by Tom Wilemon
A radiation therapy device for the treatment of a rare cancer has been designed, custom built and installed at Vanderbilt-Ingram Cancer Center at Maury Regional Spring Hill, offering patients from Alabama, Mississippi, Georgia and southern Tennessee more convenient care.
The device is needed for total skin electron beam therapy, a treatment for patients with mycosis fungoides, a rare form of T-cell lymphoma of the skin.
Low-dose radiation is emitted over the entirety of the skin while the patient stands on a rotating platform, which facilitates even distribution of the electron beam. Rotating platforms for this highly specialized treatment are not mass produced because of low commercial demand.
The device also includes an electron scatter plate, which degrades and lowers the beam energy for appropriate treatment.
“It is a fairly rare need to have the entirety of the skin treated,” said Eric Shinohara, MD, MSCI, chair of Radiation Oncology at Vanderbilt University Medical Center. “Even at large academic medical centers, many of them don’t do this type of treatment. With severe cases, mycosis fungoides can be incredibly debilitating and cosmetically devastating.”
Shinohara and George Ding, PhD, professor of Radiation Oncology reached out to Vanderbilt University Biomedical Engineering, and a group of four students did the design fabrication. The students, working with Ding and Michael Price, PhD, vice chair of Medical Physics, created a small model of the design, followed by a full-size prototype that was modified into the final product.
“The radiation beam only penetrates to a very shallow depth of the skin,” Ding said.
An overhead, adjustable bar that patients grip provides them with stabilization and helps them maintain balance. The standing device is also equipped with a camera and microphone so that patients can communicate with radiation therapists while receiving the treatment.
The system’s design and installation involved multiple people with diverse areas of expertise: physicists, biomedical engineers, machinists, carpenters, administrators, radiation oncologists and others.
“This required a lot of teamwork,” Shinohara said. “It was a great collaboration between the Medical Center and Vanderbilt University, between our clinical staff and physicists as well as teams working together at both our Nashville and Spring Hill clinics.”
Randy McIntosh, manager of the VUMC Apparatus Shop, supervised the modifications to the Spring Hill clinic to accommodate the rotating stand. One of the first actions he took was to tour the total skin electron beam therapy system at Vanderbilt-Ingram. His team designed the bar that patients hold for balance and did modifications to the ceiling and wall for the device. They began the work in November 2020 and completed it within three months.
“It turned out really nice, and I’m very pleased with the end result,” McIntosh said.
So are the staff who work at the Vanderbilt-Ingram Cancer Center at Maury Regional Spring Hill, which is located at 1003 Reserve Blvd., Suite 120, Spring Hill, Tenn.
“Over several months this all came together,” said Channing Harris, the clinic’s supervisor. “We’re really satisfied with this project and the outcome. This type of treatment has been offered at our main campus for many years, but it’s very busy there with a lot of traffic. This really makes a difference in cutting down the travel time and the stress for patients.”
The Spring Hill clinic, a joint venture between VUMC and Maury Regional Health that opened in 2013, also offers standard radiation treatments and stereotactic body radiation therapy, which delivers extremely precise, intense radiation doses to cancer cells, minimizing damage to healthy, surrounding tissue.
“This is the first time in my 24-year career with VUMC Radiation Oncology that we have been able to bring such a unique technology to a community satellite,” said Karen Munyon, MBA, senior director of operations for Vanderbilt Health Services. “We look forward to providing patients with other options for total skin electron therapy treatments closer to home and with the same Vanderbilt quality they expect and deserve.”
