Advanced arc-based radiation delivery technique further optimized with gold standard planning, enabling doctors to provide best possible treatment for patients.Afghanistan — Monday, March 29, 2010
A 63-year-old male with prostate cancer is the first patient in Europe to receive radiotherapy treatment planned with a new version of Monaco® software optimized for Elekta VMAT. Using the arc-based Elekta VMAT delivery method, Monaco planning dictates how the radiation dose should be applied—its distribution and strength on the target. The result is a therapy that not only is very rapid with VMAT, but one that also is fine-tuned to treat cancer and avoid healthy normal tissues.
The patient received his Elekta VMAT treatment at University Medical Center (UMC) Mannheim (Germany) in January. Total VMAT delivery was four minutes, while conventional delivery would have taken 6-8 minutes, says UMC Vice Chairman, Prof. Frank Lohr.
“Monaco planning will bring VMAT into the radiation therapy field on a broad basis,” Dr. Lohr says. “With Elekta VMAT and Monaco, and the full hardware and software packages running on these systems, we will no longer have any resource constraints in delivering the most complex treatments to patients immediately.”
Delivery and planning fully optimized
With Elekta VMAT, the treatment gantry—the part of the machine from which radiation beams originate—is in constant motion, with single or multiple gantry arc(s) sweeping around the patient. During these arc(s), the radiation intensity is continuously varied and modulated. This ensures a computer assisted delivery, according to the anatomical and tumor characteristics of the patient and the dose prescription.
Using the dynamic gantry arcs, Elekta VMAT results in significantly reduced treatment times, while providing a more personalized treatment.
In conventional “fixed gantry” therapy, the gantry makes several stops, which add to the overall treatment time and result in a longer session.
To improve Elekta VMAT planning, Elekta have designed enhanced Monaco treatment planning software for a rotating gantry technique. Monaco treatment planning software has been used for many years in fixed gantry IMRT, and its Monte Carlo algorithm is widely considered the gold standard for dose calculation. Monaco VMAT benefits from the same superior Monte Carlo dose calculations as do fixed gantry methods. While planning treatments with Monaco VMAT, clinicians can use the Monte Carlo dose engine to accurately predict how much of a proposed radiation dose the target and normal tissues will receive. From there, they can fine tune or optimize the planned dose and radiobiological parameters to ensure the patient receives the most therapeutic Elekta VMAT treatment possible.
“With Monaco, Elekta has extended its leadership in treatment planning,” says David Murphy, Director of Marketing, Elekta Software. “Virtually all aspects of Elekta VMAT are now optimized: planning and delivery hardware and software are comprehensive and robust. We accomplished this, in large part, due to our collaborations with sites such as Mannheim.”
"These continued collaborative efforts have led to major progress for patient care in precision radiotherapy,” adds Prof. Frederik Wenz, UMC’s Chairman, Department of Radiation Oncology. “Reducing daily treatment times not only improves patient comfort and safety, but also gives us the option to make this form of treatment available for more patients."
Elekta VMAT with Monaco software on fast track to daily use at UMC
The initial UMC Mannheim clinical results for VMAT-Monaco have been so good that clinicians are considering replacing their current techniques, Prof. Lohr says.
“We probably will replace fixed gantry IMRT for most indications, including lung and head and neck cases. And I predict that Elekta VMAT’s speed will enable us to increase our patient volume on the Elekta Synergy® from 35 patients per day to 50 patients per day receiving complex modulated therapy.
“Patients with tumors in regions that are affected by motion, such as those in the lungs and prostate,” he continues, “could benefit substantially from Elekta VMAT’s speed. It also is beneficial for patients whose pain makes prolonged treatment sessions undesirable.”