Varian Medical Systems (NYSE: VAR) highlighted the company's technologies for the non-invasive treatment of lung cancer at the 54th annual meeting of the American Society for Radiation Oncology (ASTRO) in Boston this week. Many of Varian's cancer treatment systems can be utilized for attacking lung tumors—which often move during treatment—very precisely, with carefully-shaped, high dose X-ray beams.
"Our latest treatment systems have integrated tools designed for 3- and 4-D imaging, treatment planning, patient positioning, treatment delivery, and motion management, including high resolution beam-shaping and real-time tumor tracking," says Kolleen Kennedy, president of Varian's Oncology Systems business. "These capabilities will further enable efficient, accurate treatments for some forms of lung cancer. Clinicians will be able to use them to more efficiently plan and deliver a personalized radiotherapy or radiosurgery treatment based on each patient's clinical needs."
Lung Cancer Treatment Technologies
Numerous Varian technologies that were on display at ASTRO this year are particularly applicable for planning and delivering lung cancer treatments. They include solutions for patient positioning, motion management, and treatment planning, as follows:
Patient Positioning
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The PerfectPitch™ six-degrees-of-freedom (6DoF) treatment couch, which was designed to provide access to tumors from more angles, giving clinicians more flexibility for carrying out stereotactic radiosurgery procedures for lung and other tumors. It will be fully integrated into the newly-launched EDGE™ Radiosurgery Suite and is also available for the TrueBeam™ system.
Motion Management
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An advanced motion management package, available on the EDGE and TrueBeam systems, which offers clinicians more options for using real-time imaging during radiotherapy treatments. It also enables expanded use of fluoroscopy and 4-D cone-beam CT—imaging techniques that show motion over time—to better compensate for tumor motion during treatment.
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The newly enhanced Calypso® system for real-time tracking of tumors that are subject to respiratory motion, which enables adaptation if the magnitude of tumor motion changes during a treatment, and is compatible with the couch rotations that are often used to optimize targeting during stereotactic treatments in the lung.
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Calypso anchored Beacon® transponders, which are position signaling devices that can be implanted in the lung, as well as surface Beacon transponders, allowing different approaches to real-time tracking of respiratory and other patient motion during treatment.
Treatment Planning
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Treatment planning tools now include thoracic anatomy templates and automated contouring of 4-D CT images (which obviates the need to draw contours manually on multiple image sets from each phase of the respiratory cycle).
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Acuros™ dose calculation algorithm for accurate dose calculations in areas like the lung, where tissue density varies, as well as analytical tools that enable clinicians to determine the dose levels likely to reach nearby critical organs when treating tumors that shift position from day to day.
Lung Cancer Treatment Research and Education
"Clinical evidence has been accruing to support the use of stereotactic body radiation therapy (SBRT) in the treatment of lung cancer—especially inoperable early-stage non-small cell lung cancer," Kennedy points out. "As a leading provider of technology for these types of non-invasive treatments, Varian has launched a broad lung cancer initiative that encompasses research and education, as well as technology development."
Varian is currently supporting an NCI-sponsored trial comparing surgery with SBRT for the treatment of high-risk operable early-stage cases. The company is also planning a series of physician education webinars and regional symposia to offer insight into the rationale for lung SBRT, along with information about a new code that reimburses physicians for collaborating with radiation oncologists in the lung cancer treatment planning process.
"This code will help promote multidisciplinary collaboration in the delivery of SBRT treatments for lung cancer," says Calvin Huntzinger, M.S., senior director of surgical sciences at Varian. "The AMA's decision to create a code that reimburses physicians for collaborating in the treatment planning process underscores the importance of working in multidisciplinary teams to deliver quality care for oncology patients."
Varian has also broadened its outreach activities to include attendance at meetings like the American College of Chest Physicians (ACCP) and the Society of Thoracic Surgeons (STS) annual meetings. "Thoracic surgeons and pulmonologists often play a significant role in helping lung cancer patients understand their treatment options," Huntzinger points out. "At this year's ASTRO meeting, Varian showcased a world-class solution for treating lung cancer with radiosurgery. It's our hope to see it used to save more lives."