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Breast
Cancer Patients may have a new treatment
option when Cancer spreads
Newswise — For orthopaedic researcher Joyce
Keyak, Ph.D., finding ways to battle breast
cancer is a personal as well as a
professional mission. Her cousin died from
the disease several years ago. Dr. Keyak
still remembers the incredible pain her
cousin experienced when the cancer spread to
her spine.
A new study released by Dr. Keyak and her
colleagues at the University of California,
Irvine, shows patients whose breast cancer
metastasizes to their spines may have a
better option than the usual treatment,
which can include up to 10 sessions of
radiation therapy.
The study looked at alternative — injecting
radioactive bone cement into the vertebral
body — with promising results.
The UCI researchers collaborated with a
colleague from St. Jude Heritage Medical
Group in Fullerton, Calif., to investigate
this technique.
Dr. Keyak is presenting the team’s findings
in the paper “Feasibility of Using
Radioactive Bone Cement to Treat Vertebral
Metastases” during the 55th Annual Meeting
of the Orthopaedic Research Society, Feb.
22–25, 2009, in Las Vegas.
“With further development, this technology
may yield a clinically feasible procedure
that would eliminate the need for 10
radiation therapy sessions, making it more
convenient for the patient,” says Dr. Keyak,
an associate professor in UCI’s department
of orthopaedic surgery.
“This procedure would also deliver a higher
dose to the bone metastases and a lower dose
to the spinal cord and other normal tissues
than conventional external beam radiation
therapy, potentially improving the clinical
outcome,” she explains.
“The negligible dose to the spinal cord
would also make it possible to treat
recurrent spinal tumors in patients who have
already received the maximum allowable
radiation dose to the spinal cord.”
According to the American Cancer Society,
almost 185,000 people in the United States —
mainly women — were diagnosed with invasive
breast cancer in 2008. In addition, a study
published in the journal Spine showed that,
of those patients whose breast cancer
metastasizes, almost 75 percent develop
spine tumors.
Spinal metastases can cause pain and
vertebral collapse. And, due to the
proximity of the spinal cord and nerves,
those tumors can lead to serious
neurological complications. Conventional
treatment often occurs in two phases:
1. A surgical procedure (vertebroplasty or
kyphoplasty) in which bone cement is
injected into the body to stabilize the bone
2. Subsequent external beam radiation
therapy (or EBRT) to control tumor growth
The effectiveness of EBRT for spinal
metastases is limited because the spinal
cord restricts the dose of radiation that
can be safely delivered.
In addition, EBRT is typically provided in
multiple sessions to reduce toxicity to the
spinal cord, making treatment inconvenient
for the patient.
The therapy investigated by Dr. Keyak and
her colleagues would combine the two
treatment phases into one procedure by
mixing a radioactive compound with the
injected cement.
A single procedure using this radioactive
bone cement would provide structural
reinforcement to the bone while
simultaneously irradiating the tumor from
within (i.e., vertebral brachytherapy).
Results of the study showed that a
therapeutic dose of radiation would reach
the intended bone without undue risk to
tissue beyond a certain range (such as the
spinal cord).
Once the results are validated, subsequent
studies will look at the following:
• Refining the choice of radioisotope(s),
amount of activity and geographic
distribution of the cement
• Sensitivity of the radiation dose
distribution to variations in bone size,
density and tumor type; differences in bone
cement formulations; and other factors
associated with a potential clinical
application
An abstract of the study is available online
at
http://www.ors.org/web/Media.asp.
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