Mayfield Clinic

A Mayfield Brain & Spine neurosurgeon is the first surgeon in the eastern United States to perform a new targeted-radiation therapy procedure designed to delay brain tumor recurrence.

Vincent DiNapoli, M.D., Ph.D., who also serves as director of the Brain Tumor Center at The Jewish Hospital-Mercy Health, used GammaTile Therapy in this historic patient case, a process cleared by the Food and Drug Administration (FDA) for treatment of recurring brain tumors, including glioblastomas, gliomas, meningiomas and brain metastases. 

“A glioblastoma is an aggressive, intrinsic brain tumor that comes from the brain itself. It’s the same type of tumor Sen. John McCain and Sen. Ted Kennedy were stricken with,” says DiNapoli. “They’re very difficult to eradicate because, even when you remove what appears as abnormal cells on an MRI, there can still be abnormal cells at a significant distance from the actual focus of the tumor. So, those tumors tend to recur adjacent to the site of the initial tumor.”

During GammaTile Therapy, a bioresorbable, conformable 3D-collagen tile, embedded with tiny radiation seeds, is placed in the cavity following removal of the recurring brain tumor. The tile immediately begins targeting residual tumor cells with radiation while limiting the impact on healthy brain tissue.

“Previously, we embedded 20 to 30 individual seeds about the size of a grain of rice into the brain, and glued them into place,” Dr. DiNapoli recalls. “Despite our best efforts, however, they had the potential to migrate to another part of the brain. With GammaTile Therapy, the radiation is embedded into a wafer similar in size to a surgical sponge, eliminating the worry that individual seeds will migrate from their original placement.”

And GammaTile Therapy is quick – by implanting tiles that contain four seeds each rather than placing two dozen or more seeds one-by-one, the process lessens the length of time a patient is under anesthesia. “We can basically treat the entire cavity in less than five minutes,” DiNapoli notes.

That also means less time for the patient’s brain to be exposed.

GammaTile, manufactured by Tempe, Arizona-based GT MedTech, uses cesium-131 radiation, which has a half-life of 10 days. Earlier radiation seeds used iodine-125, which had a half-life of 60 days. The shorter half-life, of course, means that patients and their families are exposed to radiation for a much shorter period of time.

Glioblastoma is the most aggressive type of glioma tumor and tends to be resistant to current treatments. Patients who undergo surgery for newly diagnosed glioblastoma are also treated with external beam radiation for six weeks and chemotherapy. If the cancer recurs and patients have to have surgery a second time, they tend to feel defeated, as though they are back to square one. Because GammaTile Therapy is performed at the same time as the second surgery, there are no additional trips to the hospital – a patient time and energy saver.

“It provides patients with a new treatment that gives them hope in a situation where they don’t have many other options,”

DiNapoli says. 

Mayfield Brain & Spine is located at 3825 Edwards Road, #300, Cincinnati, OH 45209. For more information, visit www.mayfieldclinic.com.