Pancreatic cancer, a patient saved with internal radiotherapy: first case in Italy

The first implant in Italy was successfully performed at the Rome Hospital.

An innovative “internal radiotherapy” technique to make an otherwise inoperable pancreatic tumor operable. At the San Camillo Forlanini Hospital the first implant in Italy of OncoSil™ was successfully performed, a device with microparticles labeled with Phosphorus-32 aimed at reducing the volume of a locally advanced, inoperable pancreatic tumor. An important step that places the San Camillo Forlanini Hospital at the forefront in Europe in the field of research and technological innovation for the treatment of pancreatic carcinoma.

Performed endoscopically on May 11 on a 65-year-old patient, the procedure uses a brachytherapy technique, a type of radiotherapy in which a radiation source is placed directly inside the patient's body, and was carried out as part of the European “Osprey” study, which in Italy also involves the Gemelli Polyclinic, the Pancreas Institute of Verona, and the Tumor Institute of Milan.

The procedure is the result of a year of work by a multidisciplinary team involving the units of Nuclear Medicine, Gastroenterology, Oncology, Transplant Surgery, General Surgery, and Health Physics at San Camillo-Forlanini.

“Research, innovation, and the courage of professionals can make a qualitative leap in care, especially when it comes to complex or very complex diseases, such as oncological ones, in this case one of the most aggressive tumors we know. There is a real need for experimentation, for the possibility of building new ways to attack the tumor itself. The contribution of each of the professionals involved was fundamental in achieving this milestone,” says Narciso Mostarda, general director of the San Camillo-Forlanini hospital. Pancreatic carcinoma is the fourth most common and is the only one that has not shown a reduction in mortality rates over time, both in men and women. In Italy, about 14,300 new diagnoses and 12,400 deaths were estimated in 2020.

In most cases, it progresses asymptomatically and is diagnosed at an already advanced stage: for this reason, every step in research and technological innovation is therefore fundamental for the fight against and treatment of this tumor. The OncoSil™ brachytherapy device represents an innovation in the treatment of pancreatic cancer as it allows for the targeted and permanent endoscopic intra-tumoral placement of a “container” of Phosphorus-32 microparticles, a radioisotope capable of emitting highly therapeutic particles in the short range where it is deposited. The treatment is minimally invasive and is aimed at cases of locally advanced pancreatic carcinoma, considered inoperable at diagnosis, to bring them back to the possibility of radical surgical intervention. The first worldwide trial of the OncoSil™ therapeutic device dates back to 2017 and showed that 33% of treated patients became operable again, surgical resection of the tumor was performed in 1 out of 4 patients involved in the study, and the risk of death in these patients was reduced by 20%.

“The case presented considerable difficulties, such as to make it suitable for use for training purposes and to strengthen experiences for future implants in other European centers,” explains Dr. Guido Ventroni, director of the UOC Nuclear Medicine and clinical manager for the San Camillo-Forlanini hospital in the international trial. “The patient responded very well to the procedure, so much so that he was able to be discharged the very next day.” Yesterday, the first follow-up visit confirmed the success of the implant without any adverse effects and the patient's excellent reaction. The oncologist who identified the patient as a candidate for treatment will take charge of the 65-year-old man again for subsequent diagnostic reassessments and for a possible future surgical approach in an already established multidisciplinary company pathway.

Original article: https://www.ilmessaggero.it/roma/metropoli/tumore_pancreas_operazione_primo_caso_italiasan_camillo_r...