Newly installed technology enables clinicians to target lung and other tumors quickly and precisely using finely shaped radiation beams rather than surgery
NORMAL, Ill. — When a diagnostic chest X-ray revealed a nodule on his left lung, Paul Hoffman, 79, had a biopsy and soon got bad news: it was Stage 1 lung cancer. He was given two options. The first was surgery, which would have been risky because Hoffman has a heart condition and a pacemaker. The second option was radiosurgery—a non-invasive treatment that uses finely shaped radiation beams to target a tumor without making a single incision.*
"I really didn't want to be operated on if I could avoid it," said Hoffman. Hoffman was referred to the Community Cancer Center in Normal, Illinois, where a new TrueBeam™ STx system from Varian Medical Systems (NYSE: VAR) had been installed just a few weeks earlier. The TrueBeam STx system targets tumors with great speed and accuracy, including tumors that move during treatment as the patient breathes. It features a multitude of technical innovations that synchronize imaging, patient positioning, motion management, and treatment delivery and can deliver a treatment more quickly than was possible with earlier generations of technology.
Patrick Fernandes, M.D., radiation oncologist, designed Hoffman's treatments to carefully target his lung tumor while minimizing exposure of nearby healthy tissues and organs, especially the spinal cord, rib cage, esophagus, and the delicate healthy lung tissues that surrounded the tumor.
"For patients with heart or lung problems, conventional surgery can be risky," said Fernandes. "Stereotactic body radiotherapy, or SBRT, can be a viable option for these patients, and often leads to good local tumor control. We use very high doses with the goal of completely destroying the tumor." *
Each of Hoffman's five treatments was completed in about ten minutes, using RapidArc radiosurgery. "RapidArc is a capability of the TrueBeam machine that enables us to modulate the dose, vary the speed of rotation around the patient, and continually shape the treatment beam in a way that dramatically shortens the duration of each treatment," Fernandes said. "Similar treatments using other technologies could have taken as long as an hour each day."
"The hardest part of the treatment was having to hold a position with my arms over my head," Hoffman said. "That's the only thing that bothered me at all. I'm 79 years old and don't move as well as I used to. Fortunately, when it was time for my treatment, the TrueBeam machine was in and ready to go. I was one of the first patients. Otherwise, I'd have been treated on another machine, and I'd have had to hold still with my arms up for 25-30 minutes at a time, which would not have been fun."
Hoffman says that the biggest side effect of treatment was feeling tired for a couple of weeks, but it was nothing like the fatigue his wife experienced when she was treated for breast cancer many years ago. "I assumed that would happen to me, and it didn't. I was tired, but it wasn't debilitating," he said.
It will be another three to six months before Hoffman is brought back for follow-up scans, said Shermian Woodhouse, M.D., radiation oncologist and cancer center medical director. "There's every reason to hope that we'll see no more evidence of the tumor in the best case scenario, and shrinkage of the tumor at the least," she said. "That would be in line with our prior experience, and also, the medical literature on the use of stereotactic body radiotherapy to treat inoperable lung cancer."
Since its installation at the end of March, clinicians at the Community Cancer Center have used the TrueBeam machine to treat cancer of the lung, breast and multiple other disease sites.
"Having the TrueBeam STx makes it possible for us to offer more varied treatment options to a wider range of patients," said Woodhouse. "The system also offers us more tools for ensuring and documenting the accuracy of treatments. From the perspective of our staff, it has enabled a significant improvement to our workflow. Since it was installed, I've seen an increase in staff morale. Our people know that the Cancer Center is dedicated to providing them with the tools they need to do their jobs really well."
Note: high resolution images of the TrueBeam™ STx system are available by in Varian's online media room.
1Timmerman R, et al. Stereotactic Body Radiation Therapy for Inoperable Early Stage Lung Cancer. JAMA; 2010;303(11):1070–1076.
2 Haasbeek, CJA et al. Early-stage lung cancer in elderly patients: A population-based study of changes in treatment patterns and survival in the Netherlands. Ann Oncol 2012;23:2743-2747.
3Lagerwaard FJ, et al. Outcomes of stereotactic ablative radiotherapy in patients with potentially operable stage I non–small cell lung cancer. Int J Radiat Oncol Biol Phys. 2012;83(1):348–353.
4Onishi H et al. Stereotactic Body Radiotherapy (SBRT) For Operable Stage I Non–Small-Cell Lung Cancer: Can SBRT Be Comparable To Surgery? Int. J. Radiation Oncology Biol. Phys. 2011;81(5);1352–1358.
*Radiosurgery or SBRT may cause side effects that can vary depending on the part of the body being treated. The most frequent ones are typically temporary and may include, but are not limited to, irritation to the respiratory, digestive, urinary or reproductive systems, fatigue, nausea, skin irritation, and hair loss. In some patients, they can be severe. Treatment sessions may vary in complexity and time. Radiation treatment is not appropriate for all cancers. Patients should discuss the potential for side effects and their severity as well as the benefits of radiation with their doctors to make sure radiation treatment is right for them.
About Community Cancer Center
As Central Illinois' leader in cancer care, the clinical team at the Community Cancer Center offers the care of multiple physician specialties, the latest drug therapies, radiation treatment, research protocols and support services. The Center is committed to excellence in patient care and is driven by a mission to improve the health status of individuals by providing comprehensive, community-based cancer care.
About Varian Medical Systems
Varian Medical Systems, Inc., of Palo Alto, California, is the world's leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, and brachytherapy. The company supplies informatics software for managing comprehensive cancer clinics, radiotherapy centers and medical oncology practices. Varian is a premier supplier of tubes, digital detectors, and image processing software and workstations for X-ray imaging in medical, scientific, and industrial applications, and also supplies high-energy X-ray devices for cargo screening and non-destructive testing applications. Varian Medical Systems employs approximately 6,500 people who are located at manufacturing sites in North America, Europe, and China and approximately 70 sales and support offices around the world. For more information, visit http://www.varian.com or follow us on Twitter.
For Information Contact:
Meryl Ginsberg, 650-424-6444
Varian Medical Systems