Friday, August 06, 1999
New device attacks tumors precisely
University Hospital gets first in the world
BY TIM BONFIELD
The Cincinnati Enquirer
University Hospital has become the first medical center in the world to treat patients with a device that experts say represents the next great leap in radiation treatment for brain tumors and several other diseases.
The hospital, along with doctors from the recently formed Neuroscience Institute, on Thursday unveiled the LEXAR radio-surgery system, made by Radionics Inc. and Siemens Medical Systems Inc.
The $1.5 million system, located on the lower level of the Barrett Cancer Center, is a significant technical advance for two main reasons:
• It can aim radiation beams more accurately than ever before, which allows higher tumor-killing doses with less damage to nearby tissues. Better accuracy allows better treatment, possibly even cures, for tumors in previously untreatable locations. In some cases, the system might even replace traditional surgery.
• Beyond brain tumors, the LEXAR system can zap tumors in the neck and along the spine, and treat other diseases. That means the device may find uses far beyond the estimated 40,000 people a year who develop brain tumors. Doctors say potential applications include treating malformed blood vessels, chronic pain from nerve problems, even epilepsy and Parkinson's disease.
“We see this as a great step in enhancing the quality of life for our patients,” said Sharon Lamb, president of the National Brain Tumor Foundation.
During the first year of use, University Hospital officials predict at least 300 patients will be treated with the LEXAR system. Many more may be
treated in future years as uses for the equipment expand.
Eric Cosman, president of Radionics Inc., said the manufacturers chose University Hospital to install its first LEXAR system because the companies have been working with the hospital for many years. In fact, the relationship between Mr. Cosman and Dr. John Tew, the renowned local neurosurgeon who serves as medical director of the Neuroscience Institute, goes back 30 years, Mr. Cosman said.
The Cincinnati system was installed about a month ago and has been used to treat seven patients so far, said Dr. John Breneman, a radiation oncologist with the Neuroscience Institute.
The full medical results of the treatments will take three to six months to develop. However, patients already praise the fact that they can get the very latest in care without an overnight stay.
Karen Jackson, a sixth-grade teacher from Tipp City, Ohio, received traditional surgery four years ago at University Hospital to remove a brain tumor. She came back July 12 to deal with a malformed blood vessel in her brain that posed a stroke risk.
The difference in her experience was amazing, she said.
“I came in at 6:45 a.m. and I left that evening. I even stopped for dinner with my husband on the way home,” Mrs. Jackson said. “I wouldn't have known they'd done it if they didn't tell me.”
In comparison, it took seven weeks to return to work from her previous brain surgery, and longer still to return to feeling normal, Mrs. Jackson said.
Doctors have used radiation for many years to treat inoperable brain tumors. However, traditional treatments have been limited by the inability to tightly focus the radiation.
In traditional brain tumor therapy, the radiation forms a cube-shaped high-dose “zone” around the tumor, sometimes so big that the cube includes the optic nerve and the brain stem.
Too much radiation to either part could result in blindness or paralysis, Dr. Breneman said. Such tricky locations have often prevented doctors from giving enough radiation to kill the tumor.
In recent years, better computer controls and beam-shaping techniques have allowed doctors to tighten the high-dose zone closer to the tumor.
The LEXAR system goes one step better, focusing the radiation to within 0.5 millimeters, about the width of two human hairs. In addition, the system has an advanced system for shaping the radiation beam, allowing the device to more effectively attack oddly shaped tumors.
“This technology is winning the battle against certain brain tumors today,” Dr. Tew said.
Within weeks, doctors plan to use the LEXAR system to treat neck tumors. Within months, they plan to treat tumors along the spine. Eventually, they hope to treat tumors in many parts of the body.
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