News & Updates

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.

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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.

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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

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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).

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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

Tacoma/Valley Radiation Oncology Center Physicians Recognized For Medical Care Contributions In Partnership With Pierce County Project Access

By Tacoma Radiation on March 28th, 2013

Tacoma, WA – Tacoma/Valley Radiation Oncology Centers is pleased to announce that seven of their physicians have been recognized by Pierce County Medical Society for their participation in Pierce County Project Access, a non-profit organization who strives to ensure every Pierce County resident has access to medical care. Named Pierce County Medial Society Champions, Doctors Mastras, Sorum, McDonough, Bergman, Wang, Sanders, and Pittier, have served as integral partners in proactively addressing the health care crisis in Pierce County and have been honored as co-recipients of the 2012 Community Service Award.

Since its inception in 2009, Pierce County Project Access has enrolled 832 patients in the program with $6.7 million dollars of donated care. The success of the program is built on minimal administrative cost complemented by significant physician participation through donated leadership time and direct patient care. Senior partner, Dr. Dean Mastras noted, “The physician team at TVROC is dedicated to ensuring all residents of our community have access to cutting-edge, comprehensive cancer treatment provided with compassion and respect.”

At Tacoma/Valley Radiation Oncology Centers 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.

Download a PDF copy of this press release

Tacoma/Valley Radiation Oncology Centers Launch a New Website

By Tacoma Radiation on March 14th, 2013

Tacoma, WA – Tacoma/Valley Radiation Oncology Centers recently launched a new website offering patients easier site navigation and a more consumer friendly design. The new design also provides current and future patients with a better understanding of the services available at their centers, as well as access to some of the latest research in the radiation oncology industry. Pages specifically created to showcase TVROC’s commercials, advertising campaigns and recent company news are also featured. The site was redesigned with feedback from company stakeholders to include patients, visitors, staff and physicians.

At Tacoma/Valley Radiation Oncology Centers we proudly provide exceptional service and patient care whether that comes through a visit to our website or a treatment consultation at one of our centers. With our experience, expertise, and strong service commitment, our goal is to be the radiation oncology provider of choice in the communities we serve. 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 phone us at (253) 627-6172 or visit our new website at www.defeatyourcancer.com.

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Treatment of Plantar Fasciitis Now Available at Tacoma/Valley Radiation Oncology Centers

By Tacoma Radiation on January 30th, 2013

Foot stepping legsTacoma, WA – There is great news for patients suffering from painful heel spurs, commonly know as Plantar Fasciitis. Tacoma/Valley Radiation Oncology Centers (TVROC) is pleased to announce that radiation treatment for Plantar Fasciitis is now available at all five center locations. Known for its anti-inflammatory effect, radiation is an excellent treatment alternative for patients who’ve had little to no success with standard treatment options. Patients with refractory Plantar Fasciitis should consider radiation therapy to reduce their pain and improve their quality of life. Studies have concluded that patients will benefit from treatment with low dose radiation. A randomized controlled trial demonstrated that 6 painless treatments offer effective therapy. A simple consultation with one of our physicians will help determine if radiation treatments are the right fit for each patient and it puts them one step closer to relief from this painful condition.

At Tacoma/Valley Radiation Oncology Centers 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 or to schedule a consultation you may phone us at (253) 627-6172.