Advanced technology for more precise treatment of brain and spine tumors

Monday, February 2, 2015

Photo of Dr Susan PannulloDr. Susan Pannullo NewYork-Presbyterian/Weill Cornell Medical Center now offers a system that uses image-guided radiotherapy (IGRT) to treat patients with brain and spine tumors and other brain abnormalities. With this new system, NewYork-Presbyterian/Weill Cornell doctors can deliver highly accurate doses of radiation therapy to targeted areas in the brain while maximizing patient comfort in a procedure called stereotactic radiosurgery.

"We are entering a new era in radiation therapy," said Dr. Susan Pannullo, director of neuro-oncology in the Department of Neurological Surgery at NewYork-Presbyterian/Weill Cornell Medical Center and an associate professor of clinical neurological surgery at Weill Cornell Medical College. "By using IGRT technology, we can deliver the most precise radiation treatment in the most comfortable way for our patients."

Dr. Pannullo is currently leading an American Society for Radiation Oncology initiative that is studying stereotactic radiosurgery outcomes at 30 sites nationwide.

Radiation therapy is a primary treatment for benign and malignant tumors of the spine and brain, especially tumors that are inoperable due to their location in the brain. Treatment is carefully planned using imaging and computer software to target radiation precisely to the affected area. However, small shifts in patient movement can cause radiation beam misalignment with the tumor, causing accidental damage to healthy brain tissue.

The accuracy and precision of the new IGRT system, named ExacTrac and made by Brainlab, allows physicians to apply higher treatment doses within one millimeter of a tumor with non-invasive immobilization of patients. The system consists of X-ray units installed in the treatment room floor that closely monitor patient movement throughout treatment. Unlike traditional radiation therapies for brain and spinal cord tumors, there is no need to restrict patients with rigid head or body frames that may cause discomfort or pain during the procedure. This frameless approach also spares more healthy tissue from radiation, and patients may require fewer treatments due to the higher doses of radiation being supplied to the tumor. The system's speed and accuracy is comparable to other forms of stereotactic radiosurgery offered by NewYork-Presbyterian, with the added bonus of a more comfortable patient experience.

"This new system is revolutionizing treatment delivery for tumors of the central nervous system region," said Dr. Gabriella Wernicke, radiation oncologist at NewYork-Presbyterian/Weill Cornell Medical Center, and an associate professor of radiation oncology in clinical neurological surgery at Weill Cornell Medical College. "It offers highly accurate single or multi-fraction treatment using a patient-friendly, head-to-shoulder non-invasive mask. The system also streamlines workflow, which improves scheduling flexibility for imaging, planning and treatment, all while improving patient comfort."

Since August, NewYork-Presbyterian/Weill Cornell physicians have used the system to treat patients with conditions such as brain metastases, benign tumors, malignant glioblastomas and spinal metastases. The new IGRT system is the latest advance for NewYork-Presbyterian/Weill Cornell Medical Center, a leader in advanced radiation therapy.

"IGRT gives our physicians and patients more options and helps patients to make informed choices about their care," said Dr. Jenghwa Chang, director of centralized treatment planning in the Department of Radiation Oncology at NewYork-Presbyterian/Weill Cornell Medical Center and an associate professor of radiation oncology at Weill Cornell Medical College. "A frameless approach to cranial radiosurgery provides a very significant improvement on patient comfort, setup accuracy and delivery of treatment."