Technological Advances in Radiation Oncology

Rakesh Patel, MD; Advancements in Technological RadiationThe following question was answered byRakesh Patel, MD, (pictured left) an associate professor in the Department of Human Oncology, UW School of Medicine and Public Health. As a radiation oncologist, his area of focus is on breast cancer, specifically focusing on targeted radiation with brachytherapy.
Q. What technological advancements have been seen in radiation oncology at the University of Wisconsin?

A. Over the last decade the UW Carbone Cancer Center has played a leading role in developing several key innovative strategies that allow targeted delivery of radiation therapy. The primary aim of these efforts has been to maximize cancer cell kill while minimizing damage to nearby healthy tissues. UW researchers are now exploring the use of these relatively new technologies in combination with novel drugs and functional imaging studies to further improve the therapeutic ratio. A few of these approaches include:

Brachytherapy: a form of treatment in which radioactive seeds are placed in or around a tumor, giving a high dose of radiation directly to the cancerous tumor instead of using penetrating external x-rays. This can be done with permanent "low-dose rate" seeds using Iodine or Cesium for prostate cancer or with a "high-dose rate" (HDR) Iridium seed, which is temporarily placed within applicators and is used for breast, cervical, endometrial, lung and prostate cancers. UW has one of the largest HDR brachytherapy programs in the country led by Kristin Bradley, MD for gynecologic malignancies and Rakesh Patel, MD for prostate and breast cancers.

Stereotactic radiosurgery: a focused method of giving a single high dose of radiation to a small area within the brain or lung, thereby avoiding the need for an invasive surgical procedure. The radiation is delivered from multiple angles to allow minimization of radiation toxicities. The internationally renowned program was started by Minesh Mehta, MD who is currently the Principal Investigator in National Cancer Institute-sponsored studies to learn how best to combine this approach with various forms of drug therapy.

Helical Tomotherapy: a novel, highly-precise form of intensity-modulated radiotherapy that was invented and developed by UW researchers including Rock Mackie, PhD. Tomotherapy combines a megavoltage CAT scanner with a helical radiation delivery system, which allows 3-D imaging verification of a tumor's size, shape and location immediately prior to delivering conformal radiation. Tomotherapy affords unprecedented accuracy in delivering radiotherapy, and ensures normal tissues are protected to the fullest possible extent. This results in a significant decrease in side effects and allows for complex treatment plans that previously were not possible. Since the first unit was placed in the UW Carbone Cancer Center more than seven years ago, this technology has spread around the world.

Overall, the technological advances in radiation oncology are aimed at optimizing cancer control rates and improving patient quality of life while minimizing potential side effects.

Date Published: 08/11/2008

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