New Therapy Shortens Treatment From Weeks to Days

April 30, 2007 – Glenda Lamb, 68, was finding it harder and harder to breathe. A former smoker with emphysema, she had been hospitalized with congestive heart failure when her doctor discovered a tumor growing in her right lung.

Using new technology, her medical team at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine is not only successfully treating the tumor using a new treatment technique called image-guided stereotactic body radiotherapy (SBRT), but they also are able to shorten the length of Lamb's therapy from six weeks to three days.

"Without this option, there would not have been anything they could do," Lamb says. "I feel so lucky because with my heart and lung conditions, I couldn't have chemotherapy or surgery."

"A patient with respiratory disease doesn't have much healthy lung to spare," explains Jeffrey Bradley, MD, associate professor of radiation oncology at Washington University School of Medicine. "This kind of situation tends to make a patient ineligible for invasive surgery to remove the tumor."

The medical team at Siteman delivered the advanced treatment with a new Trilogy treatment machine. This unique device combines a powerful medical linear accelerator that generates a carefully shaped and focused treatment beam with high-resolution imaging technology for pinpointing the tumor so that surrounding healthy tissues are preserved.

Unlike traditional therapy, which often requires six to seven weeks of daily treatments, Lamb's stereotactic body radiotherapy treatment was delivered in just three treatments. The speed of treatment was essential for Lamb, who lives more than 70 miles from St. Louis and had to travel back and forth with her daughter by car and train for each treatment.

Stereotactic body radiosurgery is made possible by the three-dimensional imaging and tumor tracking capabilities of the Trilogy system. The high-quality three-dimensional CT images generated right at the time of treatment enable doctors to accurately pinpoint a tumor and attack it safely with high doses of radiation without the added risk of moving the patient. Prior to the Trilogy machine, patients often had to be immobilized, scanned in one place, moved to the treatment room and treated – a process that took many hours and created uncertainty because tumors can shift within the body when a patient is moved from place to place.

"With our Trilogy machine, I can set the patient up for treatment, generate CT images to verify the location of the tumor and make any needed positioning adjustments prior to treatment, all right there in one place," Bradley says. "The patient is on the table for less than half the time we would have needed with our earlier protocols, before we had the Trilogy machine."

Lamb's first post-treatment checkup revealed that her tumor is shrinking nicely, although it will be several more months before Bradley knows if he eradicated it. "She tolerated the treatment extremely well – she didn't miss a beat," Bradley says. "We'll do follow-up CT scans every three months for the next two years and every six months thereafter to monitor her condition."

Radiation oncologists at Siteman also are using the Trilogy system to treat brain, head and neck, and gynecological cancer cases.

Because Siteman is a tertiary referral center for the region, it receives referrals for patients who live as much as 300 miles away. "Having state-of-the-art treatments that can be delivered quickly, in just a few days, without any compromise in the quality of care, is very important for our center," Bradley says.

The American Cancer Society estimates that there are approximately 210,000 new cases of lung cancer in the U.S. each year. For those whose tumors that are found to be inoperable, stereotactic body radiosurgery on a Trilogy machine may offer a viable treatment option.