Physicians at Scripps Health have recently started performing a unique breast cancer treatment that delivers an entire course of radiation therapy to the patient in the operating room during surgery, eliminating the need for what is typically weeks of post-surgery radiation.
Most breast cancer patients require approximately three to six weeks of conventional X-ray radiation therapy after breast-conserving surgery (or lumpectomy). But electron intraoperative radiation therapy (EIORT) can deliver a full course of radiation in a single dose, or fraction, in about two minutes. Candidates for this treatment include selected patients with early-stage breast cancer.
EIORT technology at Scripps uses a mobile linear accelerator to deliver electron beam radiation treatment into the patient’s open surgical site after the tumor is removed. Developed by IntraOp Medical Corporation, the IntraOp Mobetron® is the only EIORT technology in San Diego County and is housed on the campus of Scripps Memorial Hospital La Jolla.
Direct visualization of tumor site
In addition to its speed, EIORT delivers radiation more precisely and effectively to the targeted tissue than conventional external beam radiation, because it has the benefit of direct visualization of the tumor site, no entry dose, little if any exit dose and a very uniform radiation distribution.
EIORT is the only mode of radiation confirmed by the American Society of Radiation Oncology for use in single-treatment intraoperative radiation for breast cancer patients.
Excellent tumor control
“The precise radiation delivery of EIORT translates into excellent tumor control and low probability of cancer recurrence,” said Mary Wilde MD, who is medical director of the Scripps Polster Breast Care Center at Scripps Memorial Hospital La Jolla and was instrumental in bringing the technology to Scripps.
Candidates are pre-screened for this therapy option by the treating surgeon, with the final determination regarding suitability being made by the radiation oncologist.
The American Cancer Society reports that approximately 249,000 new cases of breast cancer will be diagnosed in the United States in 2016. Dr. Wilde, whose practice as a breast cancer surgeon spans more than 20 years, estimates that approximately 70 percent of her breast cancer patients are treated with lumpectomy, and many of them are candidates for EIORT.
“EIORT can benefit our patients in multiple ways,” said Scripps surgeon Cheryl Olson, MD. “It is highly targeted, because the surgical oncologist and radiation oncologist can visually pinpoint the optimal site for radiation. This helps avoid irradiating the heart, lung and surrounding healthy tissue.”
A welcome respite after surgery
According to Scripps radiation oncologist Kenneth Shimizu, MD, the new approach offers a welcome respite from what has traditionally been a lengthy treatment. “This option helps reduce the time and inconvenience of daily radiation treatments, five days a week, for several weeks, which lets patients move forward with their recovery sooner,” he said.
Scripps first began using EIORT in December 2014 as a boost dose to a patient’s post-surgery radiation treatments. To date, more than 60 patients have been treated at Scripps with EIORT. Scripps also plans to investigate the possibility of expanding this treatment option to other types of cancer.
Scripps funded the purchase of the $1.4 million EIORT technology entirely through philanthropy. The Ellen Browning Scripps Foundation helped fund this equipment, as well as a clinical trial that will track patient care outcomes.
According to IntraOp Medical Corporation, this treatment for breast cancer has been available in Europe for more than 15 years, with excellent results. Medical studies have demonstrated the safety and effectiveness of EIORT therapy for breast and other tumor sites.
IntraOp reports that this technology is currently utilized by leading medical institutions such as Mayo Clinic, University of California, San Francisco, Massachusetts General Hospital, Stanford University Medical Center, and dozens of other locations in the United States and worldwide.
The Mobetron received Food and Drug Administration approval in 1998. Medicare approved reimbursement for EIORT in 2013. EIORT has an established history of reimbursement by many private health insurance payers.
Cancer care at Scripps Health
Scripps is a nationally recognized leader in cancer therapy, providing treatments at its five hospital campuses, radiation therapy centers and various Scripps Clinic locations. Scripps cancer physicians and staff work collaboratively toward cancer prevention, early detection, coordinated treatment and community support services.
Scripps offers advanced treatment technologies at its various radiation therapy facilities, the San Diego Gamma Knife Center, and through its minimally invasive surgical program and CyberKnife stereotactic radiosurgery. Additional resources include specialized breast care centers, infusion clinics, nurse navigators, rehabilitation services, support groups and the Scripps Center for Integrative Medicine.
In August, Scripps announced a partnership with MD Anderson Cancer Center to create a comprehensive and clinically integrated cancer care program in San Diego. Work to establish the Scripps MD Anderson Cancer Center is now under way, and the program will be developed during the coming months.
Learn more about Scripps Health, a nonprofit integrated health system in San Diego, Calif.