December 4, 2020 by John Fernandez
Brachytherapy: Radioactive Implants to Fight Brain Tumors Mark Pioneering Turn at Miami Neuroscience Institute, Miami Cancer Institute
Brachytherapy is not a well-known term outside of the oncology and neuroscience healthcare fields, but more and more cancer patients are welcoming this treatment option. It refers to internal radiation therapy that uses capsules containing a radiation source implanted within the body.
It allows for the safe placement of the radioactive source, often in or near a tumor, or the cavity that’s left after a tumor has been removed. Actually, brachytherapy has been around for decades, mostly as a treatment for gynecological and prostate cancers.
Now, brachytherapy is being used more often to treat patients with recurring meningiomas, or brain metastases (cancer that has spread from other parts of the body). It is often the go-to therapy after surgeries and more common external radiation treatments have been exhausted.
Brachytherapy Expertise at Miami Neuroscience Institute
Before becoming the new chief medical executive at Miami Neuroscience Institute, part of Baptist Health South Florida, earlier this year, Michael McDermott, M.D., (watch video above) played a pioneering role in brachytherapy as it applies to brain tumors, including the treatment of meningioma, a slow-growing tumor in the head that affects the brain. He co-authored many publications on the subject while at the University of California at San Francisco (UCSF).
Dr. McDermott’s team at the Institute (he is pictured above at left, with neurosurgeon Vitaly Siomin, M.D.) and a team from Miami Cancer Institute, recently performed one of the first brachytherapy procedures in Florida using a new delivery device on a patient with a recurrent brain metastasis. The patient was implanted with specially encased, radiation-emitting cesium-131 capsules that target residual tumor cells. Most of the radiation is emitted over the first 30 days after the surgery.
“Brachytherapy provides us with another alternative for treatment, once some of the other therapies have failed,” explains Dr. McDermott. “So, it’s an additional form of treatment that is new … to our practice here at Miami Neuroscience Institute. I have a lot of experience with brachytherapy over the last 30 years at UCSF before I came to Miami Neuroscience Institute. And I’m delighted that we’re doing it now.”
Miami Cancer Institute has been using other variations of brachytherapy, he emphasizes. “Miami Cancer Institute has a wide variety of treatment options and treatment delivery systems,” says Dr McDermott. “It’s unlike any place in the world that I’ve seen — in terms of the radiation therapy facilities.”
Brachytherapy Expands Range of Radiation Treatment Options
Rupesh Kotecha, M.D., radiation oncologist at Miami Cancer Institute, said brachytherapy is often the best option for patients who have exhausted other external radiation therapies. Those can include an array of prior treatments, such as GammaKnife, CyberKnife, or even proton therapy, which targets tumors precisely and spares healthy surrounding tissue. (Proton therapy was introduced at Miami Cancer Institute nearly three years ago.)
“The benefit of brachytherapy is that you’re actually putting the high dose of radiation therapy directly to the area of tumor or disease, and you’re minimizing the dose of radiation to the remainder of the brain,” explains Dr. Kotecha. “So, there’s radiation properties that can be exploited by doing brachytherapy, which is why for over 50 years brachytherapy has been around as a form of radiation therapy.”
Brachytherapy implants emit most of their radiation after a relatively short period of time. When first put in place, the patient may need to limit his or her time around other people and take other safety measures. After surgery, a patient will likely need to wear a lead-lined cap to “absorb some of that additional energy when the radiation dose rate and activity is at its highest,” adds Dr. McDermott.
“One of the things that patients need to be aware of is that because the radioactive source is implanted into the tumor cavity, they are safe,” said Dr. McDermott. “They are not excreting radioactive material in their urine or in their stool. And the skull is one of the best absorbers of radiation therapy.”
In a study published this year co-authored by Dr. McDermott, the findings indicate that brachytherapy for recurrent and high-grade meningiomas is showing “good long-term survival” and that it may be a good option for “recurrent high-grade tumors.”
“I’m happy to be able to add brachytherapy to the armamentarium of options for treating patients at Miami Neuroscience Institute,” says Dr. McDermott.Here are some of Dr. McDermott’s published works related to brachytherapy.