Fast Clinical Adoption of Advanced Radiotherapy and Radiosurgery

Of the first 50 TrueBeam systems to begin treating patients clinically, ten are in Europe, where thousands of patients have already received advanced treatments. "We have seen an unprecedented adoption for a new linear accelerator platform and we are delighted that hospitals globally are using TrueBeam to treat a greater number of patients while pushing back the boundaries of advanced radiotherapy treatments, enabling difficult to treat tumors such as lung and liver to be treated effectively by radiotherapy and radiosurgery," stated Rolf Staehelin, head of international marketing for Varian's (Palo Alto, CA, USA) oncology systems unit.

TrueBeam is the centerpiece of Varian May 2011 at the annual meeting of the European Society for Therapeutic Radiation Oncology (ESTRO) in London, UK, where the UK's first TrueBeam system will enter clinical use at University College Hospital this summer in a joint project between HCA National Health Service (NHS) Ventures and the hospital. Derek D'Souza, head of radiotherapy physics at UCH, said, "TrueBeam will offer patients new treatments using small, high-intensity fields of radiation to treat the tumor. It provides greater efficiency in the steps needed for imaging, positioning, and treating patients and offers a high degree of precision."

Richard Yacob, director of medical physics at HCA-NHS/ Ventures, added, "TrueBeam was selected for this project as we believe it to be the most advanced system of its kind. As well as being able to deliver higher doses faster than other systems, it is also capable of advanced real-time imaging and gated RapidArc. It will be a big step forward in providing higher precision in treatment delivery."

TrueBeam was designed to treat tumors in a quick and precise manner, including tumors that move during treatment as the patient breathes in and out. Designed to advance the treatment of lung, breast, prostate, head and neck, and other types of cancer, TrueBeam features many technical developments that dynamically synchronize imaging, patient positioning, motion management, and treatment delivery. With its high intensity mode, TrueBeam can deliver very high doses quickly and accurately, more than twice as fast as earlier generations of technology.

At Humanitas Institute (Rozzano-Milan, Italy), TrueBeam is routinely used to treat 50 patients a day and treatments focus on hypofractionated stereotactic body radiotherapy (SBRT), in particular for liver and pancreatic cancer, non-small-cell lung cancer and lymph-node metastases, along with total marrow irradiation. "TrueBeam enables us to offer treatments for different kinds of pathologies than have previously been possible with radiosurgery here at Humanitas," said Dr. Marta Scorsetti, head of radiation oncology and radiosurgery at the hospital. "We are impressed by the greater precision and higher quality imaging, higher possible dose rate, the ability to deliver the total dose in fewer fractions and the speed of the treatment, which allows for shorter treatment sessions for patients." To date, Humanitas Institute has treated more than 420 patients using the TrueBeam device, with 25 new patients commencing treatment on the system each week.

Two TrueBeam devices are treating up to 100 patients a day at VU University Medical Center (Amsterdam, Netherlands), and according to department head Dr. Ben Slotman, the devices have become a vital part of their stereotactic body radiotherapy program. "From a clinical perspective, TrueBeam enables better integration between imaging and treatment delivery, much faster dose output using the flattening filter free mode, and a much shorter time is needed for pretreatment setup due to the user-friendly nature of the equipment," he said.

Zurich University Hospital (Switzerland) was the first clinic in the world to commence treatment with TrueBeam in March 2010. "We have found the system technically wonderful, giving us dose distributions that are slightly superior to intensity modulated radiotherapy from conventional systems, with lower doses to surrounding healthy tissues," stated Prof. Urs M. Lütolf, MD, clinical director and chairman of the department of radiation oncology. "I have been astonished and excited to see the degree to which the TrueBeam image isocenter matches the beam isocenter, at a level of precision I have never seen before."

Routine clinical TrueBeam treatments have also begun at the Institut Catala d'Oncologia (ICO) in Barcelona, Spain; Neolife Medical Center in Istanbul, Turkey; Davidoff Center in Petah Tikva, Israel; Casa di Cura San Rossore in Pisa, Italy; Radioonkologie Amsler in Liestal, Switzerland Strahlentherapie-Bonn-Rhein-Sieg/St. Josef Hospital in Troisdorf, Germany; and Azizia Royal Clinic/Azizia Royal Palace in Riyadh, Saudi Arabia.

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