Surgically Targeted Radiation Therapy (STaRT) for patients with operable brain tumors
Right Treatment. Right Time. Right Place.
GammaTile Therapy is a Surgically Targeted Radiation Therapy (STaRT) that provides immediate, dose-intense treatment at the completion of resection. By getting a head STaRT on fighting the tumor, resection plus GammaTile Therapy can extend local recurrence-free survival with minimal complications, reduced patient burden, and assured compliance.
Elevating Outcomes With Optimized Dosimetry
GammaTile Therapy vs Intensity-Modulated Radiation Therapy (IMRT)
GammaTile is designed with uniform radiation-source spacing to ensure an even dose distribution. The favorable depth-dose profile optimizes local tumor control.
The colors indicate the radiation location and intensity from the 2 types of treatment. Blue-green indicates lower radiation levels. Red indicates higher levels. The extracranial dose is likely lower than shown, as the planning system did not utilize inhomogeneity corrections.
LOCAL CONTROL: RECURRENT BRAIN METASTASES AND RECURRENT MENINGIOMAS
GammaTile Therapy significantly improves local control vs the previous standard-of-care treatment in patients with recurrent brain metastases and recurrent meningiomas.[3,4]
RECURRENT BRAIN METASTASES[3,+]
OVERALL SURVIVAL: RECURRENT GLIOBLASTOMA [5,6]
GammaTile Therapy demonstrates a potential for improved overall survival when comparing the effectiveness of surgery plus GammaTile Therapy to other treatment modalities across different clinical studies in patients with recurrent glioblastoma (GBM).
Designed with the brain’s delicate environment in mind to limit radiation changes in healthy tissue
RADIATION-RELATED ADVERSE EVENTS
How It Works. An Eloquent Solution.
GammaTile Therapy targets tumor cells while preserving brain tissue. Surgically guided treatment of the local radiation dose to the operative bed optimizes the therapeutic margin while minimizing complications.
Structural offset of the radiation source from the brain tissue prevents harmful direct seed-to-tissue contact and enables intraoperative adjustment.
Achieve local control with optimized dosimetry
- 50% of the therapeutic dose is delivered within the first 10 days after surgery, which helps prevent residual tumor cells from replicating.
- 88% of the therapeutic dose is delivered within 30 days, with more than 95% of the dose delivered by 6 weeks.
- A favorable depth-dose profile optimizes local tumor control.
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Cesium-131 Distribution and Intensity
Bioresorbable, conformable collagen tile preserves healthy tissue
• GammaTile uses a Cesium-131 radiation source, which has a half-life of 9.7 days
• Favorable depth-dose profile optimizes local tumor control[15,16]
• Uniform radiation-source spacing ensures a predictable, therapeutic radiation dose
• Its design helps limit the radiation exposure to medical staff and caregivers
Uniform Radiation Source,
Structurally Offset Design
2-cm height | 2-cm width | 4-mm thickness
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1. Nakaji P, Youssef E, Dardis C, Smith K, Pinnaduwage D, Brachman D. Surgically targeted radiation therapy: a prospective trial in 79 recurrent, previously irradiated intracranial neoplasms. Poster presented at: 2019 AANS Annual Scientific Meeting; April 2019; San Diego, CA.
2. Armpilia CI, Dale RG, Coles IP, Jones B, Antipas V. The determination of radiobiologically optimized half-lives for radionuclides used in permanent brachytherapy implants. Int J Radiat Oncol Biol Phys. 2003;55(2):378-385.
3. Nakaji P, Smith K, Youssef E, et al. Resection and surgically targeted radiation therapy for the treatment of larger recurrent or newly diagnosed brain metastasis: results from a prospective trial. Cureus. 12(11):1-12.
4. Rogers L, Nakaji P, Youssef E, et al. Resection and surgically targeted radiation therapy for initial salvage treatment of aggressive meningioma: results from a prospective trial. Presented at: CNS 2020 Virtual Meeting; September 30, 2020.
5. Brachman D, Nakaji P, Smith K, et al. Resection and Surgically Targeted Radiation Therapy for locally recurrent GBM. J Clin Oncol. 2021;39(15):abstr 2054.
6. Tsien C, Pugh S, Dicker AP, et al. Randomized phase II trial of re-irradiation and concurrent bevacizumab versus bevacizumab alone as treatment for recurrent glioblastoma (NRG Oncology/RTOG 1205): initial outcomes and RT plan quality report. Int J Radiat Oncol Biol Phys. 2019;105(1):S78.
7. Clarke J, Ennis M, Yung W, et al. Is surgery at progression a prognostic marker for improved 6-month progression-free survival or overall survival for patients with recurrent glioblastoma? Neuro-Oncology. 2011;13(10):1118-1124.
8. Stupp R, Wong E, Kanner A, et al. NovoTTF-100A versus physician’s choice chemotherapy in recurrent glioblastoma: a randomised phase III trial of a novel treatment modality. Euro J Cancer. 2012;48(14):2192-2202.
9. Shi W, Bryan M, Gilbert M, et al. Investigating the effect of reirradiation or systemic therapy in patients with glioblastoma after tumor progression: a secondary analysis of NRG Oncology/Radiation Therapy Oncology group trial 0525. Int J Radiat Oncol Biol Phys. 2018;100(1):38-44.
10. Brachman D, Youssef E, Dardis C, Smith K, Pinnaduwage D, Nakaji P. Surgically targeted radiation therapy: Safety profile of collagen tile brachytherapy in 79 recurrent, previously irradiated intracranial neoplasms on a prospective clinical trial. Brachytherapy. 2019;18(3):S35-S36.
11. Combs SE, Debus J, Schulz-Ertner D. Radiotheraputic alternatives for previously irradiated recurrent gliomas. BMC Cancer. 2007;7:167.
12. Wernicke AG, Smith AW, Taube S, et al. Cesium-131 brachytherapy for recurrent brain metastases: durable salvage treatment for previously irradiated metastatic disease. J Neurosurgery. 2017;126(4):1212-1219.
13. Magill ST, Lau D, Raleigh DR, Sneed PK, Fogh SE, McDermott MW. Surgical resection and interstitial iodine-125 brachytherapy for high-grade meningiomas: a 25-year series. Neurosurgery. 2017;80(3):409-416.
14. Brachman D, Youssef E, Dardis C, et al. Resection and permanent intracranial brachytherapy using modular, biocompatible cesium-131 implants: results in 20 recurrent, previously irradiated meningiomas. J Neurosurgery. 2019;131(6):1819-1828.
15. Pinnaduwage D, Youssef E, Sorensen S, et al. Dosimetric impact of radioisotope type on permanent brain seed implants. Medical Physics. 2017;44(6):3146.
16. Armpilia C, Dale R, Coles I, et al. The determination of radiobiologically optimized half-lives for radionuclides used in permanent brachytherapy implants. Int J Radiat Oncol Biol Phys. 2003;55(2):378-385.
17. Moss NS, Imber BS, Prasad K, et al. Permanent intracavitary Cs131 brachytherapy for previously-irradiated recurrent brain metastases: initial clinical and radiation safety experience. Neuro-Oncol Advances. 2020;2(suppl 2):ii14.
GammaTile Therapy is indicated to deliver radiation therapy for patients with newly diagnosed malignant intracranial neoplasms and recurrent intracranial neoplasms. For full safety information, refer to the GammaTile Instructions for Use.