Well-Tolerated Radiotherapy Provides Longer Life to Patients With Recurrent Brain Cancer

ScienceDaily (May 24, 2010) — Patients who received hypofractionated stereotactic radiotherapy for their recurrent brain cancers lived longer lives, according to researchers at Thomas Jefferson University.

Not only does hypofractionated stereotactic radiotherapy (H-SRT) provide longer survival, patients do not experience side effects commonly seen with use of chemotherapies and targeted therapies, the researchers found. They believe these findings, reported online in the Journal of Clinical Oncology, set a new bar for the treatment of recurrent gliomas.

"In many centers, patients with tumor progression within six months after the initial conformal radiotherapy are denied a second radiotherapy course (such as H-SRT), based on the assumption that their prognosis is poor." said senior author Maria Werner-Wasik, M.D., professor of Radiation Oncology at Jefferson Medical College of Thomas Jefferson University and Co-Director of the Stereotactic Radiosurgery Program at Jefferson Hospital for Neuroscience. "Our findings support the recommendation that essentially all patients with progressive high-grade gliomas, who are in good shape and have tumors amenable to local radiotherapy, should be considered for H-SRT."

source: Science Daily release

Varian Medical Systems Introduces ProBeam™ Proton Therapy Platform at Particle Therapy Co-operative Group (PT COG) 2010 Meeting

GUNMA, Japan, May 18 /PRNewswire-FirstCall/ -- Varian Medical Systems (NYSE: VAR) is introducing the fully-integrated ProBeam™ proton therapy system at the 2010 Particle Therapy Co-operative Group (PT-COG) meeting here this week. The ProBeam system incorporates imaging, gating, robotic patient positioning, treatment planning and oncology information software to enhance treatment quality for patients and workflow efficiency for clinicians.

"ProBeam is the result of decades of leadership in proton therapy research and development and it has been designed from the ground-up to meet the needs of clinicians and patients alike," says Moataz Karmalawy, head of Varian's particle therapy group. "This fully integrated system can be used for all forms of advanced proton therapy including image-guided proton therapy and intensity-modulated proton therapy."

The ProBeam system incorporates Dynamic Peak™ integrated scanning technology which paints a precise radiation dose on the target volume, enabling true intensity modulated proton therapy. The system also incorporates proprietary pencil-beam scanning technology, which allows for precise dose distribution.

source: Varian

U-M study achieves reduced side effects in head and neck cancer treatment

ANN ARBOR, Mich. — Researchers at the University of Michigan Comprehensive Cancer Center have applied advanced radiation techniques for head and neck cancer to avoid treating critical structures that affect swallowing and eating. A new study shows these principles and techniques treated the cancer effectively while greatly reducing long-term swallowing complications.

The researchers applied highly conformal, intensity-modulated radiation therapy and knowledge of the anatomy and physiology of the structures involved to carefully craft a novel treatment plan that avoids certain muscles in the mouth and throat that are most involved in swallowing. Generally, head and neck tumors do not spread to these structures.

Of the 73 patients treated with this technique, all but four were eating a normal diet after their treatment ended and only one was dependent on a feeding tube. Typically up to 20 percent of head and neck cancer patients remain dependent on a feeding tube after finishing an intensive course of radiation treatment concurrent with chemotherapy.

Results of the study appear online in the Journal of Clinical Oncology.

source: University of Michigan Health System

Experts Discuss the Potential of Stereotactic Body Radiotherapy (SBRT) in the Treatment of Lung, Spine, and Liver Cancer

NEW YORK, April 27 /PRNewswire-FirstCall/ -- Radiosurgical approaches to cancer treatment are showing promise in the treatment of lung, liver, and spinal tumors, according to four leading clinical experts who presented at a symposium in New York earlier this month. New approaches to image-guidance and motion management are making it possible to successfully target tumors that are typically hard to reach with a radiosurgical technique doctors call stereotactic body radiotherapy (SBRT).

"Evidence has shown that increasing the dose to the targeted tumor improves local control or survival, while reducing the dose to normal surrounding tissues reduces treatment toxicity of treatment," said John J. Kresl, M.D., Ph.D., medical director of Radiation Oncologists of Central Arizona at Banner Good Samaritan Medical Center. "This is precisely what stereotactic body radiotherapy enables us to do so well. In the past, outcomes for radiation therapy weren't as good as we hoped for, because side effects prevented us from making the dose high enough to control the cancer. By enabling us to minimize exposure of the normal healthy tissues, stereotactic treatments are helping to overcome this problem."

Radiosurgical treatments involve the use of numerous small, powerful, highly focused radiation beams to attack tumors from many different angles in just one to five sessions. Conventional radiotherapy approaches involve delivering smaller daily doses over 30 to 40 treatment sessions.

source: Varian Medical Systems

SBRT For Lung Cancer Report Released By ASTRO

The American Society for Radiation Oncology (ASTRO) has released its Emerging Technology Committee's report evaluating the use of stereotactic body radiotherapy (SBRT) in lung cancer treatment.

SBRT is a newer radiation therapy treatment that uses focused radiation beams to target a well-defined tumor and relies on detailed imaging, computerized three-dimensional treatment planning and precise treatment setup to deliver the radiation dose with extreme accuracy to any part of the body, excluding the brain or spine. It typically uses higher radiation doses in fewer treatments than other standard treatments.

Historically, the preferred treatment for lung cancer patients is surgery, but numerous lung cancer patients are unfit for surgery due to the presence of other medical conditions, such as cardiopulmonary disease related to chronic smoking, that put them at an unacceptably high risk of surgical morbidity and mortality. Traditionally six to seven weeks of radiation have been used for this group of patients, but studies showed a high risk of local failure.

source: ASTRO

Smoking During Radiation Therapy For Head And Neck Cancers Linked To Poorer Outcomes

(SACRAMENTO, Calif.) — Smokers who don’t quit before radiation therapy for throat, mouth and other head and neck cancers fair significantly worse than those who do, research from the UC Davis Cancer Center has found.

Allen Chen, an assistant professor in the Department of Radiation Oncology at the UC Davis Cancer Center, found that head- and neck-cancer patients who continue to smoke during radiation therapy have poorer 5-year overall survival and higher rates of disease recurrence than those who quit smoking prior to treatment.

The study, published online recently in the International Journal of Radiation Oncology, Biology and Physics, should help oncologists counsel patients about the benefits of quitting smoking after a diagnosis of head and neck cancer, said Chen, lead author of the study.

“I always tell patients, ‘You should really stop smoking,’ but I had no tangible evidence to use to convince them that they would be worse off if they continued to smoke,” Chen said. “I wanted concrete data to see if smoking was detrimental in terms of curability, overall survival and tolerability of treatment. We showed continued tobacco smoking contributed to negative outcomes with regard to all of those.”

source: UC Davis Health System

Varian Medical Systems Introduces a Trilogy® Accelerator With Gated RapidArc® and Advanced Motion Management

PALO ALTO, Calif., April 14 /PRNewswire-FirstCall/ -- Varian Medical Systems (NYSE: VAR) has added advanced motion management capabilities including gated RapidArc to its Trilogy platform for treating cancer with targeted radiotherapy. A set of sophisticated new tools now enables clinicians to monitor and adjust for tumor motion during treatment, and to utilize respiratory gating during a RapidArc® treatment.

"Extensive research and development into motion management systems has culminated in powerful new capabilities that will be standard on the new Trilogy accelerators and available as an upgrade on our large installed base of Trilogy and Clinac iX machines," said Dow Wilson, president of Varian's Oncology Systems business. "Our Clinac iX and Trilogy accelerators together with our new TrueBeam platform (see accompanying press release) can now offer clinics an unmatched combination of motion management, speed, and versatility."

Gated RapidArc® radiotherapy makes it possible to monitor patient breathing and compensate for tumor motion while quickly delivering dose during a continuous rotation around the patient. This development enables the use of RapidArc to target lung tumors with greater precision by "gating" the beam—turning it on and off—in response to tumor motion.

source: Varian

Appropriate Radiation Therapy Lacking For Terminal Cancer Patients

A new analysis has found that a considerable proportion of patients with end-stage or terminal cancer do not benefit from palliative radiation therapy (radiotherapy) despite spending most of their remaining life undergoing treatments. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the study indicates that greater efforts are needed to tailor appropriately palliative radiotherapy to patients with end-stage cancer.

Palliative radiotherapy for end-stage cancer patients is intended to control cancer-related pain and other symptoms and to help patients maintain a good quality of life when long-term cancer control is not possible. By reducing the number of cancer cells, palliative radiotherapy can ease pain, stop bleeding, and relieve pressure, even when the cancer cannot be controlled. However, for many patients, the treatments are not effective. In addition, if patients are close to death, they may wish to stop treatments if they would like to die at home.

source: Medical News Today

Elekta Introduces Next Generation SBRT for Lung Cancer with Ground-Breaking 4D Image Guidance to Manage Tumor Motion and Enhance Safety

Atlanta, GA (April 8, 2010) /PRNewswire/ — Elekta has introduced an advanced solution for treating lung tumors that enables doctors to visually confirm the tumor's position during the breathing cycle. This new technology treats the lesion with a continuous radiation beam, increasing therapy accuracy while using less imaging radiation during treatment delivery.

Lung tumors have been among the most challenging radiation therapy targets because the patient's breathing causes tumors to move. New research has shown that the lung tumor shifts position from day to day during the course of treatment (baseline shift).1 Doctors often have had to use external skin surface markers or implanted markers to estimate lung tumor position during the breathing cycle and then apply the beam only during certain points in the patient's respiration. These strategies require complex, time-consuming planning and delivery, and prolong treatment with an inefficient stop-start (i.e., gated) beam delivery.

"Elekta's XVI Symmetry™ and XVI Intuity™ completely change the approach when it comes to the treatment of lung tumors," says Dee Mathieson, Senior Vice President, Oncology Business Line Management. "Symmetry provides tools to manage shifts in the relative positions of the tumor and organs-at-risk during the respiratory cycle, and Intuity ensures that not only is the tumor's position accounted for, but also the position of nearby healthy critical structures. This contributes to a more patient-friendly and safe treatment."

source: PR Newswire

Imaging and Conformality Highlighted in Study of TomoTherapy Technology for Craniospinal Irradiation

MADISON, Wis. – April 5, 2010 – TomoTherapy Incorporated (NASDAQ: TOMO), maker of advanced radiation therapy solutions for cancer care, today cited results of a study from McGill University Health Centre (MUHC) in Montreal, Quebec, Canada, that showed the benefits of TomoTherapy® technology in a variety of cases requiring craniospinal irradiation (CSI) in children and young adults. The study—entitled “Standard and Nonstandard Craniospinal Radiotherapy Using Helical TomoTherapy” and published online (Int J Radiat Oncol Biol Phys., March 2010; Epub ahead of print)—concluded that the TomoTherapy platform offers a major dosimetric advantage in treating both standard and complicated cases by utilizing integrated daily imaging and helical radiation delivery to more accurately target tumors and spare surrounding structures and organs.

As reported in the study, “Helical TomoTherapy delivers continuous arc-based [intensity-modulated radiation therapy] (IMRT) that gives high conformality and excellent dose homogeneity for the target volume. Helical TomoTherapy allows for differential dosing of multiple targets resulting in very elegant dose distributions. By its conformal nature, IMRT is very sensitive to improper patient setup. The use of pretreatment [megavoltage CT] (MVCT) imaging with [helical TomoTherapy] allows for increased precision with respect to patient positioning and use of a reduced [planning target volume] (PTV) margin. Daily imaging of our patients has shown the technique to be very reproducible. We conclude that [helical TomoTherapy] is an excellent tool for planning and delivery of conformal IMRT for both standard and nonstandard CSI.”

source: TomoTherapy