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International brain cancer consortium takes aim at better linear accelerator outcomes

by John W. Mitchell, Senior Correspondent | September 01, 2015
Rad Oncology Radiation Therapy X-Ray
A just-announced initiative between Elekta and physicians at health care systems in three countries will work to set best practice standards for treating brain cancer patients with noninvasive stereotactic radiosurgery (SRS) and stereotactic radiation therapy (SRT) using linear accelerators.

“The inaugural meetings held recently were to identify SRS clinical practices at consortia members in the U.S., Canada and Germany,” Kris Walmsley, corporate communications manager at Elekta told HCB News. “These members treat high patient volumes and offer influential academic radiotherapy institutions.

The three founding members are: Massachusetts General Hospital; Odette Cancer Center at Sunnybrook Health Sciences Centre, University of Toronto, Canada; and University Medical Center, Mannheim Germany.

SRS and SRT are noninvasive focused radiation treatments for brain disorders, including cancer. About 70,000 patients worldwide receive the therapy annually. The treatment delivers pinpoint, high doses of radiation through the skull. The consortium’s goal, according to Dr. Joel Goldwein, Elekta’s senior vice president of Medical Affairs, is to improve clinical confidence and outcomes and lead to greater implementation of the procedure.

According to a 1996 study published in Cancer, between 25-45 percent of oncology patients’ cancer spreads to the brain.

“This is an exciting international collaborative,” said Dr. Arjun Sahgal, associate professor of radiation oncology and surgery, University of Toronto. He said the group will initially study the differences between single treatments and hypofractionated treatments (delivered in multiple doses) as to how both methods relate to minimizing the impact of the radiation and effectiveness in obliterating the tumor.

“We have the ability to report on our outcomes and toxicities with both approaches and for intact tumors, surgical cavities and benign tumors,” said Sahgal

Sahgal said SRS and SRT are emerging techniques. The group plans to work to help the physician community develop new, safe treatments for applying brain stereotactic technology. Goldwein said that the group first plans to conduct a medical practice survey on intact brain metastases and a tumor contouring study. Once the results are published, a retrospective observational study is planned to examine correlations with clinical outcomes.

“We want the consortium to identify any clinical evidence gaps to help derive consensus guidelines on linac-based brain stereotactic procedures.” Goldwein added. He said that eliminating variability in current treatments would help validate best practices and also enhance efficacy and safety.

“Our ultimate goals is to improve outcomes for these unfortunate prognosis patients,” he said.

According to Walmsley, Elekta will fund the consortium’s research.

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