Target That Tumor: New Treatment Takes Aim at Cancer

Here is some encouraging news for patients with certain types of difficult-to-treat cancers: Montefiore cancer specialists are now using a sophisticated and powerful form of radiation treatment, called radiosurgery, to improve patients’ odds of winning the battle against cancer.

Traditional external radiation therapy has been used for decades to treat many types of cancer. But doctors typically base their dosing decisions — the amount of radiation they use — on how much radiation the healthy tissues near the tumors can tolerate rather than how much radiation is needed to destroy the cancer.

“Radiosurgery is a more precise form of radiation that allows us to deliver an extremely high dose of radiation to a very small area,” says Shalom Kalnicki, MD, FACRO, chairman of the Department of Radiation Oncology at Montefiore Medical Center who leads a team of radiation oncologists at the Montefiore-Einstein Cancer Center. “We can target tumors more accurately and minimize damage to surrounding tissue.”

Radiosurgery was first used to target brain tumors. Patients undergoing radiosurgery for brain tumors typically wear a frame attached to the skull that immobilizes the head and neck during radiosurgery. Today, doctors use advanced stereotactic technology and a frameless motion-correcting system that allows them to treat other types of tumors, including cancers of the lung, liver, spine and pancreas.

“This treatment is often an effective option when tumors are near nerves or other vital structures. Patients don’t face the risks and side effects of conventional surgery,” Dr. Kalnicki says.

Prior to radiosurgery, doctors outline anatomical landmarks or insert a tiny gold seed that serves as a marker into the tumor. Then patients undergo combined CT/MRI scans that give doctors important information about the size and location of tumors. Doctors use the scans and complex software programs to develop a comprehensive treatment plan for each patient.

Next, doctors use advanced technology that detects seed movement and makes adjustments with submillimeter accuracy as it guides radiation to the tumor and destroys the tissue in the targeted area. Most patients who have radiosurgery go home the same day. They generally experience no pain and very few side effects.

Dr. Kalnicki says there are circumstances in which the higher doses of radiation used during radiosurgery are much more effective than conventional radiation therapy — and it’s easier on patients. Those who have traditional radiation may undergo treatments for months. Patients who have radiosurgery usually need just a few treatments.

“Radiosurgery is a major breakthrough for patients with certain types of cancers,” Dr. Kalnicki says. “We’re using highly curative doses of radiation and seeing incredible results. We’re able to cure some patients who have cancers for which we previously had few effective options. And, even when radiosurgery doesn’t cure cancer, it often helps prolong patients’ lives.”

The Montefiore-Einstein Cancer Center offers patients a full range of radiation services, including radiosurgery. In fact, doctors and physicists at the Cancer Center helped develop a new cuttingedge motion management system — the Trilogy System™— that takes radiosurgery to a new level.

“This new system takes CT scans while patients are on the treatment table and uses the patients’ own anatomy to track and target tumors in real time,” says Dr. Kalnicki. “Eventually, we’ll be able to perform radiosurgery without frames or gold seeds.”

The Montefiore-Einstein Cancer Center is one of only a few facilities in the United States equipped with the Trilogy System. Its cancer specialists — including neurosurgeons, neurologists, head and neck surgeons, thoracic and liver surgeons, radiation oncologists and physicists — work together as a team and use this state-of-the-art technology to provide cancer patients with the most advanced radiosurgery treatments available.

For more information about radiosurgery services at the Montefiore-Einstein Cancer Center, please call 718-920-4361 or visit: www.montefiore.org/cancer.