Posts Tagged ‘Elekta Infinity’

5 Day Prostate Cancer Treatment

September 26th, 2011

When you are researching prostate cancer there are a lot of treatment options out there and I highlighted them in a previous blog. What I would like to highlight today is a 5 day course of treatment.

What is a 5 day course of treatment? It is a five-day, non-invasive treatment for prostate cancer (called “stereotactic body radiation therapy” or “SBRT”). SBRT is a specialized form of IMRT (intensity modulated radiation therapy) that delivers high doses of radiation over a period of five days. Instead of giving small doses of radiation each day for several weeks, SBRT involves delivery of very focused beams of high-dose radiation. Several beams are aimed at the tumor from different angles. When for other cancers it is delivered in a single fraction it is known as stereotactic body radiosurgery. Like other forms of external radiation, these treatments are painless.

Currently there are nuances determined by which machine you are treated on. Cyberknife is one machine, another is Elekta Infinity which is what we have here at The Farber Center.

TOTAL TREATMENT TIME: 45 minutes on CyberKnife vs. 20 minutes on Elekta Infinity.

TREATMENT PLANNING: Both CyberKnife and Elekta Inifinity use Monte Carlo based dose calculations. Unlike other planning software programs that use theory models to calculate dose, Monte Carlo is statistical planning and the most accurate. Because Elekta Infinity utilizes a multileaf collumater, which can change shape instantaneously we can mimic the shape of the prostate as seen from different beam angles better, compared to the circular aperture in a CyberKnife system. This will reduce the normal tissue being irradiated from various gantry angles. Thus we can achieve better DVH (Dose Volume Histogram) with LINAC based prostate SRT compared to CyberKnife.

TARGETING THE PROSTATE: None of these machines can track the motion of the prostate throughout treatment AND adjust delivery accordingly. The CyberKnife System uses invasively implanted fiducials as reference points to identify the exact location of the prostate. Patients will wait approximately one week after insertion of the fiducials before CyberKnife treatment planning can begin to ensure that fiducial movement has stabilized.

At The Farber Center for Radiation Oncology we have a completely non-invasive approach to targeting the prostate. We use a RadiaDyne balloon. The balloon acts primarily as an immobilizer reducing the daily variations in location of the prostate, and allowing the rectum and prostate to be positioned in a more predictable and reproducible location during the treatment course. Because of the decreased probability of the prostate moving out of the treatment fields, smaller treatment margins around the prostate may be used. This will have the effect of lowering the radiation dose to the normal tissue surrounding the prostate and lowering the incidence of potential side effects to normal tissues. We also take a second Cone Beam CT Scan in the middle of treatment to verify the position of the prostate. This together with the placement of the RadiaDyne ballon ensures consistency in the location and motion of the prostate during the course of treatment. Due to the fact that we can complete a entire treatment including setup and imaging in under 20 minutes, the amount of prostate motion documented from studies (Both, et al) is kept at a clinical minimum.

KEY POINTS with Elekta Infinity:
5 Day Treatment
No need for surgical procedure
No Hormones
Better bladder DVH
Higher Rate of Erectile Function Preservation
CBCT to see prostate/rectum interface

In my opinion, the most important factors in selecting the right team are the reputation, training and experience of the radiation oncologists and their support staff (physicists, dosimetrists, therapists, nurses, etc.) in treating prostate cancer using SBRT.

Lung Cancer Treatment

November 15th, 2010

Both small cell and non-small cell lung cancers are frequently treated with radiation therapy, which is often combined with chemotherapy, surgery or both. More than half of those diagnosed with non-small cell lung cancer will receive radiation therapy at some time during their treatment. Depending upon the type and stage of your lung cancer, radiation therapy may be used:

After surgery – To treat cancer cells that might remain after surgery
Before surgery – To decrease the size of tumor to make surgery more effective
To cure cancer – With small tumors, in patients that are unable to have surgery, location of a tumor
To treat lung cancer – Both locally, such as nearby lymph nodes, and to other parts such as the brain
To treat symptoms – Such as shortness of breath, pain
For prevention – In small cell lung cancer, radiation therapy to the brain is sometimes given to kill any microscopic cells that have spread to the brain but are not detected by scans. )

What we do differently at The Farber Center for Radiation Oncology:

CT Simulation:
We have the largest Bore CT Simulator in the radiation market which allows us to plan with an unobstrutive field of view and allows patients more comfort and reproducibility.

Treatment planning:
We are the first and only in NY to offer the same state-of-the-art system used by renowned MD Anderson’s BrainSuite. Anatom-e combines the best anatomic atlas’, the best papers that define standards of care, and treatment guidelines with CT scans. This allows our radiation oncologist a second check in developing a precise plan that avoids potential anatomical structures that if treated could cause side effects. We are also part of a research collaboration that allows us access and participation in ongoing protocols.

Treatment:
We are the first and only in NYC to offer Elekta VMAT technology. Using real-time 3D imaging that helps conform the radiation beams to the shape of your tumor. This next- generation therapy allows the radiation to be delivered only to the intended area, allowing clinical staff to spare more surrounding healthy tissue and better avoid nearby critical anatomy. To further ensure accuracy, CT and 3D imaging allows staff to quickly and safely verify tumor position prior to treatment. Sophisticated monitoring tools further enhance precision by monitoring treatment in real-time to ensure that the dose is delivered as precisely as the radiation oncologist prescribes it. The flexibility to deliver treatments in uninterrupted rotations of the linear accelerator allows for faster treatment times (as little as two minutes per day).

Elekta Infinity with VMAT technology

The Environment:
From the moment you walk into The Farber Center, your tension begins to melt away. We are Manhattan’s first freestanding radiation oncology treatment center completely conceived with your comfort and well-being in mind. Here you can relax by the fireplace, slip into a plush robe in your own private dressing room, and take in the peaceful calm of our beautiful flora aquarium. To us, the tranquility of a spa-like setting is part of your healing process. But the real comfort of being at The Farber Center is knowing that you’re treated by Ivy League-trained physicians with the most advanced radiation technology, which means faster treatment, fewer side effects, and a greater potential for cure.