Pioneering cancer treatments developed at Dutch oncology centre with
RapidArc radiotherapy
17 July 2009
Doctors at the VU University Medical Center in Amsterdam have
developed new ways to perform radiosurgery on benign acoustic tumours
using fast and precise RapidArc radiotherapy technology from Varian
Medical Systems (NYSE: VAR). This is among the findings in several
papers published by the research team.
Radiation oncologist Dr. Frank Lagerwaard and his team compared
RapidArc with five-arc dynamic conformal arc radiosurgery for vestibular
schwannoma, a benign tumour that affects hearing and balance. “Treatment
delivery time after patient setup was less than five minutes versus 20
minutes for dynamic conformal arc radiosurgery,” says Dr. Lagerwaard.
“We found that RapidArc planning was completed within 30 minutes in all
cases.”
His team found that the RapidArc plans consistently achieved greater
conformity and a reduction in areas of low-dose irradiation compared to
conventional radiosurgery. “This, together with the benefits of shorter
treatment times, allows us to replace our conventional five-arc
radiosurgery technique for vestibular schwannomas with RapidArc,” added
Dr. Lagerwaard.
RapidArc delivers a precise and efficient treatment in single or
multiple arcs of the treatment machine around the patient and makes it
possible to deliver image-guided intensity-modulated radiotherapy (IMRT)
two to eight times faster than is possible with conventional IMRT.
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.
Cancer patients at VU University Medical Center are treated on two
Varian Clinac 2300 CD linear accelerators, a Trilogy linear accelerator,
and the Novalis Tx radiosurgical suite of products, all equipped with
RapidArc capability. The clinical team has published scientific papers
on early RapidArc treatments, including research comparing RapidArc
volumetric modulated arc therapy with conventional IMRT, in peer
reviewed journals.
Dr. Ben Slotman, chairman of the hospital’s department of radiation
oncology, says, “In the past we treated about fifteen percent of
patients with IMRT but now use RapidArc for a much larger number of IMRT
indications. In addition to standard head and neck and prostate
treatments, a range of new indications, such as whole brain radiotherapy
with simultaneous boost to multiple brain metastases, pelvic tumors and
small lung tumors are now being treated with RapidArc.
“Our experience so far is that RapidArc planning and delivery is
considerably faster than alternative methods,” added Dr. Slotman. “We
are expanding the range of cancers for which we use RapidArc and we
believe we can replace our full stereotactic radiotherapy program with
RapidArc, just as has happened with IMRT.”
Previous findings by Dr. Wilko Verbakel, medical physicist,
describing how RapidArc plans could deliver better dose distributions
than is achievable with conventional IMRT for head and neck tumours in
less than three minutes, has now been substantiated by actual clinical
data on more than 100 such patients who have received RapidArc for this
indication.
Similarly, a publication in production on small primary lung tumours
by Dr. Verbakel describes how clinical delivery of RapidArc for
stereotactic radiotherapy could be completed in as little as ten
minutes.
In the year since RapidArc was installed at VU University Medical
Center, more than 300 cancer patients have been treated using this fast
and precise treatment technology.
“VU University Medical Center was one of the first hospitals in the
world to introduce RapidArc a year ago and to my knowledge no other
hospital has treated as many patients with this technique,” says Rolf
Staehelin, Varian’s European marketing director. “Our sincere
congratulations to everyone in the team at VU for making this happen so
quickly. They are carrying out some pioneering work that is making
radiotherapy treatments faster and more precise.”
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