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A New Hope for Brain Cancer Patients

Radioactive 'seeds' attack tumor site but leave tissue healthy

Dr. Camarata performs cesium brachytherapy to treat brain cancerNeurosurgeons at The University of Kansas Health System are pioneering a more effective, safer approach to fighting brain cancer – offering new hope to patients with certain types of tumors.

Neurosurgery Chair Paul Camarata, MD, and a collaborative clinical team scored a medical first in the Midwest in June by performing cesium brachytherapy to treat Janice Witthuhn's recurrent brain tumor. Camarata implanted ultrathin strands holding tiny radioactive "seeds" in the spot where he'd just removed her tumor. Two days later, the patient was headed home to Hays, Kan.

Only six other U.S. hospitals have treated certain malignant brain tumors with the procedure, which uses a newly available radioactive material, cesium 131. Neuro-Oncology Director Fen Wang, MD, PhD, flew to New York to watch experts at Cornell University perform the procedure.

Camarata calls the new approach a "revolutionary tool" to treat metastatic brain cancer. Cornell reported astounding results with a small study of metastatic brain cancer patients: At 18 months, the 24 patients showed no recurrence of brain cancer.

Radioactive seeds used during cesium brachytherapy to treat brain cancerEqually important, none experienced radiation necrosis, a complication that occurs when over-radiated tissue dies, causing brain swelling. Witthuhn's tumor was near her brain stem. Radiation necrosis could have affected her ability to walk and move her limbs, as well as her balance and gaze.

Previously, brain-related brachytherapy was performed as a follow-up surgery, once the tumor was removed and the site had started to heal.

"The process was fairly cumbersome, and the rate of radiation necrosis was fairly high because of the different radioisotope used," Camarata noted. "Cesium brachytherapy is much simpler, with less risk of infection because the strands are laid in right when the tumor is removed." The new procedure also delivers cancer-killing radiation immediately, unlike the previous method.

He also said it's safer for the patient, physicians and patient's loved ones. With a half-life of only 9.7 days compared to 60 days for iodine 125 – the radioisotope commonly used previously – cesium 131 works faster and in a shorter time frame, requiring fewer seeds.

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