University College Hospital In London Introduces Treatments Delivering Faster Form Of Radiotherapy

Main Category: Radiology / Nuclear Medicine
Article Date: 20 Nov 2009 - 0:00 PST

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Two female brain tumor patients have become the first people in the south of England to be treated using a faster form of radiotherapy that extends more advanced care to more patients. RapidArc technology from Varian Medical Systems (NYSE: VAR) makes it possible to deliver image-guided IMRT (intensity modulated radiotherapy) two to eight times faster than is possible with conventional IMRT.

Clinicians at University College Hospital (UCH) carried out the pioneering treatments in October, making it only the second hospital in the country to introduce the technique routinely. Both patients were treated using a single arc - or rotation - of the machine around the patient and the treatments were delivered in under two minutes, compared with 10-15 minutes for conventional IMRT.

"RapidArc performed very satisfactorily in its first treatments, addressing what would have otherwise been difficult brain tumor volumes," says Susan Short M.D., consultant clinical oncologist in charge of the brain unit at UCH. "It delivered lower overall dose to tissue outside the target area compared with IMRT, which was particularly important in the first case because the patient had received previous radiotherapy." Minimizing dose to healthy tissue reduces the possibility of complications.

"The radiotherapy department is very impressed and it is quite a straightforward treatment from the patient's point of view," she added, explaining that benign brain tumors can cause cranial nerve problems and visual problems if untreated. "We won't know yet whether it has been successful in shrinking the tumors as it can take some time to determine that, but certainly the shorter treatment time is more convenient and allows for a more comfortable treatment for our patients."

Anna Cassoni, lead clinical oncologist at University College London Hospitals NHS Foundation Trust (UCLH), said, "RapidArc produced a lower dose to the optic nerve than conventional IMRT treatment and its precision minimized exposure to surrounding critical tissues."

"The treatment is very quick and that's a good thing," said Jet Payne, aged 24, from Muswell Hill in London, who is undergoing the treatment to remove traces of her tumor following surgery at The National Hospital for Neurology and Neurosurgery, which is part of UCLH. "I just want everything to be back to normal again and I am looking forward to continuing with my life." Ms Payne was diagnosed in April when a scan revealed that a benign, but locally aggressive tumor, was pressing on her optic nerve. "I just woke up one morning with double vision. I thought it was a trivial sinus infection, I never for a moment thought it could be something this serious."

Faster treatments allow for greater precision, since there is less chance of patient or tumor movement during treatment delivery and, with less time on the treatment couch, also allow for greater patient comfort. Conventional IMRT treatments are slower and more difficult for radiotherapy radiographers because they target tumors using a complex sequence of fixed beams from multiple angles.

Since its introduction in early 2008, more than 270 hospitals worldwide have introduced RapidArc radiotherapy treatments into their clinical routine. Clatterbridge Centre for Oncology in the Wirral became the first in England to introduce RapidArc late last year and several other English cancer centers including hospitals in Exeter, Norwich, Leicester, Stoke, Ipswich and London have installed the system and will commence treatments early in 2010.

Source
Varian Medical Systems