St. Peter’s University Hospital, New Brunswick, is up and running with intensity modulated radiation therapy (IMRT) for the treatment of cancer, Carol Paul, director of oncology, announced Oct. 27. The hospital will also offer high-dose radiation (HDR) brachytherapy and the MammoSite Radiation Therapy System (RTS), Paul added.

"St. Peter’s has always been the front runner in cancer treatment in New Jersey," said Dr. Alexander Haas, clinical director of radiation oncology at the hospital. "We were the first hospital in the state to provide 3-D conformal radiation treatment planning in the early ’90s. We were the first to bring IMRT to New Brunswick.

"We will also be the first in our area to offer MammoSite RTS for breast cancer, and will be one of the few facilities in our area to offer high-dose radiation brachytherapy." These therapies deliver high doses of radiation to the tumor with a high degree of precision, thereby sparing more of the surrounding healthy tissue, Dr. Haas said.

Intensity modulated radiation therapy, or IMRT, is an external-beam radiation therapy that uses linear accelerator technology with a multi-leaf collimator, a computer-controlled device that shapes the radiation into "beamlettes." The beam gun is programmed to move across the body emitting up to 20 beamlettes per second. The clinician therefore can vary dose intensity and "paint" the tumor with radiation while sculpting the beam away from surrounding healthy tissue and sensitive structures in the body.

"IMRT increases our ability to completely eradicate the tumor," said Dr. Robert Knee, radiation oncologist with St. Peter’s Radiation Oncology Center. "Because we can use higher doses of radiation and target the tumor far more accurately, there are fewer side effects for our patients, and they can recover more quickly." IMRT is indicated for certain cancers, and is especially effective in treating many cases of prostate cancer, Dr. Knee said.

"We have brought in a special team of physicists, lead by Dr. David Marsden, who have enabled us to begin IMRT treatments," Dr. Haas said. "Dr. Marsden and his team at Marsden Medical Physics Associates are uniquely qualified to deliver IMRT, and we’re proud to have them on board.

"Several of our patients have completed or are currently undergoing IMRT treatment, and we are working out the treatment plans for several more patients."

A new radiation treatment for breast cancer

MammoSite RTS is a type of high-dose radiation brachytherapy that delivers radiation internally to treat breast cancer. A balloon catheter is inserted through the breast and into the tumor bed, after the tumor has been removed. Radiation is delivered through the catheter, which is left in place for the duration of treatment.

Because radiation passes through the catheter and not through healthy tissue from outside the breast, many side effects experienced with traditional breast cancer radiation treatment are reduced.

According to Scarlett Szymanski, St. Peter’s manager for radiation oncology, treatment time is also reduced from the traditional six to eight weeks to five days. "Patients can recover more quickly because only a portion of the breast is exposed to radiation," she said. "It also reduces the inconvenience of having to come to the hospital every day for weeks on end to receive cancer treatment."

Szymanski added that MammoSite RTS is not indicated for all breast cancer patients.

High-dose radiation brachytherapy

St. Peter’s also will offer high-dose radiation brachytherapy, Szymanski said. Like the MammoSite system, HDR brachytherapy delivers radiation internally, through a catheter or cylinder, to the tumor bed or body cavity where tumor cells may exist. Besides the breast, it can be used in treating cancers of the cervix, lung, prostate, rectum, tongue, and uterus.

"HDR brachytherapy allows us to treat cancer from inside the body without going through healthy tissue to get there," Dr. Haas said. In the most common cases, he said, treatment is a 20-minute outpatient procedure that eliminates the need for patients to stay overnight in the hospital.