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News

RapidArc radiotherapy technology is used to treat multiple brain metastases

Varian : 03 September, 2008  (Application Story)
Two leading cancer centres have carried out radiosurgery treatments for multiple brain metastases using new RapidArc radiotherapy technology from Varian Medical Systems.
The MIMA Cancer Center in Melbourne, Florida and VU University Medical Center in Amsterdam, Netherlands were each able to treat brain metastases more quickly and efficiently than would have previously been possible.

Stereotactic Radiosurgery is used to quickly eradicate tumors by targeting them with high doses of radiation using precisely-shaped, image-guided, X-ray beams in just one to five treatment sessions. Varian's RapidArc, which targets treatment beams at tumors while rotating continuously around the patient, makes it possible to complete stereotactic Radiosurgery sessions many times faster than conventional techniques that use stationary beams.

At VU University Medical Center in Amsterdam, doctors used a RapidArc-equipped linear accelerator from Varian to treat six patients with multiple brain metastases, delivering in a single plan a combination of whole brain Radiotherapy with a stereotactic integrated boost, an extra measure of dose that is focused directly on the multiple tumours.

'Our experiences to date have demonstrated that RapidArc appears to be excellent for stereotactic radiosurgery,' said Dr Frank Lagerwaard of VU Medical Center.

The patients, all of whom had developed multiple brain metastases stemming from primary lung or breast cancer, received their high-dose treatment over five sessions.

'The total time needed for patients to enter and leave the treatment room has decreased to less than 15 minutes as we gain experience,' added Dr Lagerwaard. 'In these treatments the 'delivery' time was just 210 seconds per session.'

By comparison, conventional stereotactic treatment of three brain metastases using multiple dynamic conformal arcs takes more than 50 minutes from first beam on to last beam off, according to Dr Lagerwaard.

At MIMA, Dr Todd Scarbrough and his team treated a 77-year-old man with a history of small-cell lung cancer who had recently developed a brain metastasis.

'Given his smoking and lung cancer history he was not considered a candidate for conventional neurosurgery,' said Dr. Scarbrough. 'We felt fast, non-invasive Radiosurgery would be easier on this patient.'

Joseph Ting, PhD, medical physicist, compared a RapidArc Radiosurgery treatment plan with a non-coplanar IMRT plan using 14 stationary beams, which is how this patient would have been treated prior to RapidArc's availability.

'We were delighted to see that the RapidArc plan actually conformed the dose more closely to the size, shape and location of the tumor and could be delivered in three minutes instead of the 40 minutes needed for the 14-beam plan,' Scarbrough said. The treatment was completed in four sessions over a four-day period.

Dr Scarbrough added, 'Our plan is to use RapidArc any time the treatment plan gives us a dose distribution that is equal to or better than what we can get with standard IMRT, because RapidArc is so much faster. And that's much better for our patients.'

In the August 15, 2008, issue of Clinical Cancer Research, (published online August 12) researchers from the University of Chicago Medical Center report that targeted radiation therapy had completely controlled all signs of cancer in 21 percent of patients who had five or fewer sites of metastatic disease.

Treatment planning analyses show that RapidArc matches or exceeds the precision of conventional IMRT systems and spares more of the healthy tissue surrounding the tumour. Unrelated clinical studies on Radiotherapy correlate the ability to spare more healthy tissue with reduced complications and better outcomes.
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