WVU Cancer Institute first in the nation to offer IORT for glioblastoma

One of seven worldwide participating in this clinical trial

Friday, September 1, 2017

Christopher Cifarelli, MD

The WVU Cancer Institute is the first institution in the United States to offer intraoperative radiation therapy (IORT) to treat glioblastoma.

Glioblastoma is a lethal form of brain cancer with a median survival of only 14 to 20 months after treatment. Within a week of diagnosis, patients undergo surgery to remove the tumor, followed by external beam radiation three to five weeks later once the surgery site has healed. Unfortunately, the disease always returns, and at this time, there are no reliable treatments for recurrence.

“The real hope of the investigators and all of us that are involved in this clinical trial is that by decreasing lag time, being upfront and immediate, we will allow for a longer cessation of disease and maybe even overcome some of the progression,” Christopher P. Cifarelli, M.D., Ph.D., WVU Medicine neurosurgeon, director of the WVU Gamma Knife Radiosurgery Program, and lead investigator for this clinical trial at the WVU Cancer Institute, said. “Right now, there’s not much these patients have other than hope.”

The clinical trial uses IORT as a boost to the current standard of care for glioblastoma, which is surgery and external beam radiation. Dr. Cifarelli hopes to also examine using IORT to treat cancers that have metastasized to the brain from elsewhere in the body.

WVU Cancer Institute physicians hope to use IORT to increase the time between initial treatment and recurrence, ultimately extending survival time, improving quality of life, and potentially increasing overall survival.

This treatment is through the INTRAGO-II study, an international FDA-approved clinical trial sponsored by University Medical Centre Mannheim in Germany. Only seven institutions worldwide are currently involved in the trial.

IORT involves bringing a radiation therapy device into the operating room immediately after a tumor has been removed. The tip of the device is inserted into the cavity where the tumor was and delivers an immediate dose of radiation therapy directly to the affected area, with the intent to kill any cancer cells lingering after surgery. The WVU Cancer Institute has used IORT to treat breast cancer for more than a year.

Because glioblastoma virtually always recurs within two centimeters of the original tumor, the investigators hope that by targeting the tumor area directly, the cancer will not regrow as quickly, if at all. Additionally, while traditional external beam radiation requires a lag time while the surgical wound heals, giving the tumor time to regrow, IORT is administered immediately, hopefully eliminating the cancer’s foothold.