Axxent Electronic Brachytherapy for Breast Cancer
Updated September 03, 2013.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
Breast radiation after a lumpectomy is done to help prevent a recurrence of breast cancer. Energy from the radiation kills stray cancer cells that may remain near the tumor site.
That radiation may come from traditional brachytherapy, which uses small radioactive seeds to generate radiation from inside the surgery site. Or, it may come from x-rays, which emit radiation and treat the site from outside the body.
A newer option, Axxent Electronic Brachytherapy, instead uses a tiny x-ray tube to emit radiation.
While x-ray-delivered breast radiation can be given over six or seven weeks, only twice-daily treatments over 5 days are necessary for brachytherapy.
Brachytherapy radiation treatments (also referred to as internal radiation and sealed source radiotherapy) are a type of accelerated partial breast radiation (APBI). That is, only the tissue around your lumpectomy cavity receives radiation, while the rest of your breast is spared.
Typical brachytherapy uses a radioactive seed to emit radiation within your lumpectomy cavity. One of the downsides of this is that patients must be isolated during treatment, as the implanted seeds are constantly emitting radiation.
With the electronic option, however, the micro-miniature x-ray tube (which can be placed during or after your lumpectomy) can be turned on only when needed. This allows patients to receive treatment in a regular exam room, instead of being isolated for the duration of their session. Some patients have reported that this has helped make treatment more comfortable.
The radiation, and therefore effectiveness, is the same as the dose generated by a standard brachytherapy seed.
If you have been diagnosed with early stage breast cancer and are a candidate for intracavity accelerated partial breast irradiation (ask your doctor), Axxent may work for you. You should:
These conditions would exclude you from the treatment:
Likewise, if you have had previous radiation to the thorax or breast on the same side of your body as your present tumor, that would disqualify you from treatment with Axxent.
This system consists of a tube (catheter) with an inflatable balloon on the end.Saline is injected to inflate the balloon and hold it in place during treatment. To make your catheter fit properly or to help excess fluids drain, suction will be used around the balloon.
During each treatment, you will lie comfortably on an exam table while the radiologist connects the radiation machine to your catheter.A drape will be used to shield technicians from the radiation. The radiation source is then guided into the balloon and turned on.After treatment, the x-ray tube is turned off and withdrawn.The end of the catheter will be taped into place.
Although the Axxent system has been cleared by the FDA for the treatment of early stage breast cancer and endometrial cancer, it isn't available everywhere yet.You may have to shop around to find a clinic that offers electronic brachytherapy, but the makers of the system (Xoft Inc.) hope for the eventual widespread adoption of their technology.
As with any similar device, you will have a catheter line sticking out of your breast during the treatment period.Just wear a soft, stretchy bra and take care of the insertion point until the catheter is removed.Sleep on your back or your side opposite the catheter.
You can expect some side effects from any kind of radiation treatment. With the tightly targeted dose of x-ray radiation that electronic brachytherapy provides, exposure to your heart, lungs, and skin should be less than what you'd get with radioactive seed radiation.
In studies, patients sometimes had some blistering, breast pain, fatigue, and breast firmness. Infections occurred in a few cases, requiring the use of antibiotics. Most of these side effects faded over a five-year follow-up period, and patients were pleased with their results.
In a small study, researchers found that both Axxent and MammoSite generated the proper dose of radiation within the lumpectomy cavity. But radiation expands away from its source like a radiant halo, affecting more than just nearby tissue. Axxent worked in a more targeted way than MammoSite, primarily affecting the lumpectomy cavity, and sparing nearby healthy tissues. MammoSite's halo of radiation was wider, affecting more tumor and healthy tissues alike.
Axxent is available for the treatment of other cancers. There are special devices that can deliver x-ray radiation for vaginal and endometrial cancers as well as skin cancer. Axxent has been cleared by the FDA for intraoperative radiation therapy (IORT) for breast cancer -- a one-time high dose of radiation done at the end of your lumpectomy, while you are still under anesthesia.
Sources:
Electronic Xoft Intersociety Brachytherapy Trial: Electronic Brachytherapy (EBT) For Treatment of Early Stage Breast Cancer (EXIBT).ClinicalTrials.gov.
A dosimetric comparison of MammoSite high-dose-rate brachytherapy and Xoft Axxent electronic brachytherapy. Dickler A, Kirk MC, Seif N, et al. Brachytherapy. 2007 Apr-Jun;6(2):164-8.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
Breast radiation after a lumpectomy is done to help prevent a recurrence of breast cancer. Energy from the radiation kills stray cancer cells that may remain near the tumor site.
That radiation may come from traditional brachytherapy, which uses small radioactive seeds to generate radiation from inside the surgery site. Or, it may come from x-rays, which emit radiation and treat the site from outside the body.
A newer option, Axxent Electronic Brachytherapy, instead uses a tiny x-ray tube to emit radiation.
Breast Brachytherapy Speeds Treatment
While x-ray-delivered breast radiation can be given over six or seven weeks, only twice-daily treatments over 5 days are necessary for brachytherapy.
Brachytherapy radiation treatments (also referred to as internal radiation and sealed source radiotherapy) are a type of accelerated partial breast radiation (APBI). That is, only the tissue around your lumpectomy cavity receives radiation, while the rest of your breast is spared.
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Axxent Electronic Brachytherapy (eBx) Benefits
Typical brachytherapy uses a radioactive seed to emit radiation within your lumpectomy cavity. One of the downsides of this is that patients must be isolated during treatment, as the implanted seeds are constantly emitting radiation.
With the electronic option, however, the micro-miniature x-ray tube (which can be placed during or after your lumpectomy) can be turned on only when needed. This allows patients to receive treatment in a regular exam room, instead of being isolated for the duration of their session. Some patients have reported that this has helped make treatment more comfortable.
The radiation, and therefore effectiveness, is the same as the dose generated by a standard brachytherapy seed.
Requirements for Axxent Electronic Brachytherapy
If you have been diagnosed with early stage breast cancer and are a candidate for intracavity accelerated partial breast irradiation (ask your doctor), Axxent may work for you. You should:
- be 50 years old or older
- have a tumor that is 3 centimeters in diameter or smaller and estrogen receptor positive
- have clear lymph nodes
- have negative surgical margins
These conditions would exclude you from the treatment:
- pregnant or breast-feeding
- collagen vascular disease
- scleroderma
- systemic sclerosis
- active lupus
- infiltrating lobular carcinoma
Likewise, if you have had previous radiation to the thorax or breast on the same side of your body as your present tumor, that would disqualify you from treatment with Axxent.
What to Expect During Electronic Brachytherapy
This system consists of a tube (catheter) with an inflatable balloon on the end.Saline is injected to inflate the balloon and hold it in place during treatment. To make your catheter fit properly or to help excess fluids drain, suction will be used around the balloon.
During each treatment, you will lie comfortably on an exam table while the radiologist connects the radiation machine to your catheter.A drape will be used to shield technicians from the radiation. The radiation source is then guided into the balloon and turned on.After treatment, the x-ray tube is turned off and withdrawn.The end of the catheter will be taped into place.
Disadvantages of Electronic Brachytherapy
Although the Axxent system has been cleared by the FDA for the treatment of early stage breast cancer and endometrial cancer, it isn't available everywhere yet.You may have to shop around to find a clinic that offers electronic brachytherapy, but the makers of the system (Xoft Inc.) hope for the eventual widespread adoption of their technology.
As with any similar device, you will have a catheter line sticking out of your breast during the treatment period.Just wear a soft, stretchy bra and take care of the insertion point until the catheter is removed.Sleep on your back or your side opposite the catheter.
Recovery from Electronic Brachytherapy
You can expect some side effects from any kind of radiation treatment. With the tightly targeted dose of x-ray radiation that electronic brachytherapy provides, exposure to your heart, lungs, and skin should be less than what you'd get with radioactive seed radiation.
In studies, patients sometimes had some blistering, breast pain, fatigue, and breast firmness. Infections occurred in a few cases, requiring the use of antibiotics. Most of these side effects faded over a five-year follow-up period, and patients were pleased with their results.
Comparing Axxent with MammoSite
In a small study, researchers found that both Axxent and MammoSite generated the proper dose of radiation within the lumpectomy cavity. But radiation expands away from its source like a radiant halo, affecting more than just nearby tissue. Axxent worked in a more targeted way than MammoSite, primarily affecting the lumpectomy cavity, and sparing nearby healthy tissues. MammoSite's halo of radiation was wider, affecting more tumor and healthy tissues alike.
Other Treatments Using Axxent Electronic Brachytherapy
Axxent is available for the treatment of other cancers. There are special devices that can deliver x-ray radiation for vaginal and endometrial cancers as well as skin cancer. Axxent has been cleared by the FDA for intraoperative radiation therapy (IORT) for breast cancer -- a one-time high dose of radiation done at the end of your lumpectomy, while you are still under anesthesia.
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Sources:
Electronic Xoft Intersociety Brachytherapy Trial: Electronic Brachytherapy (EBT) For Treatment of Early Stage Breast Cancer (EXIBT).ClinicalTrials.gov.
A dosimetric comparison of MammoSite high-dose-rate brachytherapy and Xoft Axxent electronic brachytherapy. Dickler A, Kirk MC, Seif N, et al. Brachytherapy. 2007 Apr-Jun;6(2):164-8.
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