RapidArc image-guided radiotherapy treating tumours of the head and
23 September 2008
Cancer treatment centres in the United States and the Netherlands are
now treating head and neck cancer using RapidArc radiotherapy technology
from Varian Medical Systems.
RapidArc was used to deliver ultra-precise image-guided
intensity-modulated radiotherapy (IMRT) significantly faster than was
previously possible with conventional IMRT. The RapidArc treatment plans
for these cases also did a better job of protecting surrounding normal
tissues and organs, says Varian.
"Traditional IMRT has been a gold standard for several years in
radiotherapy when it came to avoiding healthy tissue and targeting the
tumour mass," said Ben Slotman, MD, PhD, professor and chairman of the
Department of Radiation Oncology at the VU University Medical Center in
Amsterdam, Netherlands. "We have been so satisfied with the faster
treatment planning and the faster delivery with RapidArc that we plan to
treat all of our head and neck IMRT candidates using this technology."
Slotman and his colleagues recently treated a 46-year old male with
throat cancer. "The RapidArc plan showed better and more even tumour
coverage, compared with a standard 7-field IMRT plan," said Slotman.
"With RapidArc, we were also able to spare more of the organs at risk
than with IMRT," he added. When treating a tumour in the head or neck it
is important to avoid the highly sensitive organs nearby, such as the
spinal cord, eyes, brainstem, and other vital areas of the central
At the Center for Radiation Therapy of Beverly Hills, Henry Yampolsky,
MD, recently used RapidArc to deliver an unusual unilateral neck tumour
treatment that avoided the opposite half of the 68-year-old patient's
oral cavity, salivary glands, and neck.
The treatment involved immobilizing the patient for each of his daily
treatments using an awkward mouth piece that immobilized the tongue. "A
conventional treatment would have taken 15 minutes a day at least — a
long time to be immobilized in that way. With RapidArc, we had him in
and out of there in less than five," Yampolsky said.
"Compared with conventional forms of IMRT, RapidArc also helped us
achieve better sparing of the healthy side of the patient's neck," said
Yampolsky. "This was important to preserve his salivary function and as
much of his oral cavity as possible."
On the other side of the country, a gentleman with advanced throat
cancer was able to keep his voice, thanks to RapidArc treatments. This
82-year-old patient had been enjoying an active lifestyle with his wife
of 40 years, when a lingering hoarseness led to the discovery of larynx
cancer. "One treatment option was for him to have a laryngectomy, which
would have removed his voice box, leaving him with no ability to speak
and requiring him to breathe through a tracheostomy, which is a hole in
the throat," said Shawn H. Zimberg, MD, medical director of radiation
oncology at Advanced Radiation Centers of New York. "Another option was
a 'larynx preservation' course of radiotherapy." Using RapidArc
technology, Zimberg and his team were able to deliver a non-invasive
radiotherapy treatment very quickly, and preserve this patient's larynx
"Prior to his treatment, we compared two radiotherapy plans. One was
for conventional IMRT and the other for a RapidArc treatment," Zimberg
added. "It was clear that the RapidArc plan was going to spare more of
his normal tissues from radiation, reducing the likelihood of
undesirable side effects. Clearly, being able to preserve his larynx
while limiting the toxicity of his treatment has great potential for
significantly improving the quality of life for this patient and his
family after treatment is over."