Moffitt Cancer Center
Located in Tampa, Florida, Moffitt Cancer Center enjoys a reputation as one of the world’s most sophisticated cancer centers and, as such, consistently attracts fellowship-trained physicians and medical researchers who are among the best in their fields. Moffitt has 14 partnerships in Florida, Puerto Rico, Georgia, and Pennsylvania, and is listed in US News & World Report as one of “America’s Best Hospitals” for cancer care.
Now in its 26th year of operation, the National Cancer Institute-designated center is using the latest innovations to uphold its commitment to comprehensive care. Indeed, Moffitt’s trademarked Total Cancer Care™ model, introduced in 2003 by Moffitt scientists and employees, is an evolving protocol that combines information technology, cutting-edge basic science, and stateof- the-art clinical care aimed at identifying and meeting all the needs of each patient in the most personalized way possible.
Among the programs that best exemplify this approach are Moffitt’s breast cancer program, which now offers its patients singledose intraoperative radiotherapy and low-dose mammography, and its new Personalized Medicine Institute.
Single-Dose Intraoperative Radiotherapy
for Early Breast Cancer
In November 2010, Moffitt became the first center in the Tampa Bay area to acquire INTRABEAM (Carl Zeiss Meditec), a radiation platform designed to replace as many as 6½ weeks of radiotherapy (typically administered 5 days per week) with a single 30- to 45-minute targeted intraoperative treatment administered while patients are anesthetized for lumpectomies.
INTRABEAM, which is cleared for use in most countries and was FDA-approved in 1999, is considered the least disruptive radiotherapy treatment available to patients with early-stage breast cancer. The system’s miniature x-ray source, highly flexible support stand, and full range of radiation applicator options enable targeted delivery of a precise dose of intraoperative radiation directly to the tumor bed immediately after excision. The intraoperative delivery method minimizes geographical misses and essentially eliminates the adverse effects associated with external-beam radiation therapy (EBRT), which can include skin reactions, irritation of healthy breast tissue, and exposure to the lungs and heart.
Eleanor Harris, MD
The benefits of INTRABEAM extend beyond symptom reduction and the convenience of onetime radiation, which in and of itself is highly significant to patients. Eleanor Harris, MD, clinical director and section chief for the Breast and Gynecological Clinical and Research Divisions within Moffitt’s Radiation Oncology Program, explained that intraoperative, singledose, partial-breast radiation can “eliminate treatment delay for patients who need to undergo chemotherapy. This dramatically reduces treatment time and will improve women’s access to breast conservation therapy.”
Moffitt’s decision to acquire the ground-breaking system was based largely on the findings of the landmark TARGeted Intraoperative radioTherapy (TARGIT-A) study, in which investigators showed that, based on local recurrence rates, postlumpectomy single-dose, targeted intraoperative radiotherapy was as effective as EBRT. The international, multicenter clinical trial followed 2232 patients for a median of four years and, to date, remains the largest randomized clinical trial ever conducted in the field of intraoperative radiotherapy for the treatment of early breast cancer.
Currently, patients eligible for treatment with accelerated partial-breast radiotherapy, including INTRABEAM, are postmenopausal women with small (<3.0 cm) tumors, negative excision margins, and negative lymph nodes. Harris explained that the postmenopausal criterion stems from recommendations put forth in radiation oncology guidelines for the use of accelerated partial-breast radiation, and reflects the limited data on such treatment for premenopausal women, who are at higher risk for local recurrence.