Memmingen cancer clinic first in Germany to offer image-guided
radiotherapy
26 March 2007 Memmingen, Germany. A private radiotherapy institute in
Bavaria has begun treating cancer patients with a new, more precise form of
radiotherapy using a linear accelerator and special On-Board Imager
accessory from Varian Medical Systems. The new equipment, the first of its
kind in clinical operation in Germany, is being used at the private
radiotherapy institute at the Klinikum Memmingen to treat breast, prostate
and head/neck cancer patients with image-guided radiotherapy (IGRT). The
new imaging capability enables doctors to locate and target tumours more
accurately during treatments. “This is really important because it enables
us to offer more precise radiotherapy,” says Dr. Andreas Rhein, senior
therapist at the new institute, which was constructed last year. “It allows
us to increase the dose, particularly for our prostate patients, because we
are confident that we are hitting the target and minimising the affect on
surrounding healthy tissue.” The on-board imager makes it possible for
clinicians to image and treat on a single machine that rotates around the
patient to take X-ray images and deliver treatments from virtually any
angle. Mounted on the medical linear accelerator, the OBI device produces
high-resolution X-ray images of the tumour and tracks changes in tumour
shape, size or position over a multi-week course of treatment. It also
allows clinicians to track and adjust for tumour motion caused by the
patient’s breathing during treatment sessions.
The private radiotherapy institute at the Klinikum Memmingen is offering
these IGRT treatments in collaboration with nearby Klinikum Kaufbeuren,
which has treated cancer patients on Varian linear accelerators for many
years. Although the new Varian Clinac 2100 high energy linear accelerator
equipped with the On-Board Imager device has been located at the new centre,
much of the planning and preparation work is carried out at Kaufbeuren.
Doctors at Memmingen acquire radiographic and 3D Conebeam CT images at the
time of treatment using the On-Board Imager and these images are compared to
diagnostic images. The On-Board Imager’s auto-match functionality
automatically suggests changes in the patient’s position to line them up
more precisely with the treatment beam. Any adjustments to the patient’s
position can be carried out by a radiography nurse entirely from outside the
treatment room, ensuring the fastest and most automated image-guided
radiotherapy in the world. Before image-guided radiotherapy Prior
to the advent of image-guided radiotherapy (IGRT), radiation oncologists had
to contend with variations in patient positioning and with respiratory
motion by treating a relatively large margin of healthy tissue around the
tumour. This increased the risk of complications from the treatment and
forced doctors to use lower, less effective doses in their treatments. IGRT
enables doctors to minimize the volume of healthy tissue exposed to the
treatment beam, giving them the option of using higher doses when the
patient needs them. Varian equips about 3,000 radiotherapy centres around
the world with treatment machines, accessories and software for the most
advanced forms of radiotherapy and radiosurgery. The market and technology
leader in image-guided radiotherapy, Varian had more than 400 installations
of its On-Board Imager complete or in progress at the beginning of the
calendar year.
Radiotherapy in Germany Clinicians at Memmingen hope other
private and public cancer centers will follow their lead in offering
patients more advanced treatments. “At present it is only private practices
like ours that are thinking about introducing such advanced techniques
because public hospitals have been under-funded for the last five years and
there have been many advances in that time,” says Dr. Rhein. In most
developed countries medical linear accelerators are in operation for 10-15
years. The average age of Germany’s linear accelerator base is 16 years.
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