Banner Good Samaritan treats cancers and neurological disorders with the Novalis Tx radiosurgery platform

Sep 4 2009

John J. Kresl, M.D., Ph.D., and colleagues at Banner Good Samaritan Medical Center are now treating a wide variety of cancers and neurological disorders with highly-accurate, non-invasive, image-guided radiosurgery using the Novalis Tx(TM) radiosurgery platform from Varian Medical Systems (NYSE: VAR) and BrainLAB. The versatile machine has now been used to treat numerous conditions quickly and accurately, including lung cancer, head and neck cancer, liver cancer, brain tumors, spine tumors and trigeminal neuralgia, a debilitating nerve disorder that triggers intense facial pain.

Novalis Tx is optimized to deliver stereotactic radiosurgery for tumors of the brain or spine, and stereotactic body radiotherapy (SBRT) for tumors elsewhere in the body. Both types of treatment involve attacking a tumor or abnormality with high doses of radiation while minimizing exposure of surrounding normal cells and tissues. The Novalis Tx platform at Banner Good Samaritan is also outfitted with RapidArc(R) radiotherapy technology, which further speeds up treatment in some cases to just a few minutes. In most cases treatment is given on an out-patient basis, requires no anesthesia or head-frame screwed to the patient's skull, and is completed in one week or less.

Treating Lung Cancer with SBRT

A 76-year-old woman with early stage lung cancer was among the first patients to benefit from SBRT on the Novalis Tx platform, delivered using RapidArc. "Her treatments took less than 30 minutes to deliver; comparable treatments using older radiosurgery technology had been taking anywhere from 45 to 60 minutes a day, sometimes more," said Dr. Kresl, medical director for the Department of Radiation Oncology. "In addition to being faster to deliver, and so more comfortable for this patient, the RapidArc treatment plan was superior in terms of both the amount of dose we could direct at the tumor, and the degree to which we could minimize exposure of the patient's healthy tissues -- particularly the lung and spinal cord. This patient was adamantly opposed to conventional surgery and the associated risks. Fortunately, we had a noninvasive option for her that is superior to standard forms of radiation therapy."

Protecting the Brain and Cranial Nerves during Treatment for Nasopharynx Cancer

Another recent radiosurgery patient was treated for a tumor at the top of his nasal cavity, which was invading his skull, destroying bone, causing significant pain, and affecting his optic nerve, making his left eye useless.

This patient was treated in five 20-30 minute sessions, delivered on an outpatient basis over five consecutive days, without the need for anesthesia. "Four weeks later, the tumor had shrunk considerably, the patient was off his pain medications, and had regained the use of his left eye," Dr. Kresl said. "He was very excited, and we fully expect to see further regression of the tumor in future follow-up visits."

Treating Trigeminal Neuralgia: An Incapacitating Pain Disorder

The Novalis Tx radiosurgery platform can also be used to treat a variety of neurological disorders, including trigeminal neuralgia. "To treat trigeminal neuralgia with radiosurgery, you need enormous precision," Dr. Kresl said. "We treat just a short segment of the nerve, right where it exits the brain stem. That requires hitting a target that's only two to four millimeters long and less than a millimeter in diameter." Within a week of launching a radiosurgery program for treatment of trigeminal neuralgia, Dr. Kresl treated three patients. "The treatments are completed in a single 30-minute session," he said. "At this point, two of the most recently treated patients report feeling much less facial pain within the first two weeks after treatment."

"I feel confident working with Dr. Kresl, and referring patients to him for image-guided radiosurgery procedures on the Novalis Tx machine," said Jose Menendez, MD, neurosurgeon with the Arizona Neurosurgery & Spine Specialists. "It incorporates state-of-the-art technologies for ensuring accurate treatments that can be delivered quickly, and that's good for my patients."

About the Novalis Tx Platform

The Novalis Tx platform incorporates a selection of imaging technologies that are used to guide treatments and ensure precise targeting. A 3-D CT imager or in-room 2D stereoscopic X-ray imager can be used to position patients for treatment with submillimeter accuracy. In addition, the stereoscopic X-ray imager with Snap Verification generates images during a treatment to ensure accurate targeting throughout.

"This is an important feature of the platform -- the ability to generate images during the treatment delivery or 'beam on' process, in order to monitor and ensure the position of the radiation beam relative to the targeted area," Dr. Kresl said. "This level of precision is what makes it possible for us to treat something as small as a trigeminal nerve. It also makes it possible for us to treat cancers anywhere in the body without using invasive head frames to immobilize patients."