An out-of-body operation stirs interest
for the first time, cancer has been successfully treated by removing an organ from the body, giving it radiotherapy and then re-implanting it. The out-of-body operation allows doctors to administer high doses of radiation to widespread tumours without affecting other organs.
Doctors in Italy recently announced that they have used the technique to treat a 48-year-old man with multiple tumours in his liver. One year after the operation, which took 21 hours, the man is alive and well. The team of surgeons at the Italy-based San Matteo Hospital and physicists from National Institute of Nuclear Physics, is now waiting for approval to treat another six patients with multiple liver tumours.
The patient they treated had a colon tumour removed, but the cancer spread to his liver. Scans revealed no fewer than 14 tumours in his liver. The tumours proved resistant to chemotherapy, or conventional radiotherapy.
So doctors decided to try boron neutron capture therapy, in which boron atoms are attached to the amino acid phenylalanine and injected into a patient. Because they grow quickly, tumours take up more of the compound than normal cells. Two to four hours later, a low-energy neutron beam is directed at the organ, splitting the boron into high-energy particles that mainly kill the cancer cells.
But to ensure that all cancerous cells are destroyed, an even dose of neutrons has to be given to the entire organ. That's not easy to do in the body, where obstructions such as bones block the neutron beam.
What the surgeons did was remove the entire liver. The organ was placed in a Teflon bag, irradiated and then re-implanted. "By explanting the organ, we could give a high and uniform dose to all the liver," says Tazio Pinelli, a physicist who coordinated the work together with liver surgeon Aris Zonta. "It was a bold stroke and has stirred the interest of many in the field," says Paul Busse, a neutron radiology expert at Harvard Medical School in Boston, usa.
The technique is dubbed taormina, Italian for "advanced treatment of organs by means of neutron irradiation and auto-transplant". But with only one person treated so far, it is too early to judge how safe and effective it is.
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