APBI Brachytherapy Associated with Higher Rate of Later Mastectomy, Increased Toxicities, and Post-Operative Complications, Compared to Traditional Radiation Therapy in Women with Early Breast Cancer

Accelerated partial breast irradiation (APBI) brachytherapy, the localized form of radiation therapy growing increasingly popular as a treatment choice for women with early-stage breast cancer, is associated with higher rate of later mastectomy, increased radiation-related toxicities and post-operative complications, compared to traditional whole breast irradiation (WBI), according to researchers from The University of Texas MD Anderson Cancer Center.

The retrospective study was presented in the CTRC-AACR San Antonio Breast Cancer Symposium's press briefing by Benjamin Smith, M.D., assistant professor in the Department of Radiation Oncology, and in the meeting's scientific session by Grace Smith, M.D., Ph.D., a resident in MD Anderson's Department of Radiation Oncology and the study's first author.

"Our study compared the two radiation therapy techniques available to women with early-stage breast cancer. We found that women treated with accelerated partial breast irradiation therapy have a two-fold increased risk for subsequent mastectomy, most likely because of tumor recurrence or local complications, as well as an increased risk for post-operative and radiation-related complications," said Ben Smith, the study's senior author.

There are numerous types of APBI; the MD Anderson study only looked at the brachytherapy technique, in which a form of radiation treatment involving insertion of a catheter containing a radioactive source to kill breast cancer cells that may remain after lumpectomy surgery.

source: MD Anderson

Elekta's Leksell Gamma Knife Perfexion Earns Nearly Perfect Score in 2011 KLAS Radiation Therapy Report

ATLANTA, Dec. 9, 2011 /PRNewswire/ -- With a score of 94.4 out of 100, Elekta's Leksell Gamma Knife® Perfexion™ is "practically perfect in every way," ranking at the top among six advanced radiation therapy systems, according to KLAS research firm's recently released customer survey, Radiation Therapy 2011: A Dose of New Technology. The Elekta Infinity™ radiation treatment system garnered the #2 ranking with a score of 84.4, improving its score over the 2010 report.

The 2011 KLAS report – the result of interviews with 213 U.S. provider organizations – referenced respondents' regard for the Perfexion system's technological sophistication, making "treating very complicated tumors in a difficult spot easy for providers," and for the radiosurgery platform's unprecedented uptime statistics. The report summarized customer opinion by noting: "The speed, accuracy, reliability, and sophistication of the treatments all came together for the Gamma Knife Perfexion to earn the highest score in the study by a 10-point margin."

Gamma Knife® surgery is a gentler alternative to traditional brain surgery for illnesses such as metastatic disease – cancer that has traveled to the brain from elsewhere in the body. The system delivers thousands of low-intensity radiation beams to one or more targets in a single session. Leksell Gamma Knife Perfexion provides even greater speed and ease of use than previous versions, especially for treating multiple metastases.

source: Elekta

Radiation Therapy for Breast Cancer: American Society of Breast Surgeons Responds to San Antonio Breast Cancer Symposium Data

n a study presented on 12/7/2011 at the San Antonio Breast Cancer Symposium (“Partial Breast Brachytherapy is Associated With Inferior Effectiveness and Increased Toxicity Compared to Whole Breast Irradiation in Older Patients”), physicians from the MD Anderson Cancer Center compared the 5-year results of accelerated partial breast irradiation (APBI) to whole-breast irradiation (WBI) in patients undergoing breast-conserving therapy. They observed higher rates of mastectomy (4% vs.2.2%) and of treatment-related complications in the APBI patients, differences which are statistically significant but small in absolute terms. The study comprises more than 130,000 patients' Medicare claims data, but is retrospective and therefore cannot assure that the ABPI and the WBI patients were comparable in all other ways. In addition, because this is a claims database, it cannot be concluded that the additional mastectomies were necessarily performed because of a recurrence of cancer.

The American Society of Breast Surgeons (ASBrS) maintains a registry of 1440 patients treated by APBI with the MammosSite® balloon catheter device through 2004, and in numerous publications has observed 1) a 5-year local recurrence rate of <5%, comparable to that of whole-breast radiation therapy, 2) a low rate of other complications, and 3) good or excellent cosmesis in approximately 90% of patients. Several single-institution randomized and nonrandomized studies using another technique of APBI, multiple interstitial catheters, also report rates of local recurrence comparable to WBI. source: PR Web

Varian Medical Systems Adds High Dose Delivery and Prone Breast Treatment Capabilities to Clinac® and Trilogy® Cancer Treatment Machines

PALO ALTO, Calif., Dec. 6, 2011 /PRNewswire/ -- Clinac® and Trilogy® medical linear accelerators from Varian Medical Systems (NYSE: VAR), machines that are used to treat cancer with targeted radiotherapy, have been updated to deliver higher doses up to two times faster than was previously possible. They can now also better facilitate treating breast cancer patients on their stomachs (in the prone position) rather than their backs—an approach that can reduce the volume of lung and heart tissue exposed to radiation during treatment. Updated control software, which received 510(k) clearance in November from the U.S. Food and Drug Administration (FDA), adds a High Intensity Mode to the Clinac and Trilogy machines, enabling dose delivery rates of up to 2400 monitor units per minute—double their former highest output.

"Our High Intensity Mode makes it possible to deliver some treatments up to 50 percent faster than is possible without it," said Chris Toth, senior director of marketing for Varian's Oncology Systems business. "We're seeing trends toward the use of hypo-fractionation and radiosurgical approaches for many types of cancer, which means that higher doses are delivered in just one or a few treatment sessions for quick ablation of a tumor. There has been encouraging research supporting this approach for the treatment of cancers of the brain[1], spine[2], and lung[3], as well as for prostate cancer.[4] With High Intensity Mode, our Clinac and Trilogy machines can deliver these high dose treatments within a clinically-feasible timeframe."

Varian also received FDA clearance for the Pivotal™ Care Solution for Prone Breast Treatment, an innovation that allows patients to be treated on their stomachs rather than their backs. Recent studies have shown that, for many women without axillary lymph node disease, treatment in the prone position can be used to significantly reduce the volume of lung and heart tissue exposed to the treatment beam.

source: Varian

Accuray Receives Outstanding Innovative Improvement Award for its CyberKnife System

SUNNYVALE, Calif., November 30, 2011 - Accuray Incorporated (Nasdaq: ARAY), the premier radiation oncology company, today announced that the company received the Outstanding Innovative Improvement Award for its CyberKnife® Robotic Radiosurgery System at the 3rd Annual Employer Healthcare Congress, which took place October 25 - 28, 2011 in Chicago.

The award was presented to Accuray in recognition of the fact that patients treated with the CyberKnife System are able to complete treatment in five days or less, compared to radiation therapy treatments, which typically require up to 40 treatment sessions. This significant reduction in the number of daily treatments helps patients get back to work faster, benefitting employees and employers alike. The CyberKnife System targets tumors anywhere in the body and delivers high doses of radiation with pinpoint accuracy. Unlike any other radiation delivery system, the CyberKnife System tracks and adjusts treatment delivery to compensate for tumor motion, including respiration.

"Treatment with the CyberKnife System is typically completed in five or fewer outpatient sessions, compared to the six weeks of daily treatments typical with conventional radiation. Fewer daily treatments allow the employee to get back to their normal schedule, including work, resulting in less stress for the employee and a more efficient workplace for the employer," said Jonathan Edelheit, president of the Employer Healthcare Congress. "Accuray has made a tremendous effort to ensure that employees are aware of the full range of options so they can make an informed treatment decision. We wanted to recognize Accuray’s innovative technology, as well as its education efforts with this award."Accuray Receives Outstanding Innovative Improvement Award for its CyberKnife System

source: Accuray

Clinicians at the University of Alabama at Birmingham (UAB) Health System First in World to Use "Triggered Imaging" Technology From Varian Medical Systems

BIRMINGHAM, Ala., Nov. 21, 2011 /PRNewswire/ -- The University of Alabama at Birmingham (UAB) Health System became the first medical center in the world last week to utilize intrafraction motion review (IMR), or "triggered imaging," to continually monitor tumor location during radiosurgery for lung cancer. IMR, which is a unique capability of the TrueBeam™ linear accelerator from Varian Medical Systems (NYSE: VAR) enables visual verification that a tumor is being properly targeted.

"With triggered imaging, clinicians use the imager on the TrueBeam system to observe the targeted tumor repeatedly, at a predetermined portion of the respiratory cycle, in order to check on the tumor's location and trajectory," said Chris Toth, senior director of marketing at Varian. "If the tumor is not where it is supposed to be, they can halt treatment and intervene to enhance the accuracy of the targeting."

Doctors at UAB used the IMR tool for the first time earlier this month when delivering a Gated RapidArc radiosurgery treatment for inoperable early-stage lung cancer. RapidArc enables fast, precise image-guided IMRT (intensity-modulated radiotherapy) by delivering dose continuously as the treatment machine rotates around the patient. Gated RapidArc makes it possible to monitor patient breathing and compensate for tumor motion during a RapidArc treatment. The Gating system turns the treatment beam on and off in synchrony with the patient's breathing to increase treatment precision. With IMR, or "triggered imaging," the gating system also triggers the imager to generate a low-dose X-ray of the targeted tumor at a specific point in the patient's respiratory cycle.

source: Varian Medical Systems

IsoRay Ships First GliaSite(R) Brain Cancer Treatment

RICHLAND, Wash., Nov 28, 2011 (BUSINESS WIRE) -- IsoRay, Inc. ISR -4.28% announced today it has shipped its first GliaSite(R) radiation therapy system. The Company initiated sales after receiving final approval this week from the State of Washington Department of Health to manufacture its GliaSite(R) radiation therapy system. The GliaSite(R) radiation therapy system is a balloon catheter device used in the treatment of brain cancer. Having already received FDA clearance, the Washington State regulatory approval opened the door for sales of IsoRay's GliaSite(R) brain cancer treatment in the United States.

IsoRay CEO Dwight Babcock says inquiries are on the rise, "News of final regulatory approval has generated a great deal of interest throughout the medical community in the U.S. and internationally. We are hearing from physicians as well as brain cancer patients who are seeking treatment options for Glioblastomas and metastasized brain cancers."

The GliaSite(R) radiation system offers an innovative alternative that presents an important advance over previous brain cancer treatments. Doctors are able to use the system to directly place a specified dosage of liquid radiation in areas where cancer is most likely to still remain after completion of brain tumor removal. The ability to precisely place a specified dosage of this form of radiation means there is less likelihood for damage to occur to healthy brain tissue compared to other alternative treatments. Importantly, the GliaSite(R) radiation treatment diminishes the ability of the tumor to recur which means important benefits for patients in longevity as well as quality of life.

source: Isoray

Prostate Cancer Study Shows Radiation Plus Hormone Therapy Greatly Improves Survival for Men with High-Risk Disease

Newswise — (Toronto – Nov. 3, 2011) – Men with locally advanced or high-risk prostate cancer who receive combined radiation and hormone therapy live longer and are less likely to die from their disease, shows clinical research led by radiation oncologists at the Princess Margaret Hospital (PMH) Cancer Program, University Health Network.

The findings are published online today in The Lancet (doi: 10.1016/S0140-6736(11)61095-7). Principal investigator Padraig Warde, deputy head, PMH radiation medicine program, says: “The study shows combining radiation and hormone therapy improves overall survival by 23 percent and disease-specific survival by 43 percent, compared with treating with hormone therapy alone.

“Based on these results, we believe adding radiation to the treatment plan should become part of the standard therapy.” Dr. Warde is also a Professor in the Department of Radiation Oncology, University of Toronto.

Prostate cancer is the most common malignancy in men and between 15% and 25% percent of cases are high risk, says Dr. Warde. The Canadian Cancer Society estimates 25,500 new cases will be diagnosed this year and that 4,100 men will die from the disease.

source: NewsWise

iCAD Announces Recent Adoption of Its Xoft Electronic Brachytherapy System by Leading U. S. Hospitals

NASHUA, N.H., Nov 09, 2011 (BUSINESS WIRE) -- iCAD, Inc. ICAD -1.59% , an industry-leading provider of advanced image analysis, workflow solutions and radiation therapies for the early identification and treatment of cancer, today announced that its Xoft Axxent(R) eBx(TM) electronic brachytherapy system for intraoperative radiation therapy (IORT) has been recently adopted at leading hospitals across the country. Facilities that have chosen the Xoft Axxent eBx System for IORT include Diablo Valley Oncology/Hematology (Pleasant Hill, Calif.), Exeter Hospital (Exeter, N.H.), Memorial Hospital Chattanooga (Chattanooga, Tenn.), Florida Hospital Tampa (Tampa, Fla.), Rockford Memorial Hospital (Rockford, Ill.), Rose Medical Center (Denver, Colo.) and Vanderbilt Medical Center (Nashville, Tenn.)

"The recent adoption of the Axxent eBx System is an increasing endorsement of electronic brachytherapy and IORT as a safe and effective method of radiation treatment," said Ken Ferry, President and CEO of iCAD. "The growing demand for IORT offers patients expanded access to potentially lifesaving radiation therapy for their cancer treatment and an alternative to long-term radiation therapy."

IORT enables doctors to administer a high dose of radiation to the tumor bed during a lumpectomy, which reduces or eliminates the need for follow-up radiation treatments and also minimizes radiation exposure to healthy tissue and organs, such as the ribs, lungs, heart and opposite breast. The current standard of care for early stage breast cancer consists of lumpectomy, medical therapy, and a five to seven week course of daily Whole Breast External Beam Radiation Therapy (WBEBRT) delivered by linear accelerators inside a heavily shielded room. With IORT, a single dose of intraoperative radiation may be as effective in treating the tumor as 10--20 daily radiation doses.(1)

source: Business Wire

Accuray Receives 510(k) Clearance for a Rotational Dose Control for the TomoTherapy System

SUNNYVALE, Calif. — October 25, 2011 — Accuray Incorporated (Nasdaq: ARAY), the premier radiation oncology company, today announced that the U.S. Food and Drug Administration (FDA) has granted the company 510(k) clearance to market the Dose Control System (DCS), a new feature for Accuray’s TomoTherapy® System that improves system performance.

The TomoTherapy System revolutionized radiation therapy with the introduction of helical delivery, providing precise application of dose to target structures while sparing healthy tissue. With the advent of the Dose Control System the TomoTherapy System again breaks new ground as the first dose servo-controlled helical delivery system (patent pending). This approach provides even higher precision with unprecedented dose stability throughout complex rotational treatments. Static delivery provided by the TomoDirectTM option also benefits from a more stable and consistent dose rate at every gantry angle.

The new DCS feature provides these gains by automatically adjusting controls previously handled through a manual process. This means small variations in dose rate are immediately corrected by the system, resulting in fewer interruptions. The DCS application also ensures a more stable output over longer duration treatments, such as Total Marrow and Total Body Irradiation. The result of this new product feature is higher customer satisfaction, a better patient experience, and improved overall system performance.

source: Accuray