Working together to try to improve
outcomes and quality of life for
patients with a glioblastoma
(a common, malignant
brain tumor), a group of
Winthrop physicians from
areas including neurooncology,
radiation
oncology and wound care
recently joined forces to
develop a cutting-edge
clinical trial. The trial
offers an innovative treatment protocol
that utilizes Winthrop’s unique
ability to deliver hyperbaric oxygen
therapy, used in wound care, in rapid
succession with radiation therapy.
Prior studies showed that when
glioblastoma cells were treated with
hyperbaric oxygen within 20 to 30
minutes of radiation, they became
more sensitive to radiation therapy.
Knowing that Winthrop’s state-of-thescience
Hyberbaric Medicine Program
was located right down the hall from
the Hospital’s
Radiation
Oncology
Center,
Winthrop neuro-oncologists J. Paul
Duic, MD, and Jai Grewal, MD, saw
an opportunity to offer the innovative
combination of therapies to patients
who are suffering from this particularly
aggressive type of brain cancer.
Drs. Duic and Grewal teamed up
with Scott Gorenstein, MD, Clinical
Director of Winthrop’s Hyperbaric
Medicine Program, and Jonathan
Haas, MD, Associate Director of
Radiation Oncology at Winthrop, to
develop a clinical trial to treat
glioblastomas (GBMs).
“Glioblastomas are among the
most common brain tumors that we
treat – yet, they are also the most
aggressive,” said Dr. Haas.
For years, Winthrop’s multidisciplinary
cancer care team has
addressed the medical needs of every
glioblastoma patient, offering comprehensive
surgical, medical and support
services. Yet, despite advances in
neuroscience techniques and radiation
oncology over the years, the
median survival rate for patients
remains approximately one year.
Dr. Duic and Dr. Grewal, who are
the Principal Investigators of this Phase
II clinical trial, have extensive research
experience, having conducted clinical
trials for the National Institutes of
Health (NIH). Dr. Duic and Dr. Grewal
worked with the Hospital’s Institutional
Review Board (IRB) to obtain protocol
approval in order to make it available
to newly diagnosed GBM patients. The
trial began in June 2009 and to date
four patients have begun treatment.
“We have brought a unique clinical
trial to the community and are offering
a service to Long Island residents who
would otherwise have to travel to New
York City or even out of state for this
treatment,” said Dr. Duic.
The trial involves six consecutive
weeks (30 treatments) of oral
chemotherapy (Temodar®), radiation
therapy, and hyperbaric oxygen therapy
(HBOT). Patients undergo HBOT
for 30 minutes prior to undergoing
radiation therapy – which typically
ranges from five to 15 minutes.
During HBOT, the patient breathes
100 percent oxygen while reclining in
a pressurized chamber. Inhaling the
pure oxygen allows greater amounts
of oxygen (up to 10 times more than
what is possible while breathing
oxygen at sea level pressure) to be
absorbed into the bloodstream and
then carried to body tissues.
“Studies have shown that severe
hypoxia – lack of oxygen – within tumor
cells can influence their unresponsiveness
to radiation and chemotherapy.
Administering hyperbaric oxygen
therapy prior to radiation can increase
oxygen levels in the blood and tumor,
making it more sensitive to radiation,”
said Dr. Gorenstein.
“For most patients there is usually
no discomfort associated with HBOT
and patients can rest, watch TV or
movies, or sleep during treatment,”
added Dr. Gorenstein.
Following HBOT, the patient is
quickly transferred from the Hospital’s
Hyperbaric Center to the Radiation
Oncology Center for the next phase
of treatment.
“Winthrop-University Hospital has
a unique advantage when compared to
other centers around the nation,” said
Dr. Haas. “Winthrop’s Radiation
Oncology Center and hyperbaric oxygen
therapy facility are in close proximity to
each other. This is vital as radiation
therapy should be administered within
15 minutes of HBOT in order to maximize
the benefits of this added therapy.”
Upon completing six weeks of
chemotherapy, radiation and HBOT,
patients have a four week respite
after which they begin adjuvant
chemotherapy under close supervision
of their team of physicians.
“It is exciting that Winthrop-
University Hospital is equipped with
the resources we need to offer this
treatment. We have had patients and
researchers contact us from around
the country with an interest in this
clinical trial,” said Dr. Grewal.
It is the hope of these Winthrop
physicians that the addition of HBOT
will not only redefine the current
standard of care for newly diagnosed
GBM patients, but will also positively
impact patients’ quality of life and
median survival rates.
“Glioblastoma is a deadly disease,
but if we can use a beneficial
therapy such as hyperbaric oxygen
therapy to improve patient outcomes,
then we are doing a great service to
our patients,” said Dr. Haas.
For more information on how to
enroll in this clinical trial, please call
1-866-WINTHROP.
|
Vol. 19, No. 3
Fall 2009
Back to Publications
|
