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Special report: Radiation therapy on trial

by Nancy Ryerson, Staff Writer | September 30, 2013
From the September 2013 issue of HealthCare Business News magazine

Image-guided treatment is especially useful for lung cancer because tumors move as the patient breathes. Versa HD, released by Elekta in March, includes capabilities that support specialized treatment for patients with breast, prostate and lung cancer, among others. Image-guidance is helpful for some of these lung cancer patients because often these tumors move as the patient breathes. Symmetry technology (part of the Versa HD lung treatment package) helps to manage the tumor motion during respiration, and targets that tumor in a way that minimizes dose to normal tissue during breathing.

Liver cancer is the next disease SBRT will tackle, Huntzinger says. He says that traditional radiotherapy liver cancer treatments had limited success and that treatment options are sometimes limited for frail patients, creating a need for a different, less invasive treatment.

“I think the treatment of liver cancer with SBRT is about where lung was five or six years ago,” says Huntzinger.

Best for breast?
New radiotherapy techniques are also providing treatment options for complicated breast cancer patients, physicians say.

“We’ve been using it for very complicated breast cancer patients, especially for left sided tumors where you’re trying to protect the heart,” says Daniel Landis, a practitioner at Swedish Cancer Institute, who uses Accuray’s TomoTherapy. TomoTherapy combines CT imaging with radiation treatment to better follow tumors as they move.

Accuray reports that sites are also investigating applicability of the CyberKnife System for breast cancer.

Proton therapy, too, hopes to get in on treating the most common cancer in women.

“One of the things that just came out recently was a large study in breast cancer patients that showed that even low radiation doses to the heart resulted in increased risk of death from heart disease in breast cancer survivors,” says Mendenhall of Florida Proton. “Protons are remarkable in their ability to minimize the dose in the heart. Today, breast cancer’s not one of the common sites for proton therapy, but it will become one of the most important ones in the future.”

Better images and fewer fractionations
As clinical trials continue and debates inevitably break out, OEMs still work to plan for the next stage of radiotherapy. Experts predict that next incarnation will bring MRI-aided therapy into the picture.

Elekta, for one, has a system in the works that Joel Goldwein, senior vice president of medical affairs, says will likely roll out in the next three to five years. He also predicts that improved image-guided techniques will allow physicians to plan and adapt treatment in real time as tumors move.

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