Intraoperative radiation therapy is a innovative way
to deliver radiation therapy during surgery
for pancreatic cancers.
The goal of the intraoperative radiation therapy
is to increase the doses of radiation to the tumor.
This has been shown to improve outcomes.
We're able to do this because we during surgery
can precisely target the area that needs the radiation while avoiding
surrounding organs that can be injured or damaged by radiation treatment.
It's the idea that during the operation, directly to the area
that's affected, we're going to deliver radiation
as opposed to trying to do it through the patient's tissues, the skin
or soft tissues or bowel in front of the area.
So, there's two settings where we typically consider
intraoperative radiation therapy for pancreas cancer.
One setting is in patients who've had their tumor removed,
and we can treat the post-operative bed with intraoperative radiation therapy.
The main goal of that is to decrease the risk of recurrence
that the tumor comes back in this treated area.
The second setting where intraoperative radiation therapy is used,
is in the setting, where the tumor cannot be removed during surgery.
Intraoperative radiation therapy is used to enhance or increase
the dose in lieu of surgery to improve the chance that we can control
the tumor to decrease the chance that it will grow in the future.
So, now that the technology has gotten better and essentially
a radiation machine can be brought into the room and radiation can be delivered
to the patient on the operating room table directly to the affected field
and our other therapies are so much better,
we actually have been able to show survival advantage for patients
getting, in some situations, getting intraoperative radiation
therapy, coupled with either pre...
usually preoperative radiation therapy in addition to chemotherapy.
So, we are incorporating
intraoperative radiation into the multi-modality care for patients
primarily with pancreas adenocarcinoma, but also with some other pathologies.
Benefit of using IORT for pancreas cancer is twofold.
One is being able to approach patients who have locally advanced disease
that might not be resectable or might be resectable
with very close margins and being able to offer patients
another option to help treat that locally advanced disease in the event
that surgical margins are close or the resection isn't possible.
So it allows us really
to have more confidence in the ability to bring patients to the operating room
and in cases we would not previously have done so
and to still be able to offer them treatment
no matter what the findings are at the time of surgery.
We're putting the
beam of radiation, we're focusing it on to the area,
so we're outlining that and putting the cone there, then Dr.
Unger, the radiation oncologist, would be able to use to deliver the radiotherapy.
So, it is a very collaborative process.
The intraoperative radiation therapy for pancreas
cancer is a new technology, but one that has been recently shown
to be advantageous in the form of survival for patients.
So, we are participating with a small group of other academic institutions
in a collaborative
and studying patients with borderline and locally advanced tumors,
and really are quite excited
that this will be a way to help patients that we couldn't previously.