CAROLINA REGIONAL CANCER CENTER ANNOUNCES PILOT PROGRAM FOR ADAPTIVE TREATMENT PLANNING TO FURTHER EXPAND THE BENEFITS OF ITS TOMOTHERAPY HI•ART TREATMENT SYSTEM

Carolina Regional Cancer Center (CRCC), an affiliate of MUSC Hollings Cancer Center, has initiated a Pilot Program to study the benefits of Adaptive Treatment Planning utilizing the TomoTherapy® Hi•Art® Treatment System, one of the most effective forms of radiation treatment available.  Adaptive tr... [read more]

CAROLINA REGIONAL CANCER CENTER WELCOMES NEWS AS AFFILIATE, MUSC HOLLINGS CANCER CENTER, RECEIVES PRESTIGIOUS DESIGNATION BY NATIONAL CANCER INSTITUTE

Carolina Regional Cancer Center (CRCC), affiliated with the Medical University of South Carolina (MUSC) Hollings Cancer Center (HCC), announced today that HCC recently received designation by the National Cancer Institute (NCI) as one of the top cancer research centers in the country. HCC is one of only 64 other can... [read more]

Cervical Cancer Treatment

Treatment options are basically defined by the extent of disease, the patient's basic health status and patient choices. Early stage disease in otherwise healthy women can often be treated with curative intent by radical hysterectomy. This procedure is a rather extensive operation in which the cervix and uterus are removed, and all possible lymph nodes are removed from the pelvis in continuity up to just below the diaphragm.

It is a long and difficult operation and sometimes requires a significant recovery period -- and has significant potential side effects such as incontinence -- but can have high curative potential in selected patients.

Radiation is often used in conjunction with surgery when the disease is found to be extensive at the time of operation, and it is felt that the operative procedure is not likely to be curative. The goal of radiation treatment is to kill any cancer cells that may remain in the pelvis or within the lymph node chains within the abdomen.

Cervical cancer is often frequently treated by radiation alone. Typically, the pelvis is treated with high-energy (18-25 MEV) external beam radiation treatment with delivery of a moderately high dose of radiation to the pelvis with coverage of the cervix, uterus and lymph node chains. The vagina and cervix are the two organs in the body most tolerant to radiation, and radiation oncologists are therefore able to augment their treatments by what is known as brachytherapy.

Brachytherapy simply means "close range" radiation therapy. As such, applicators are placed within the vagina and uterus and radioactive sources, which deliver a finite amount of radiation to a finite volume of tissue are inserted for a specific length of time. In this manner, doses can be achieved that can eradicate cancers that otherwise could not be destroyed because of the limitations imposed by the radiotolerance of surrounding normal tissues.

IMRT and Cervical Cancer

An interesting emerging and progressive aspect of radiation treatment is intensity-modulated pelvic radiotherapy for women with gynecologic malignancies. Intensity-modulated radiation therapy (IMRT) allows us to conform the radiation "dose cloud" to the specific volume of tissue that needs to be treated. This is particularly useful in treatment of the pelvis where IMRT allows us to enhance sparing of the radiosensitive small bowel, bladder and rectum.

A recent study published in The International Journal of Radiation Oncology and Physics in April 2002 showed that IMRT treatment planning resulted in excellent coverage of the tissues to be treated. Treatments were very well tolerated and associated with less acute gastrointestinal sequelae than with conventional external beam radiation treatment delivered to the pelvis.

As stated above, this is an emerging technology where more and longer clinical studies will need to accrue, but there is no doubt that intensity-modulated whole pelvic radiotherapy is an extremely promising approach in cervical cancer patients and, in fact, any patients with a gynecologic malignancy.

Also of consideration is the use of IMRT to potentially replace the brachytherapeutic aspect of treatment. This area of investigation is in its very early stages, but physicists have already developed and published a theoretic example illustrating how IMRT can accurately mimic the dose distributions that are attained using brachytherapy. Such an approach is not the standard of care at this time but holds significant investigational promise.