University of Turin at San Giovanni-Battista Hospital utilizes Elekta’s planning and therapy innovations to transform treatment experience for patients with non-small cell lung cancerTurin Italy — Wednesday, November 10, 2010
In September, a 75-year-old Italian man with locally advanced, non-small cell lung cancer became the first patient at San Giovanni-Battista Hospital to benefit from Elekta VMAT, an advanced radiation therapy technique that delivers treatment in one or more high-speed arcs around the patient. While a conventional IMRT technique would have taken up to 20 minutes for the patient’s radiation delivery, Elekta VMAT completed its single therapy arc in only seven minutes. Over the patient’s 24 separate treatment sessions, Elekta VMAT spared him over five hours of extra time on the therapy table.
Not only was Elekta VMAT treatment faster for this and the 24 subsequent San Giovanni-Battista patients who underwent therapy since September, but it also was much more refined by employing sophisticated new planning software called Monaco®, which is optimized for Elekta VMAT.
“To address the large volume of patients we see who have non-small lung cancer, Elekta VMAT has been impressive—it’s extremely efficient for reducing treatment time, which helps us not only manage our workload, but also helps patients comply with the treatment, including better management of respiratory gating,” says Umberto Ricardi, M.D., Director of Radiation Oncology. “For VMAT planning, Monaco provides us with features that allow us to create plans in which the greatest possible therapeutic radiation hits the cancer target while minimizing the dose to healthy normal tissues. With its dose algorithm, we can better predict the precise dose the patient will receive, enabling us to deliver the highest safe dose.”
Six to eight new patients per week are now treated using Elekta VMAT with Monaco planning, and Monaco is now the treatment planning system of choice for all advanced techniques at San Giovanni.
Difficult to treat with any therapy technique due to patient respiratory motion, San Giovanni-Battista’s Elekta VMAT lung cancer cases are facilitated by use of its Elekta Axesse™ system for Stereotactic Body Radiation Therapy (SBRT).
“We have published several papers on the SBRT approach in early stage lung tumors, so we are absolutely confident with issues regarding diaphragm movement and tumor motion in lung cancer patients,” Dr. Ricardi says.
Half of San Giovanni’s Elekta VMAT cases to date have been for patients with locally advanced non-small cell lung cancer, and several have been for lymphomas with a mediastinal disease component, in which protection of structures such as the heart and coronary vessels is critical.
“The cure rate of younger patients with lymphoma ranges from 90 to 95 percent, so carcinogenesis related to radiation exposure is an important issue,” he notes. “Elekta VMAT enables a significant reduction in total dose to the patient compared to conventional Intensity Modulated Radiation Therapy [IMRT].”
With the success of their Elekta VMAT lung cancer treatments, San Giovanni clinicians are turning their attention to head and neck tumors, an indication that looks promising compared to IMRT, which uses step-and-shoot delivery (i.e., gantry starts and stops).
“We are completing a ‘replanning’ study in 10 patients who received static IMRT and whose records are being replanned with Monaco planning and VMAT delivery,” Dr. Ricardi explains. “Preliminary data show a significant advantage for VMAT in both target coverage and normal tissue sparing.”
To learn more about Elekta VMAT, visit www.elekta.com/VMAT.
*Approval of indications may vary between different countries; additional regulatory clearances may be required in some markets.
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