In a clinical milestone for the treatment of late-stage cervical cancer, Medanta has been awarded a patent for its Medanta Anterior Oblique Lateral Oblique (MAOLO) template. It has been conceptualised by Dr Susovan Banerjee, Associate Director, Medanta and developed alongside Dr Tejinder Kataria, Chairperson, Division of Radiation Oncology, Cancer Institute, and the Medanta Medical Physics Team. MAOLO can help tackle tumours as large as 100cc (cubic centimetres), while the commercially available intracavitary applicators are known to be effective against tumours of 36cc or lesser in volume.
This innovation indicates improvement in the treatment of cervical cancer, which is the second most common cancer among women in India. The MAOLO was conceptualised to help patients of advanced-stage cervical cancer stay disease-free for longer. Approved by the Medanta Institutional Review Board and Independent Ethics Committee, the MAOLO is a high-precision, patient-friendly applicator to deliver image-guided adaptive Brachytherapy to larger areas in the pelvis. Although a few devices with interstitial and intracavitary applications have been available commercially for the last decade, they are uncomfortable for patients.
Brachytherapy, also called plesiotherapy, places the radiation source close to the tumour—on the skin’s surface, mucosa, inside the tissue or in the cavities. It uses a higher total dose of radiation to treat a smaller area than External Beam Radiation Therapy, which directs high-energy X-rays (radiation) at tumours from outside the body. Since the 1930s, Brachytherapy has been used to treat oral or tongue cancer, soft tissue sarcomas (for limb preservation) and cancer cervix with excellent results.
Dr Tejinder Kataria, Chairperson, Radiation Oncology, Cancer Institute, Medanta highlighted, “In India, the commercially available interstitial and intracavitary combo applicators are bulky, and have restricted reach. They need time, training and skill to assemble as they come in multiple components and can only be applied by stitching to the patient’s skin, making them uncomfortable. They can also increase the duration of general and spinal anaesthesia, requirement for pain medication, and duration of admission.” Kataria added, “The MAOLO overcomes all these challenges. It especially emerges as a ray of hope for patients of late-stage disease in whom the chances of recurrence, especially in the lateral parametria, are high even after complete treatment with chemoradiation and conventional Brachytherapy. Such recurrences cannot be salvaged by either surgery or chemotherapy.”
Dr Susovan Banerjee, Associate Director, Radiation Oncology, Medanta explains the inspiration for the device, “The MAOLO is a disk-shaped device that allows for the maximum possible number of catheters to be placed in three directions. This design makes it useful in addressing some of the largest tumours presented clinically. Improved technology of this single-piece template eliminates the need for assembly, makes it easy to use by technical staff and reduces the margin for error. Being cylindrical, MAOLO can be placed securely in the vagina making it more comfortable eliminating adverse effects like major bleeding, pain, discomfort, or geometrical asymmetry (geographical miss), issues that can lead to abandon the procedure.”
Dr Naresh Trehan, Chairman and Managing Director, Medanta said, “This patent is not just a milestone for Medanta, but a significant step forward for cervical cancer care in India. We will continue to innovate and provide solutions that cater to the needs of our community.”
The MAOLO’s integration of intracavitary and interstitial applications in a single, user-friendly instrument promises to enhance gynaecological Brachytherapy, particularly in resource-limited regions of India.