Women with early stage breast cancer increasingly choose breast conservation therapy (BCT). In the BCT option, the cancerous tumor is surgically removed in a procedure known as lumpectomy. Following a lumpectomy, most women undergo whole breast irradiation (WBI), which includes a very important “boost” phase. The boost dose is an important component of the full course of radiation therapy and is delivered to the tissue adjacent to the surgical excision site, a region from which most recurrences originate. The added boost dose to the surgical margin has been shown to provide additional protection against recurrence.
AccuBoost is designed to target and deliver the all-important boost dose accurately and reliably. The AccuBoost system is an image-guided radiation therapy (IGRT) technique that uses noninvasive high-dose rate (HDR) brachytherapy to deliver a focused dose to the lumpectomy site. By virtue of directly and precisely targeting the treatment area, patients who have used the AccuBoost system have less reddening of the skin.
Your radiation oncologist may decide that your cancer should be treated with brachytherapy. Radioactive seeds or sources are placed in or near the tumor itself, giving a high radiation dose to the tumor while reducing the radiation exposure in the surrounding healthy tissues. The term “brachy” is Greek for short distance. Brachytherapy is radiation therapy given at a short distance: localized, precise and high-tech.
Breast brachytherapy is an advanced radiation therapy used in breast cancer treatment that targets the tumor bed and limits radiation exposure to healthy tissue. This form of breast cancer treatment is typically performed in 5-8 days versus the usually 6 weeks of external beam treatment. Your surgeon will insert either a Mammosite® or Savi® balloon in to the lumpectomy cavity through a small incision in your breast.
Unlike other forms of radiosurgery, this latest generation of the CyberKnife offers an unprecedented ability to precisely target tumors while sparing damage to surrounding healthy tissue.
What makes this version of the CyberKnife so unique – and so effective – is its ability to continuously track and attack the tumor as it shifts during therapy due to patient movement or respiration.
Zevulin, Bexxar and Quadramet are the drug therapies offered at the Eugene M. & Christine E. Lynn Cancer Institute.
DVS: Dose Verification System
DVS radiation dosimeters are placed near the tumor or tumor bed and/or surrounding normal tissue. Each day, DVS measures the radiation a patient receives; the physician can then confirm that the radiation dose is within the prescribed range. Placement of the DVS will be performed by the radiation oncologist.
IGRT: Image Guided Radiation Therapy
In IGRT, repeated imaging scans are performed during treatment. These imaging scans are processed by computers to identify changes in a tumor’s size and location due to treatment and to allow the position of the patient to be adjusted during treatment as needed. Imaging increases the accuracy of radiation treatment delivery. Fiducial markers may be placed internally for alignment, if that is the physician’s recommendation.
IMRT: Intensity Modulated Radiation Therapy
IMRT uses hundreds of tiny radiation beam-shaping devices, called collimators, to deliver a single dose of radiation. The collimators can be stationary or can move during treatment, allowing the intensity of the radiation beams to change during treatment sessions. This kind of dose modulation allows different areas of a tumor or nearby tissues to receive different doses of radiation.
The goal of IMRT is to increase the radiation dose to the areas that need it and reduce radiation exposure to specific sensitive areas of surrounding normal tissue. IMRT can reduce the risk of some side effects, such as damage to the salivary glands, which can cause dry mouth, when the head and neck are treated with radiation therapy.
Novalius TX™ With Rapid ARC Linear Accelerator®
Novalis Tx™ is a powerful radiosurgery system that offers a versatile combination of advanced technologies for the treatment of tumors and other anatomical targets. With the Novalis Tx™ radiosurgery platform, facilities can offer state-of-the-art, non-invasive treatment for a wide range of malignancies and other potentially debilitating conditions, without harming nearby healthy tissue and without involving traditional surgery.
Any health issue can be cause for concern, and cancer is no exception. RapidArc® radiotherapy technology, a revolutionary breakthrough in cancer treatment that delivers powerful tumor-destroying radiation with remarkable precision, is now available from Varian Medical Systems.
Varian RapidArc® radiotherapy technology is an effective cancer treatment representing an advanced new form of image-guided IMRT. This technology enables clinicians to program a linear accelerator to deliver precise forms of IMRT up to eight times faster than other IMRT systems. It does this by delivering the complete IMRT treatment to you in fewer rotations than traditional IMRT. As a result, your tumor will receive the full radiation dose within less than two minutes compared with 10 minutes or longer for conventional IMRT.
Treatment speed is important because it reduces the time patients must lie still and avoid movement. As treatment time is reduced, Varian RapidArc® has the potential to improve both your quality of care and comfort.
The respiratory gating system, used in the linear accelerator room, allows clinicians to correlate tumor position in relation to the patient's respiratory cycle. Thresholds determine when the gating system turns the treatment beam on and off, minimizing the radiation dose to critical structures.
SBRT: Stereotactic Body Radiation Therapy
SBRT delivers radiation therapy in fewer sessions, using smaller radiation fields and higher doses. SBRT treats tumors that lie outside the brain and spinal cord. SBRT is delivered in one to five fractions. SBRT is used to treat small, isolated tumors. Our state-of-the-art Varian Novalis TxTM delivers SBRT & SRS treatments, comparable to such brands as the CyberKnife®.
SRS: Stereotactic Radiosurgery
SRS can deliver one or more high doses of radiation to a small tumor. SRS uses extremely accurate image-guided tumor targeting and patient positioning. Therefore, a high dose of radiation is given without excess damage to normal tissue.
SRS is used to treat only small tumors with well-defined edges. It is most commonly used in the treatment of brain or spinal tumors and brain metastases from other cancer types. SRS requires the use of a immobilization device to ensure that the high dose of radiation is delivered accurately.
TheraSphere® is used to treat liver cancer.
Miami Cancer Institute can provide access to clinical trials not widely available elsewhere. Clinical trials find new ways to treat and diagnose cancer and are ongoing. If an appropriate trial is available, we will talk to you about the benefits and risks.