UK HealthCare

Re-irradiation a Viable Option for Recurrence of Gynecological Cancer

LEXINGTON, Ky. (Aug. 31, 2011) — Re-irradiation using special radiation therapy implant techniques can provide a second chance at a cure for patients who have had a recurrence of gynecological cancer, says Dr. Marcus Randall, Markey Foundation Endowed Chair in radiation medicine at the University of Kentucky.

Interstitial radiation therapy, also known as seed implantation therapy, involves placing radioactive material directly into cancerous tissue. The "seeds," which are pellets of a radioactive isotope, then provide doses of radiation to the tissue directly, with very limited doses to nearby tissues such as the bladder and rectum.

"In my gynecologic cancer radiation oncology practice, I often see small recurrences or new primary tumors in the female genital tract in patients who have previously had radiation therapy," Randall said. "Options have historically been limited to the surgical removal of organs and tissue or palliative chemotherapy — a therapy not used to cure, but to prolong life and improve cancer symptoms. However, I have found that permanent seed implants to these limited volumes are very safe and quite effective with good long-term control and survival."

For cervical cancer patient Shelley Koeller, interstitial radiation was the best option when faced with a recurrence of squamous cell carcinoma. After her initial diagnosis, Koeller did six weeks of chemotherapy and radiation, only to have the cancer come back a year later.

Koeller, who is from Chicago, was receiving treatment from Dr. Jean Hurteau of the University of Chicago when he suggested interstitial radiation. His confidence helped inspire her to fly out to meet with and subsequently receive the treatment from Randall, one of the few physicians in the country who performs the procedure on gynecological cancer patients.

"Dr. Hurteau believed in this procedure," Koeller said. "He believed in Dr. Randall."

Koeller had the procedure done over a weekend and received 17 seeds of radiation. She says the overall experience of the treatment was pleasant compared to traditional radiation.
 

"I had zero complications," she said. "And no side effects."

This past January, more than five years after her treatment, Koeller is still in the clear, and Hurteau has declared her "cured." It's further proof that this unique method of radiation is very much a viable option for patients these days, said Randall.

Randall has been performing interstitial radiation for gynecological cancers for 25 years, and in that time he has mainly used the gold-198 isotope. However, gold-198 has one drawback — operator exposure to its radiation.

Although some patients might still be best managed with gold-198, in June, Randall became the first physician in the country to successfully use IsoRay's Cesium-131 isotope for re-irradiation of gynecological cancer. Cs-131 provides a similar radiation dose distribution and should have similar good results, with less radiation exposure for the staff.  

"Cesium-131 has multiple properties that make it an ideal isotope for these cases," Randall said. "The short half-life gives a good initial dose rate, the low energy enhances radiation safety for the staff, and the dose distribution properties make it easy to calculate and use in the clinic. I have had good initial experiences with this isotope."

Cs-131 has been used successfully to treat lung, head and neck, ocular melanoma, and prostate cancers, but this is the world’s first experience using this new radioisotope for the treatment of gynecological cancers.

  

MEDIA CONTACT: Allison Perry, (859) 323-2399 or allison.perry@uky.edu