissue). "A single dose of high-dose radiation isn't enough to eradicate the disease, but applying the one-time high dose of radiation right at the site of the tumor reduces the dose of radiation to healthy tissues, which can hamper bone formation, for one thing," Nag said. "We try to avoid or minimize using external radiation in children as much as possible. But avoiding it sometimes means that the tumor returns. Brachytherapy lets us apply radiation directly to the tumor site, in turn giving them more control over the area. As a result, lower levels of external radiation and other cancer-fighting treatments need to be used." A technique comparable to IO-HDRBT, simply called high-dose-rate brachytherapy, involves leaving the catheter in place in the tumor site for up to a week. In these cases, the tumor is usually very small, as is the radiation risk to surrounding tissues. Typically there is no need for additional treatments. Nag says however, leaving a catheter in place for several days can be problematic in small children . "Some patients don't fit the criteria for high-dose radiation brachytherapy," Nag said. "Leaving the catheter in for an extended time period is very difficult in young children. The intraoperative technique allows us to be more precise in directing exactly where the radiation goes without having to leave catheters in place." |
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