Jagiellonian University in Krakow, Poland treats their first IORT patients with the Mobetron

[December 2003]  The first Mobetron in Europe began clinical operation on December 2, 2003 at the Jagiellonian University in Krakow, Poland. Professor Tadeusz Popiela, Head of the Intraoperative Radiotherapy and Chemotherapy Division, and Professor Jan Kulig, Head of the Ist Department of General and GI Surgery of the Jagiellonian University, were the driving forces in instituting the first IORT program in Poland and one of only a few dedicated IORT programs in Europe.

In establishing an IORT program in Kraków, the University was faced with a number of logistical issues to overcome. In Kraków, surgery for cancer is performed at various specialty hospitals, depending on the type of cancer the patient has. For example, all GI surgery (stomach, rectal, pancreas, etc) is done at the GI surgery center, while Gynecological surgeries (cervix, breast, etc) are usually done at the GYN surgery center. Surgery for other sites, such as lung, head and neck, and extremity sarcomas are done at their own surgical centers. To further complicate the situation, radiation therapy treatments are given at the Radiotherapy Department of the Oncological Center in Kraków that is located physically separate from any of these surgery centers.

To overcome these logistical issues, a special operating theatre was built on the ground floor of the GI surgery hospital. This operating theatre is a fully equipped surgical suite and also contains the Mobetron. It is available for use by surgeons of all specialties. On the days that IORT treatment is planned, the radiation team performs the QA on Mobetron and returns later in the day to help provide the actual delivery of the IORT. Patients recover from the surgery at the surgical center, and then are followed-up in their own specialty hospitals.

This innovative approach, conceived of by Professors Popiela and Kulig with the help of Professor Reinfuss, Director of the Oncological Center in Kraków and his radiotherapy team, has resulted in an IORT program that allows the greatest possible access of IORT treatment to all patients treated at the University, despite the fact that cancer surgery at the University is usually performed at specialty hospitals based on the location of the patient's cancer. This approach could become a model for other major surgical centers that are confronted with similar logistical difficulties.