Healthcare Professionals

Advancing Breast Cancer Radiotherapy

A New Era in the Fight Against Breast Cancer Has Arrived

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GammaPod offers physicians a new tool for delivering precision stereotactic radiotherapy treatments. The sharp falloff of GammaPod dose distributions away from the target volume results in extremely low dose to the whole breast volume.  Reduced doses to the whole breast volume have been correlated with lower rates of toxicity and improved rates of excellent/good cosmesis.1 The GammaPod system is also designed to minimize dose to the heart and lungs.

Preoperative RT: Sample Isodose Distributions2

Pre Op GammaPod

with 10 mm margin

Pre Op GammaPod

with 3 mm margin

Postoperative RT: Sample Isodose Distributions

Post Op IMRT

Post Op GammaPod

with 10 mm margin

Post Op GammaPod

with 3 mm margin

The Case to Improve Breast Conservation Therapy

Early detection and treatment have yielded high survival rates for women diagnosed with early-stage breast cancer.  However, current breast radiotherapy techniques, as practices for patients with early-stage, localized disease, are not without challenges.

Whole Breast Irradiation

With whole breast irradiation (WBI) techniques following lumpectomy, patients are typically treated with conventional (CF) or hypofractionated (HF) treatment schedules lasting three to seven weeks.  Protracted treatment schedules are often impractical and inconvenient for patients and represent an inefficient use of healthcare resources because patients are scheduled for 15 – 33 treatment sessions.

Accelerated Partial Breast Irradiation

For nearly two decades, the radiation oncology community has been steadily refining multiple APBI techniques in an effort minimize dose to the whole breast by only treating the lumpectomy cavity plus a small surrounding healthy margin of tissue in fewer treatment sessions.  In an acknowledgement of the growing clinical evidence, the American Society for Radiation Oncology (ASTRO) expanded the range of patients for which APBI should be considered suitable outside of a clinical trial.2  This guidelines has also been accepted by the NCCN and is included in the organization’s Clinical Practice Guidelines in Oncology for breast cancer.

While oncologic outcomes have been demonstrated to be non-inferior to WBI, APBI techniques have produced a different set of challenges.

Clinical Challenges Associated with APBI

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Highly Invasive Approaches

Techniques such as interstitial brachytherapy are effective, yet highly invasive and operator dependant. Intracavitary brachytherapy requires additional surgeries to insert and remove expensive single-use devices

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Inconvenient Treatment Schedules

APBI is typically delivered in twice daily over 10 fractions, with at least 6 hours in between treatments. Patients remain in the radiotherapy clinic between daily treatments, posing a significant hardship for many women.

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Discomfort, Toxicity and Unfavorable Cosmesis

Clinical evidence has found the linac-based APBI may lead to higher rates of "fair" or "poor" cosmetic outcomes and increased toxicity compared to WBI.3 Evidence suggests dose-volume parameters a strong correlation between higher doses to the whole breast volume with linac-based APBI and the frequency of complications.

1 Leonard, K. L., Hepel, J. T., Hiatt, J. R., Dipetrillo, T. A., Price, L. L., & Wazer, D. E. (2013). The Effect of Dose-Volume Parameters and Interfraction Interval on Cosmetic Outcome and Toxicity After 3-Dimensional Conformal Accelerated Partial Breast Irradiation. International Journal of Radiation Oncology • Biology • Physics, 85(3), 623–629.

2 Iii, J. W. S., Mutaf, Y., Nichols, E., Hall, A., Vadnais, P., Regine, W. F., & Feigenberg, S. J. (2017). Dosimetric Improvements with a Novel Breast Stereotactic Radiotherapy Device for Delivery of Preoperative Partial-Breast Irradiation. Oncology, 92(1), 21–30.

3 Olivotto, I. A., Whelan, T. J., Parpia, S., Kim, D.-H., Berrang, T., Truong, P. T., … Julian, J. A. (2013). Interim Cosmetic and Toxicity Results From RAPID: A Randomized Trial of Accelerated Partial Breast Irradiation Using Three-Dimensional Conformal External Beam Radiation Therapy. Journal of Clinical Oncology, 31(32), 4038–4045.

Discover how GammaPod is aligned with the future of value-based healthcare

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The GammaPod system has received 510(k) clearance from the US Food and Drug Administration.
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