Lisbon, Portugal – Clinicians in Lisbon have commenced advanced radiosurgery treatments using Varian's Calypso® 'GPS for the Body' real-time tumor tracking system. Doctors at the 'Champalimaud Center for the Unknown' (CCU) utilized the Calypso system to enhance precision during a radiosurgery treatment that included the world's first clinical use of the new commercially available Calypso lung Beacon® transponder.
The center has used this method to treat three patients with stage 1 non-small-cell lung cancer (NSCLC), according to Professor Carlo Greco, head of radiation oncology at CCU.
"Our experience so far is that tracking tumors with Calypso transponders may help make a significant difference in lung treatments," says Professor Greco. "In the past, we would have to apply a more generous treatment margin around the tumor and we would have had difficulty checking for or responding to movement caused by the patient coughing. Calypso allows us to monitor the treatment real-time and reduce the treatment margin, meaning less healthy tissue is treated."
"Calypso is a tracking and monitoring device that provides additional evidence that the dose is being delivered where it should be, which is even more important in higher dose treatments," Professor Greco added.
Calypso lung transponders¹ are implanted devices that are currently used in combination with Varian's TrueBeam™ medical linear accelerator at CCU to provide advanced stereotactic radiosurgery treatments. In November, the same hospital is scheduled to become the first in the world to commence treatments using Varian's new Edge™ dedicated radiosurgery system.
Calypso surface transponders that are fixed to the patient's skin are also utilized at CCU to track motion in thoracic and abdominal tumors being treated using high-dose stereotactic ablative body radiotherapy (SABR). "Real-time tracking of motion is vital if the tumor is close to a critical structure," says Professor Greco. "These surface transponders detect truly valuable information that can enhance precision and allow us to stop the treatment if the target moves beyond a certain threshold."
Professor Greco cited an example of a Calypso surface transponder detecting a tiny lateral movement during a thoracic treatment. "The patient, who had an extremely consistent breathing pattern, admitted that she swallowed right at the end of the treatment and the transponder detected this and we were able to respond accordingly," he said. "A surface mounted device can tell you a lot about what is happening inside the body, enabling you to make corrections to the set-up during the treatment."
Professor Greco presented a paper at last week's American Society for Radiation Oncology (ASTRO) meeting in Atlanta highlighting the use of Calypso surface transponders during a SABR treatment for mediastinal adenopathy at CCU.
Clinicians at CCU have also introduced hypo-fractionated prostate cancer treatments for patients with low and intermediate risk tumors. Instead of the typical delivery schedule of 28 daily treatments over six weeks, patients are being treated in five sessions over ten days. "As each daily dose is much higher, precision is vital and with the help of the Calypso device we are able to more effectively minimize impact to the rectal wall and urethra," said Professor Greco. A phase 1 clinical trial has been initiated to validate this approach.
"The preliminary data appears extremely encouraging," adds Professor Greco. "The quality of set-up and rigorous monitoring enabled by the Calypso transponders allows us to test the efficacy and safety of such high-dose image-guided radiotherapy treatments."
The prostate is not a stationary target. It can shift by as much as several millimeters during a radiotherapy treatment session. The Calypso system enables clinicians to track the prostate in real time during treatment, in order to help enhance treatment precision. There are more than 100 Calypso installations globally and more than 15,000 patients worldwide have been treated using the system.
A clinical study entitled, "Assessing the Impact of Margin Reduction (AIM)," published in the medical journal Urology, demonstrated that the use of Calypso real-time tracking during radiotherapy treatments for prostate cancer resulted in a significant reduction in the majority of serious treatment-related side effects that were studied.²
About Varian Medical Systems
Varian Medical Systems, Inc. (NYSE: VAR), 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 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 6,350 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.
¹ Calypso Anchored Beacon® for Lung is CE marked and cleared for sale in the EU and Australia. It is not for sale in the U.S. and is an investigational device, limited by federal law to investigational use. Calypso Beacons® for Prostate and Surface Beacons® are cleared for use and sale in the US, EU, Australia and some other countries. Varian, as a medical device manufacturer, cannot and does not recommend any treatment regimen or technique.
² Sandler, Howard, et al. "Reduction in Patient-reported Acute Morbidity in Prostate Cancer Patients Treated With 81-Gy Intensity-modulated Radiotherapy Using Reduced Planning Target Volume Margins and Electromagnetic Tracking: Assessing the Impact of Margin Reduction Study." Urology 75 no. 5, (2010): 1004-1008.
Important Safety Information
Implanted Beacon transponders may migrate such that they pass from the patient's body or move to a different location within the body. The most frequent side effects associated with implantation of Beacon transponders are typically temporary and may include, but are not limited to, pain, bleeding, infection, including pneumothorax. In some patients, these side effects may be serious. Use of the Calypso System and its associated Beacon transponders is not appropriate for all patients. Use of the Surface Beacon transponder for patient setup without correlation to an independent alignment method may lead to patient mis]localization. Patients should discuss the potential for side effects and their severity, as well as the benefits of the Calypso System and its associated Beacon transponders with their doctors to make sure it is right for them.
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