Novel Radiotherapy Device Invented at UMMC Provides SBRT for Early Stage Breast Cancer
Way back in the mid-2000s, researchers at the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center recognized the need for an improvement in delivering radiotherapy to patients with early stage breast cancer who had undergone breast-conserving surgery. These patients are not always well served by linear accelerator–based radiation therapy nor by invasive breast brachytherapy; neither of these options fully respect the patient’s choice of preserving healthy breast tissue. However, a highly conformal, ablative dose of radiation to the tumor bed could potentially destroy any residual cancer cells while being gentler on the rest of the breast. In other words, stereotactic body radiation therapy (SBRT) for the breast would be an improved approach. However, external beam linear accelerators were not up to the task for this portion of the body.
Therefore, Cedric X. Yu, DSc, FAAPM and William F. Regine, MD, FACR, FACRO invented and developed the GammaPod, a novel radiotherapy device that could deliver breast SBRT. Using Cobalt-60 radiation sources, GammaPod is designed to treat patients comfortably in a prone position while the breast is immobilized. The device was FDA cleared in December 2017 and is expected to be available for patients at the University of Maryland Medical Center in summer 2018.
GammaPod is for patients who qualify for accelerated partial breast irradiation (APBI). Radiation drop-off outside the treatment target is unusually steep, significantly sparing healthy tissues compared with other forms of internal or external RT. This gives the device an advantage in terms of minimizing radiation delivered to the heart and lungs, reducing the risk for future adverse cardiac events caused by RT. Compared to whole breast RT or APBI on a linear accelerator, GammaPod treatment results in superior cosmesis, and it is less invasive compared to internal forms of ABPI. In both instances, GammaPod is less time-consuming because patients require only one to three, 5- to 40-minute treatments.
In this video, Elizabeth Nichols, MD, Assistant Professor of Radiation Oncology at the University of Maryland School of Medicine, explains the benefits of GammaPod treatment and how the device might one day change treatment protocols for some patients.
Yu CX, Mutaf Y, Regine WF, Feigenberg SJ, Nichols EM, Hoban PW. GammaPod: a dedicated device for external beam breast cancer SBRT in the prone position. Int J Radiat Oncol Biol Phys. 2015 Nov;93(S3):E586-E587.
Yu CX, Shao X, Zhang J, Regine W, Zheng M, Yu YS, Deng J, Duan Z. GammaPod-a new device dedicated for stereotactic radiotherapy of breast cancer. Med Phys. 2013 May;40(5):051703.
Comparison with Other RT Modalities Including PBI
Snider III JW, Mutaf Y, Nichols E, Hall A, Vadnais P, Regine WF, Feigenberg SJ. Dosimetric improvements with a novel breast stereotactic radiotherapy device for delivery of preoperative partial-breast irradiation. Oncol. 2017 Jan;92(1):21-30.
Snider III JW, Mutaf Y, Nichols E, Hall A, Vadnais P, Regine WF, Feigenberg SJ. Projected improvements in accelerated partial breast irradiation using a novel breast stereotactic radiotherapy device: a dosimetric analysis. Technol Cancer Res Treat. 2017 Dec;16(6):1031-1037.
Nichols EM, Snider III JW, Zhang B, Hall A, Becker SJ, Badiyan SN, Mutaf YD, Feigenberg SJ. Dosimetric comparison of intensity modulated proton therapy (IMPT) partial breast irradiation (PBI) and a breast stereotactic radiation therapy (SBRT) device. Int J Radiat Oncol Biol Phys. 2016 Oct;96(2S):E677.
Nichols EM, Cohen RJ, Cheston SB, Feigenberg SJ. Radiation therapy in the elderly with early stage breast cancer: review and role of new technology. J Nucl Med Radiat Ther. 2014 Dec;5:204.
Ödén J, Toma-Dasu I, Yu CX, Feigenberg SJ, Regine WF, Mutaf YD. Dosimetric comparison between intra-cavity breast brachytherapy techniques for accelerated partial breast irradiation and a novel stereotactic radiotherapy device for breast cancer: GammaPod™. Phys Med Biol. 2013 Jun;58(13):
Becker S, Niu Y, Mossahebi S, Yi B, Yu C, Prado K, Mutaf Y. Verifications of absolute and relative dosimetry of a novel stereotactic breast device: GammaPod™. Med Phys. 2016 Jun;43(6Part24):3634.
Mutaf Y, Yu C, Zhang J, Yi B, Prado K, D’Souza W, Regine W, Feigenberg S. Dosimetric and geometric evaluation of a novel stereotactic radiotherapy device for breast cancer: the GammaPod. Med Phys. 2012 June;39(6Part16):3796.