Hospital: The team at St. John’s are working on a new treatment. Courtesy photo

A team of doctors at Providence Saint John’s are the first in the nation to pioneer a potentially game changing treatment for one of the most severe forms of brain cancer.

Brain cancer is an extremely deadly cancer and glioblastoma, the most common type of malignant brain tumor, is particularly aggressive. Once diagnosed, the median survival rate for patients is a mere 10 to 12 months. Worldwide the disease afflicts around 300,000 people annually and is responsible for the deaths of Sen. John McCain, Sen. Ted Kennedy and Beau Biden.

At Providence Saint John’s, researchers are working to give new hope to glioblastoma patients through a revolutionary procedure that they believe could extend patients’ survival time and improve their quality of life while undergoing treatment.

The procedure is called electronic interoperative radiation therapy (IORT) and allows doctors to target radiation in a very specific location and avoid damaging broader regions of the brain. It has been utilized successfully to treat other types of cancer such as breast cancer, but Saint John’s specialists are the first team to apply it to brain cancer.

A key benefit of this method is that it allows radiation oncologists to deliver radiation therapy during the same procedure when surgeons remove the brain tumor. This makes it possible for oncologists to directly target the tumor bed and begin radiation treatment immediately instead of waiting for several weeks after the surgery to perform external radiation to a wider portion of the brain. Doctors believe that the increased speed and specificity in delivering radiation should lead to improved outcomes.

“IORT is innovative because the big problem with radiation therapy in the brain is that it targets everything around it, so it’s hard to get it to where you want it to be specifically without damaging the normal brain,” said Naveed Wagle, MD., the local principal investigator of the study and associate professor of Neurosciences at the Saint John’s Cancer Institute. “The thought was that if we can deliver radiation specifically where we need it, in smaller doses, the outcomes would be as good if not better and the quality of life for these patients would be substantially better because they don’t have a lot of those side effects from external radiation.”

Wagle and other members of the research team treated their first glioblastoma patient with IORT in November and are striving to enroll at least five to ten more patients in the next year.

During the treatment surgeons and radiation oncologists work together to remove a patient’s tumor and then use medical technology called the Xoft Axxent Electronic Brachytherapy System to insert a miniature x-ray source into the tumor cavity and deliver a single dose of radiation to the tumor bed.

“Xoft Brain IORT is a novel approach that may offer patients quality-of-life benefits, compared to traditional treatment,” said Garni Barkhoudarian, M.D., a fellow of the American Association of Neurological Surgeons and assistant professor of neurosurgery and neuroscience at the Saint John’s Cancer Institute. “By reducing radiation treatment times from weeks to just one day, Xoft not only offers a more convenient treatment option, it also may result in fewer side effects and complications, compared to other treatments.”

The research team at Providence Saint John’s is excited about how IORT could become a standard treatment and increase the life expectancy and experience of patients diagnosed with glioblastoma, which heretofore has been a deadly prognosis with little avenue for hope.

“I’m specifically interested in brain cancer research, because this is an area that needs new innovative therapies… we haven’t had a lot of progress in the field for a while,” said Wagle. “Hopefully making a big difference in the way that we treat these tumors and more importantly, how patients do once they’re diagnosed, is what drives me to do this research.”