Loyola Tests Procedure to Relieve Spinal Cancer Pain | Loyola Medicine

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Monday, June 15, 2015

Loyola first to test new procedure to relieve pain of cancer that has spread to spine

MAYWOOD, IL –  Loyola University Medical Center is the first center in the country to enroll patients in a clinical trial of a minimally invasive treatment for patients living with cancer that has spread to the spine.

The treatment is designed to help relieve pain, heal spinal fractures and prevent new fractures.

The spine is the most common site of bone metastases. A tumor can weaken a vertebra, causing it to collapse on itself, resulting in severe pain and impaired mobility.

Loyola is testing a new combination treatment that delivers radiation directly to the tumor and increases support of the spine.

The multidisciplinary group of physicians performing this treatment at Loyola includes interventional radiologists, orthopaedic surgeons and radiation oncologists.

The first patient to undergo the combination treatment has metastatic lung cancer that has spread to his spine. Physicians performed the procedure on two vertebral levels in the middle of the back (T10 and T12). “The surgery alleviated the pain quite a bit,” the patient said. 

In the procedure, interventional radiologist Angelo Malamis, MD, first makes a small incision in the spine vertebra and inserts a spinal applicator needle to deliver radiation directly to the tumor. Once the applicator is in place, a team from Radiation Oncology, led by William Small, Jr., MD, confirms proper placement and the radiation is delivered over the  course of a few minutes. This is called intraoperative radiotherapy. In contrast to standard external beam radiation , the more precise intraoperative radiotherapy can deliver a higher dose of radiation, while minimizing the adverse effects to normal tissue.   

The second half of the operation is a procedure called a kyphoplasty. It is completed by an interventional radiologist or orthopaedic surgeon. A needle cannula is inserted through the incision. A balloon at the tip of the cannula is inflated to increase the height of the collapsed vertebra. A cement-like material then is injected into the radiated area to help stabilize the spine.

The purpose of the Phase 1 study is to learn about both the good and bad effects of combining intraoperative radiotherapy and kyphoplasty. Researchers will compare the pain levels and use of pain medications before and after the procedure. They also will monitor quality-of-life issues, the effect of the procedure on the tumor and any complications.

The study is titled “Combining Intraoperative Radiotherapy with Kyphoplasty for Treatment of Spinal Metastases (Kypho-IORT)”. It is sponsored by the departments of Radiation Oncology and Radiology of Loyola University Chicago Stritch School of Medicine.

The principal investigator is Dr. Small, chair of the Department of Radiation Oncology. Co-investigators are Dr. Malamis; Abhishek Solanki, MD; Karan Shah, MD; and Janushi Dalal, MD.

To qualify for the trial, a patient must meet several criteria, including being 50 or older and having metastatic cancer that has spread from a solid tumor to the spine. For more information, call 708-216-2568.

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 92 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 129,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.