New breast cancer radiation therapy more convenient for UIHC patients

BY DORA GROTE | MAY 07, 2012 6:30 AM

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Beverly Mueller received daily conventional radiation therapy for six weeks in 1995, following her breast-cancer lumpectomy. She had a second surgery in April, when suspicious cells reappeared in her mammogram — and a new form of radiation therapy ensured she hasn't returned to the hospital since.

Intraoperative radiation therapy — which targets only the surgical cavity — allows breast-cancer patients to receive radiation treatment immediately after surgery instead of over several weeks.

"I went in for surgery that morning, and I was home that night," the 79-year-old said. "It was a very simple procedure — much easier for me this way than it was before."

The University of Iowa Hospitals and Clinics started using this new treatment method in April, following a 2010 published clinical trial, TARGIT , that randomly selected 1,113 women to receive the intraoperative treatment and 1,119 to receive conventional external beam therapy.

Sonia Sugg, a UIHC breast health center director, said the trial results showed the intraoperative method to be equally effective as conventional treatment for patients over 45 and in the early stages of breast cancer.

"We want to be pretty careful about whom we're treating and make sure it matches the patient populations studied in the trial so we don't find out later that it's not quite as effective for the others," Sugg said.

The UIHC is the first hospital in Iowa to use intraoperative therapy, which is commonly used in Europe and Italy.

Timothy Waldron, a UIHC radiation physicist, said five patients have been treated with the new radiation method since the beginning of April.

Waldron said conventional breast-cancer radiation therapy provides radiation to the whole breast. It is performed in a room with 6-foot concrete walls to provide protection from the penetrating X-ray beams of 6 million megaelectron volts.

"It's about six tons — the size of a large fork lift — and permanently installed," Waldron said. "The intraoperative radiation therapy unit is actually portable — the size of a small lunch box. We can do the treatment right there in the operating room without having a special room."

The intraoperative treatment method only provides radiation to the surgical cavity on the breast through a 50,000-volt machine, Waldron said.

Sugg said this treatment is also convenient for patients who travel great distances or live in rural areas.

"Given the fact that Iowa is a rural state and we do have a lot of patients who come from a long ways a way and some who live in rural areas and don't have access to the treatment, this treatment is great to bring to the state of Iowa," she said.

Mueller said she thought her most recent radiation therapy would cause less damage.

"The regular radiation in '95 did more damage to my voice and to my lungs than this will do because it's a small area that they used this time," she said. "I am very pleased with it so far — no problems — and everything has healed up fine."

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