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University of Cincinnati Academic Health Center
Publish Date: 01/23/02
Media Contact: AHC Public Relations, (513) 558-4553
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Advanced Technology Used to Treat Rare Cancer

Cincinnati--Eugene Blair Conrad, Director of the Dayton International Airport faced a history-making challenge when he became the second person in the world to receive a new combination treatment for a rare cancer (called a chordoma) that was wedged between the third and fourth vertebrae in the neck.

Conrad, who directs the operations that keep the Dayton Airport open and running every day (no small task in today's environment), came to University of Cincinnati (UC) physicians for a new treatment for the rare tumor attached to his cervical spine. After researching a similar treatment available in Massachusetts and California, Conrad chose the Barrett Cancer Center's treatment with neurosurgery, followed by a three-dimensional radiotherapy called stereotactic Intensity Modulated Radio Therapy (IMRT), a component of the LEXAR system that performs radiation treatments in the head, neck and upper trunk areas of the body. During stereotactic IMRT treatment, a concentrated beam of radiation, computer-programmed to conform to the exact shape of the tumor, radiates it from a specially designed high-precision linear accelerator called the LEXAR system.

Just before Thanksgiving Day in 2000, Conrad had neurosurgery. Two months later he began the IMRT treatments. Through computer programming, IMRT memorizes the tumor shape and conforms the beams of the radiation treatment to the jagged edges of the tumor. Stereotactic IMRT targets so precisely, it kills cancer cells attached to the spinal bones without damaging the vulnerable spinal cord.

Harry Van Loveren, MD, UC professor of neurosurgery and director of skull base surgery at the Mayfield Clinic and Spine Institute in Cincinnati, removed the deteriorated parts of the two vertebrae. Van Loveren then rebuilt the vertebrae with a titanium (space age metal) cage and chips of bone from Conrad's hip. After the surgery, Conrad went home and cooked Thanksgiving dinner for his family.

As the holidays passed and Conrad healed, John Breneman, MD, professor of radiation oncology at UC, programmed the LEXAR equipment to target what remained of the tumor that lay intertwined around the bones in his neck with the IMRT radiotherapy. Remnants of the tumor (that still grasped the two vertebrae in Conrad's spine) were first targeted for a concentrated beam of radiation to kill the tumor cells, without damaging the spinal cord. Breneman then programmed the powerful doses of radiation to kill the remaining tumor cells so that it wouldn't grow back.

Without IMRT, 50 percent of chordoma tumors recur. Chordoma tumors are thought to be caused by leftover fetal spine tissue that was not properly reabsorbed. "It can sometimes remain in your body for half a century and start growing when you are 50 to 70 years-old," Breneman said.

According to Breneman, location of the tumor was critical. Damage to the spinal nerve at the neck level could turn a healthy man into a paraplegic or worse.

The support team at The University Hospital Barrett Cancer Center where Breneman performs the IMRT treatments, came to know Conrad very well over the next three months. Monday through Friday, it took Breneman's team only about an hour to prepare Conrad, target the tumor precisely, and treat it with 20 minutes of a powerful beam of radiation. After the initial treatment each day, Conrad rested for four hours. Then they blasted the cancer with a second dose of radiation. Day after day, after each set of morning treatments in Cincinnati, he went to the Dayton International Airport and worked a full day.

Before the initial surgery, when Conrad had found that he would be the first person in the Western and Northern hemispheres to be treated with the stereotactic LEXAR IMRT radiotherapy, he went for a second opinion. According to the Cleveland Clinic doctors Conrad consulted, Conrad was lucky because neck chordomas are easier to detect early and surgically remove than those located elsewhere on the spine. Even better, according to the physician, the special IMRT radiation treatment was approved for use on humans and "nobody did it better than the UC doctors." Eight weeks and 70 radiation treatments later, Conrad was pronounced cancer-free.

On March 14, 2002, Conrad celebrates the first anniversary of his last treatment. February 14 he celebrates his first Valentine's Day with his new wife. An ordinary person with extraordinary courage, Conrad is a survivor and is greatly admired by his health-team friends at UC Medical Center. Breneman and Van Loveren are both members of the UC College of Medicine faculty and The Neuroscience Institute for brain and nervous system diseases.

Conrad more recently survived a serious car accident on the way back from an airport business meeting in another state. The car accident required an immediate hip-repair surgery which kept him hospitalized out-of-state for 10 days. Still a goal-oriented survivor, Conrad returned home at last to marry his sweetheart. He was recently present at his grown son's wedding as well.



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