A woman from Salisbury has become the first patient in the UK with head and neck cancer to receive radiotherapy in the operating theatre during surgery to remove a recurrent tumour.
Jayne Garrett, 53, underwent major surgery at University Hospital Southampton on 25 April after suffering a recurrence of her cancer following conventional treatment in 2015 and 2017.
During the procedure she received a full dose of radiotherapy via Mobetron, the first portable system able to administer the treatment – known as intraoperative electron beam radiotherapy (IOERT) – in this way.
This is an intensive form of targeted radiation given at the time of surgery to treat a wide variety of advanced cancers that are otherwise difficult to remove and treat.
Mobetron is a mini-version of a linear accelerator and can send high energy focused electron beams precisely to areas inside the human body immediately after a cancer has been removed.
IOERT enables surgeons and oncologists to give much higher doses of radiation to areas that are at a high risk of recurrence without causing damage to surrounding healthy tissue and organs.
This effectively limits radiation doses to protect surrounding critical structures, reducing late complications related to treatment.
Mobetron is used specifically for IOERT and can be moved between operating theatres to treat patients with pancreatic, neuroendocrine, colorectal, bladder and head and neck cancers.
Mobetron was introduced at UHS with the help of PLANETS cancer charity, which fundraises for pancreatic, liver, abdominal and neuroendocrine tumour services.
Co-founded in 2011 by surgeon Neil Pearce along with neuroendocrine cancer patient Layla Stephen and consultant radiologist Brian Stedman, PLANETS has so far raised £1 million. Part of this sum has funded the Mobetron and the charity’s aim is to continue to fund the machine over the next five years.
“IOERT is an innovative and focused radiotherapy treatment given immediately after surgery in high risk cancer patients and is currently available only in Southampton,” said Dr Shanmugasundaram Ramkumar (pictured above with Mrs Garrett), a consultant clinical oncologist and intraoperative radiotherapy lead at UHS.
“Recurrent head and neck cancer is extremely difficult to treat as these patients have been treated previously with high doses of radiotherapy and re-irradiation with conventional radiotherapy techniques are difficult and damaging to normal tissues.
“Using IOERT we can deliver focused radiotherapy and reduce the amount of toxicity for these patients and we are extremely pleased to have had the option of treating Mrs Garrett with this system.”
Dr Ramkumar added: "Due to radiation scattering effects of conventional radiotherapy treatments for head and neck cancer, the risk of damage to sensitive parts of the body such as nerves, muscles or vocal cords is relatively high.
“IOERT enables the delivery of radiation immediately after surgical resection and, therefore, directly into the tumour bed, minimising scattering effects to surrounding normal tissues.”
Nimesh Patel, the consultant ear, nose and throat surgeon who performed the operation, said: “For Mrs Garrett, who had previously received standard chemotherapy and radiotherapy, IOERT is an exciting treatment which we believe will reduce her risk of cancer recurrence.
“This treatment was previously only available in a select few cancer centres in the USA and Europe, so it is indeed a significant moment for the treatment of patients with recurrent head and neck cancer in the UK whose outcomes may improve as a result of this procedure.”
Mrs Garrett said: “I was amazed the oncologists and surgeons were able to give me radiotherapy during surgery, cutting out the need for it to be given separately.
“Additionally, with my previous radiotherapy I suffered some significant side-effects such as being unable to produce saliva but, with this treatment, I have not suffered from that at all.”
Neil Pearce, who is associate medical director at UHS, added: “IOERT using the Mobetron is a safe and effective standard of care in the treatment of complex cancers in a large number of internationally-renowned cancer centres and Southampton is among that group.”
Posted on Thursday 27 June 2019