News & Updates

Dr Dean Mastras speaks at Pierce County Dental Society General Membership Meeting

By Tacoma Radiation on June 1st, 2018

Dr. Dean Mastras of Tacoma/Valley Radiation Oncology Centers recently spoke at the Pierce County Dental Society’s General Membership Meeting. The focus of his discussion was on head and neck cancers. For more details on this story, read the full story here.

Cancer Patients Now Receiving Faster, Precise Radiotherapy at Tacoma/Valley Radiation Oncology Centers

By Tacoma Radiation on June 1st, 2018

New TrueBeam™ system from Varian Medical Systems treats cancer faster, deals effectively with tumor motion and improves the patient experience.

TACOMA, WASHINGTON — June 1, 2018 Tacoma/Valley Radiation Oncology Centers, with five locations in Pierce and Thurston Counties, has commenced treating cancer patients using the new TrueBeam system from Varian Medical Systems, an innovative medical technology that enables a radically different approach to treating cancer with image-guided radiotherapy. The new machine is located at the company’s St. Joseph Medical Center location. The physicians and staff treated patients using the company’s new system for the first time the third week of May 2018.

With dose delivery rates that are 40–140 percent higher than earlier generations of Varian technology, the TrueBeam system can complete a treatment commensurately faster. This makes it possible to offer greater patient comfort by shortening treatment times, and to improve precision by leaving less time for tumor motion during dose delivery. “Intelligent” automation further speeds treatments with an up to fivefold reduction in the number of steps needed for image guidance and dose delivery.

“TrueBeam makes it possible to deliver accurate image-guided treatments within a few minutes per day. At the same time, we can monitor and compensate for tumor motion, and that further increases treatment accuracy,” said Herbert Wang, M.D.

The TrueBeam imager can produce the three-dimensional images used to fine-tune tumor targeting in 60% less time than compared with previous Varian image-guided technologies. Additional functionality makes it possible to create images using 25% less X-ray dose. “Imaging is an essential part of modern-day, targeted radiotherapy,” explained Dr. Wang. “This machine allows us to minimize the amount of X-rays needed to generate an image—and that’s good for our patients.”

TrueBeam can be used for many forms of advanced treatments such as image-guided radiotherapy (IGRT), including intensity-modulated radiotherapy (IMRT), RapidArc® radiotherapy technology and Gated RapidArc. “Each of these approaches is appropriate for a certain type of clinical situation,” said Michael McDonough, M.D. “With TrueBeam, we can choose the optimal approach for our patients.”

Tacoma/Valley Radiation Oncology Centers
Serving the greater South Sound, Tacoma/Valley Radiation Oncology Centers has provided state-of-the-art radiation treatment to patients in our community for over 35 years. Our offices provide the latest technology complemented with caring physicians and staff. We have four centers located in Pierce County with two in Tacoma, and one in Puyallup and Gig Harbor. Our fifth center is located in Olympia, Washington. To learn more about us and the services we provide you can visit us on the web at www.tacomaradiation.com.

The Rationale, Technique, and Feasibility of Partial Breast Irradiation Using Noninvasive Image-Guided Breast Brachytherapy

By Tacoma Radiation on May 8th, 2018

Jaroslaw T. Hepel1,2 Jessica R. Hiatt1 Sandra Sha3 Kara L. Leonard1,2 Theresa A. Graves4 Doreen L. Wiggins4 Dean Mastras5 Ann Pittier5 Brown University Oncology Research Group6 David E. Wazer1,2

1 Department of Radiation Oncology, Rhode Island Hospital, Brown University, Providence, RI
2 Department of Radiation Oncology, Tufts Medical Center, Tufts University, Boston, MA
3 Department of Radiation Oncology, Watson Clinic, Lakeland, FL
4 Department of Surgery, Rhode Island Hospital, Brown University, Providence, RI
5 Department of Radiation Oncology, Tacoma Valley Radiation, Tacoma, WA
6 Brown University, Providence, RI

Purpose:

Noninvasive image-guided breast brachytherapy (NIBB) is a novel approach to deliver accelerated partial breast irradiation (APBI). NIBB is noninvasive, yet maintains a high degree of precision by using breast immobilization and image guidance. This makes NIBB an attractive alternative to existing APBI techniques.

Methods and Materials:

Forty patients were enrolled to an institutional review boardapproved prospective clinical trial evaluating APBI using NIBB. The NIBB technique is described in detail. Briefly, patients were treated with the breast compressed and immobilized sequentially in two orthogonal axes for each fraction. Radiation was delivered using collimated emissions from a high-dose-rate iridium-192 source via specialized applicators. The prescribed dose was 34.0 Gy in 10 fractions. Feasibility and tolerability of treatment were assessed.

Results:

All patients completed protocol treatment. The median age was 68 years. Sixty-three percent of patients had invasive carcinoma, and 37% had ductal carcinoma in situ. All were node negative. Ninety-three percent of patients were postmenopausal. Mean tumor size, tumor bed volume, and breast volume were 1.1 cm, 22.4 cc, and 1591 cc, respectively. NIBB treatment was well tolerated. Median patient-reported discomfort was 1 on a 10-point pain scale. Treatment delivery times were reasonable. The average treatment time per axis was 14 min (5e20 min), and the average time from start of first treatment axis to completion of orthogonal axis was 43 min(30e63 min). Acute skin toxicity was Grade 0, 1, and 2 in 20%, 53%, and 28% of patients, respectively. There were no Grade 3 or greater acute toxicities observed.

Conclusions:

NIBB holds promise as an alternative method to deliver APBI. NIBB is feasible and well tolerated by patients. Further investigation of NIBB to deliver APBI is warranted.  2014 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Download Complete Clinical Investigation (PDF)

Evaluation of Outcomes in Gamma Knife Stereotactic Radiosurgery Treatment of Essential and Parkinsonian Tremor – A Private Institution Update

By Tacoma Radiation on March 6th, 2018

D. Dunham1,2 R. Sorum1,2 H. Wang1,2 M. McDonough1,2 A. Harris, K. Bergman1,2 M. Reda1,2 K. Nkiwane1,2 A. Zemanek2 D. Mastras2 N. Bittner2 A. Pittier2 W. Gao2

1South Sound Gamma Knife, Tacoma, WA, United States of America
2Tacoma/Valley Radiation Oncology Centers, Tacoma, WA, United States of America

Purpose:

To update previously presented 2011 study examining inclusively the outcomes of 68 patients (69 cases) presenting with essential or Parkinsonian tremor. All patients were treated with Gamma Knife stereotactic radiosurgery (GKSRS) via ventralis intermedius (Vim) thalamotomy.

Methods:

Between January 2005 and December 2016, a total of 69 cases of tremors were treated at our facility (South Sound Gamma Knife at St. Joseph’s Hospital, Tacoma, WA). Sixty with benign essential tremor, seven with Parkinsonian tremor, and two with both types of tremors were included. Using magnetic resonance imaging, the contralateral Vim thalamic nucleus of the chosen treatment side was located and treated, receiving a single 4 mm shot of 130 Gy. These patients were followed by their Radiation Oncologist or Neurosurgeon. A retrospective review of medical records including physical exams, writing samples and Archimedes spiral testing, in combination with patient phone interviews, were conducted to obtain data on treatment outcomes.

Results:

In total 68 patients with a median age of 77 years received GKSRS for essential tremor or Parkinson’s tremor diagnosis. They had median pre-treatment tremor duration of 11.5 years (range, 1.5-70). With a median follow-up period of 16 months (range, 1-64), a total of 79.4% (54/68) responded to the treatment, as evidenced by lessening in their tremor severity. Of these patients, 35.2% had a complete response, with no residual tremor. The median time to response was 3 months (range, 0.1-18). 5.88% (4/68) of patients experienced symptomatic, MRI proven radiation induced perilesional edema requiring the need for steroid treatments and physical therapy.

Conclusion:

When combined with prior research data, GKSRS Vim thalamotomy at our private institution has shown consistency in providing relief from tremor at rates similar to other studies on this topic. This continues to be a viable, safe and effective treatment option for this disabling condition.

Download Complete Clinical Investigation (PDF)

Evaluation of Outcomes in Gamma Knife Stereotactic Radiosurgery in Treatment of Trigeminal Neuralgia – A Private Institution Update

By Tacoma Radiation on March 6th, 2018

D. Dunham 1,2 R. Sorum1,2 M. McDonough 1,2 H. Wang 1,2 K. Bergman 1,2 A. Harris 4 M. Goldman3 A. Zemanek 2 M. Reda 1,2 K. Nkiwane 1,2 D. Mastras2 N. Bittner2 A. Pittier2 W. Gao2

1South Sound Gamma Knife, Tacoma, WA, United State of America
2Tacoma/Valley Radiation Oncology Centers, Tacoma, WA, United States of America
3South Sound Neurosurgery, Tacoma, WA, United Sates of America
4Multicare Neurosurgical Associates

Objective:

To update previously presented 2011 study examining inclusively the outcomes of 121 patients (139 cases), presenting with Trigeminal Neuralgia (TN), treated with stereotactic radiosurgical lesioning of the trigeminal nerve entry. This study provides supportive documentation for an appealing standard alternative to invasive treatment.

Methods:

Between January 2005 and December 2016, a total of 139 cases of TN were treated with Gamma Knife stereotactic radiosurgery (GKSRS) at our facility. A single 4 mm shot of 75-85 Gy for primary treatment and 50-70 Gy for secondary treatment was delivered with the Leksell Gamma Knife 4C or Perfexion to the trigeminal nerve 4 to 7 mm from its origin from the brainstem while limiting the radiation dose to the brainstem to the 20% isodose line. Of those 139 cases, eighteen were secondary GKSRS treatments. Five patients had been lost to follow-up, leaving 116 cases available for analysis based on retrospective chart review of medical records, physical exams and patient phone interviews.

Results:

Median follow-up was 12 months. Mean dose administered for primary treatment was 79.3 Gy (range, 75-85Gy); for secondary treatment it was 65 Gy (range, 50-70Gy). A total of 83% of patients undergoing their first GKSRS experienced pain relief following treatment at a median of 30 days post -treatment. Of this population, 30% of patients experienced a recurrence of symptoms, at an average of 10.5 months after treatment. No significant differences were found between outcomes of subgroups including patients with multiple sclerosis, atypical TN, nor those who had undergone previous surgical treatment for TN. There was no difference in outcome between the doses administered (75, 80, and 85Gy). For those patients receiving their second GKSRS for TN, there was an initial success rate of 90% with 25% of that population eventually having recurring symptoms. 21% of cases developed some level of ipsilateral facial numbness.

Conclusion:

This study further supports our previous conclusion advocating that Gamma Knife stereotactic radiosurgery is an effective treatment of Trigeminal Neuralgia. Patient outcomes are comparable to other published reports. No significant predictor of recurrence or lack of response was found.

Download Complete Clinical Investigation (PDF)

The rationale, technique, and feasibility of partial breast irradiation using noninvasive image-guided breast brachytherapy

By Tacoma Radiation on February 20th, 2018

PURPOSE

Noninvasive image-guided breast brachytherapy (NIBB) is a novel approach to
deliver accelerated partial breast irradiation (APBI). NIBB is noninvasive, yet maintains a high degree
of precision by using breast immobilization and image guidance. This makes NIBB an attractive
alternative to existing APBI techniques.

METHODS AND MATERIALS

Forty patients were enrolled in an institutional review board approved
prospective clinical trial evaluating APBI using NIBB. The NIBB technique is described
in detail. Briefly, patients were treated with the breast compressed and immobilized sequentially in
two orthogonal axes for each fraction. Radiation was delivered using collimated emissions from a
high-dose-rate iridium-192 source via specialized applicators. The prescribed dose was 34.0 Gy in
10 fractions. Feasibility and tolerability of treatment were assessed.

RESULTS

All patients completed protocol treatment. The median age was 68 years. Sixty-three
percent of patients had invasive carcinoma, and 37% had ductal carcinoma in situ. All were node
negative. Ninety-three percent of patients were postmenopausal. Mean tumor size, tumor bed volume,
and breast volume were 1.1 cm, 22.4 cc, and 1591 cc, respectively. NIBB treatment was well
tolerated. Median patient-reported discomfort was 1 on a 10-point pain scale. Treatment delivery
times were reasonable. The average treatment time per axis was 14 min (5e20 min), and the
average time from start of first treatment axis to completion of orthogonal axis was 43 min
(30e63 min). Acute skin toxicity was Grade 0, 1, and 2 in 20%, 53%, and 28% of patients, respectively.
There were no Grade 3 or greater acute toxicities observed.

CONCLUSIONS

NIBB holds promise as an alternative method to deliver APBI. NIBB is feasible
and well tolerated by patients. Further investigation of NIBB to deliver APBI is warranted.  2014
American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Keywords: Noninvasive image-guided breast brachytherapy; NIBB; AccuBoost; Partial breast irradiation; APBI; Breast
cancer

Download Complete Publication (PDF)

Prospective Randomized Comparison of the Effectiveness of Radiation Therapy and Local Steroid Injection for the Treatment of Plantar Fasciitis

By Tacoma Radiation on July 9th, 2015

Summary

Based on retrospective and prospective data, radiation therapy is effective for the treatment of plantar fasciitis. Local injections of corticosteroids are used to control pain when other conservative treatments have failed. We performed a randomized, prospective trial to compare the effects of radiation therapy with those of local corticosteroid injections. We show the superiority of radiation therapy concerning pain relief and recommend radiation therapy for treating plantar fasciitis.

Purpose

The purpose of this study was to conduct a randomized trial of radiation therapy for plantar fasciitis and to compare radiation therapy with local steroid injections.

Methods and Materials

Between March 2013 and April 2014, 128 patients with plantar fasciitis were randomized to receive radiation therapy (total dose of 6.0 Gy applied in 6 fractions of 1.0 Gy three times a week) or local corticosteroid injections a 1 ml injection of 40 mg methylprednisolone and 0.5 ml 1% lidocaine under the guidance of palpation. The results were measured using a visual analog scale, a modified von Pannewitz scale, and a 5-level function score. The fundamental phase of the study was 3 months, with a follow-up period of up to 6 months. Results: The median follow-up period for all patients was 12.5 months (range, 6.5-18.6 months). For the radiation therapy patients, the median follow-up period was 13 months (range, 6.5-18.5 months), whereas in the palpation-guided (PG) steroid injection arm, it was 12.1 months (range, 6.5-18.6 months). After 3 months, results in the radiation therapy arm were significantly superior to those in the PG steroid injection arm (visual analog scale, P<.001; modified von Pannewitz scale, P<.001; 5-level function score, P<.001). Requirements for a second treatment did not significantly differ between the 2 groups, but the time interval for the second treatment was significantly shorter in the PG steroid injection group (PZ.045).

Results

The median follow-up period for all patients was 12.5 months (range, 6.5-18.6 months). For the radiation therapy patients, the median follow-up period was 13 months (range, 6.5-18.5 months), whereas in the palpation-guided (PG) steroid injection arm, it was 12.1 months (range, 6.5-18.6 months). After 3 months, results in the radiation therapy arm were significantly superior to those in the PG steroid injection arm (visual analog scale, P<.001; modified von Pannewitz scale, P<.001; 5-level function score, P<.001). Requirements for a second treatment did not significantly differ between the 2 groups, but the time interval for the second treatment was significantly shorter in the PG steroid injection group (PZ.045).

Download Complete Clinical Investigation (PDF)

Dr. Dean Mastras Highlighted in Article on Prostate Cancer Treatment

By rforsberg on November 10th, 2014

Working with our healthcare partners to ensure best practices and superior treatment options are delivered is a top priority for Tacoma/Valley Radiation Oncology Centers.  We are always pleased to be a part of our patients’ success stories.  We are even more delighted when the patient elects to go public with their cancer battle & share their story as part of an educational approach to showcasing the awesome cancer care and treatment advantages available with our team of physicians and staff at Tacoma/Valley Radiation Oncology Centers.  For more on this great story; click on the link.

TeamApproachTreatingProstateCancer

Plantar Fasciitis Treatment Covered by Most Insurances

By rforsberg on November 7th, 2014

Did you know the use of radiation therapy is a proven successful treatment for Plantar Fasciitis?  Are you aware that radiation treatment is covered by most insurances?  If you or someone you know suffers from painful heel spurs Tacoma/Valley Radiation Oncology Centers is here to offer help.  For additional details on this treatment option contact us at (253) 627-6172 and check out our link with additional information.

TVROC PF Flyer revOct.2014

PSA Screenings – Important Information You Should Know

By rforsberg on July 8th, 2013

IMPORTANT INFORMATION ON PSA SCREENINGS
TACOMA/VALLEY RADIATION ONCOLOGY CENTERS WANT PATIENTS TO BE WELL INFORMED

Tacoma, WA – Tacoma/Valley Radiation Oncology Centers want patients to be well informed on PSA screenings and recent research and data conducted on this issue.  The following articles (listed below in link form) shed light on evidence based research that suggests eliminating PSA screenings for men may result in undiagnosed or advanced cancers.  The articles also discuss the potential impact of insurance companies not paying for the testing.  The articles have been made available to educate and inform our patients and future patients, as well as website visitors.

At TVROC, we offer the most advanced treatment planning and radiation therapy services.  With our experience, expertise, and strong service commitment, no team will fight harder for a patient’s health.  With offices in Tacoma, Puyallup, Gig Harbor, and Olympia, TVROC patients have the comfort and convenience of receiving medical care in their own community without travel to distant, unfamiliar locations.  To learn more about the treatment advantages at Tacoma/Valley Radiation Oncology Centers – give us a call today!

Advanced cancer may triple without PSA tests

Quality of life effects of PSA screening

Health_Wellness part 1

Health_Wellness part 2