Posts Tagged ‘Synergy’
Elekta is improving the availability of cancer care for Russian patients by delivering clinical solutions, services and training to a number of key hospitals and cancer centers throughout Russia.
Elekta has won seven out of ten tenders being part of the new Russian National Oncology Program. The program was initiated under the auspices of Prime Minister Vladimir Putin in early 2009 with the aim to improve prevention and early detection of cancer.
Currently, patients in Russia are diagnosed with cancer mostly at stages III and IV, negatively affecting the survival rate and with expensive medical and drug treatment required. The program is considered an important step by the Russian Government to increase the life span for the Russian people.
Tatyana Golikova
“By 2012, the situation must be changed so that identification and treatment of cancer patients will already happen at stages I and II of the disease”, said the Russian Minister of Health, Tatiana Golikova at the presentation of the program.
As part of the program, Elekta will deliver four Elekta Synergy®, two Precise Treatment System™ and one Elekta Axesse™ to hospitals and cancer centers throughout the country. Engineers and medical physicists from Elekta and its Russian distributor MSM-Medimpex will provide training for all medical staff as well as services.
In addition, two other key centers in Russia recently purchased two Elekta Axesse™ for their stereotactic program.
“We are proud to be a part of the expansion of cancer care in Russia, and in making the latest clinical treatment solutions available to more patients throughout the country”, says Olof Sandén, Executive Vice President for Elekta Europe, Africa, Latin America and Middle East.
Elekta is continuing to execute on its plan for geographical expansion in key emerging markets, where Russia is one of several geographical areas with a large unmet need for cancer care.
”We have created a new structure and strategies supporting our focus on emerging markets where a large number of patients can benefit from life-saving technologies at an affordable cost per patient”, says Mr. Sandén.
Dr. Omar Salazar @ Oakwood Hospital & Medical Center talks about the Elekta Synergy and SBRT.
- Elekta Synergy
Knapp ein Jahre ist es her, dass Klinikum-Geschäftsführer Johannes Weindel den Spaten tief in den Boden des neu zu errichtenden Strahlentherapiezentrums gesteckt hat. Gestern lieferte eine Spezialfirma das 1,8 Millionen teure Herzstück der Anlage: den Linearbeschleuniger, derzeit weltweit der modernste.
Nachdem Ende 2008 der Spatenstich für die neue Strahlentherapiepraxis am Klinikum Friedrichshafen erfolgt war, erwarteten Dr. Mari Björnsgard und Dr. Ursula Reichmann sowie die beiden Medizinphysiker Marlies Pasler und Michael Bay mit Spannung die Anlieferung des eigentlichen Stars der neuen Einrichtung: den rund 1,8 Millionen Euro teuren Linearbeschleuniger der schwedischen Firma Elekta. Bereits im September soll die moderne Praxis, in der täglich bis zu 70 Patienten behandelt werden können, die Pforten öffnen. Neben den beiden Leiterinnen, Dr. Mari Björnsgard und Dr. Ursula Reichmann, werden voraussichtlich sieben weitere Mitarbeiter ihre Arbeit dort aufnehmen.
Mit Unterstützung der Friedrichshafener Volksbank finanziert die Klinikum Friedrichshafen GmbH den zwei Millionen Euro teuren Bau und vermietet diesen an die Betreiber. Die hochkomplexe Anlage ist nach den Aussagen von Medizinphysiker Michael Bay und Marlis Pasler etwas Besonderes: Eine 2,8 Meter dicke Betondecke und eine 20 Tonnen schwere Strahlenschutztür ist eingebaut worden, um die Strahlung außerhalb des Behandlungsraums abzuschirmen. “Bei dem Linearbeschleuniger handelt es sich um elektrisch erzeugte Strahlung, ähnlich einer Röntgenröhre, jedoch mit einer vielfach höheren Leistung”, erklärt Michael Bay.
Dr. Ursula Reischmann erklärte, dass die neu eingetroffene Hochleistungsapparatur mit drei Energiestufen arbeitet und zusätzlich Elektronen (Teilchenstrahlen) mit unterschiedlichen Energien hat. Das Gerät ermögliche es, neben der intensitätsmodulierten Strahlentherapie eine neu entwickelte Rotationsbestrahlung vorzunehmen, die zu einer erheblich effektiveren und schonenderen Therapie führt.
“Für die Menschen ist es wichtig, eine solche Strahlenpraxis in ihrer Nähe zu haben. Immerhin müssen die Patienten drei bis fünf Mal pro Woche über eine Dauer von bis zu acht Wochen eine Behandlung für je zehn Minuten über sich ergehen lassen. Dass ist viel Stress für den Körper und die Psyche, der durch lange Auto- oder Zugfahrten unnötig forciert wird”, führte Dr. Mari Björnsgard aus, die künftig zusammen mit ihrer Kollegin Ursula Reichmann täglich bis zu 60 Patienten aufnehmen kann.
Translation: English
- SRT for a solitary relapse lung cancer with on-line correction using Elekta Synergy®
INSTITUTION: Instituto Oncológico, Consorcio Hospitalario Provincial de Castellón
PATIENT: 52-year-old male
DIAGNOSIS: T3 N0 M0 NSCLC (epidermoid) in left lung
PLAN: 6 field non-coplanar
IMAGE GUIDANCE: Elekta VolumeViewTM
TREATMENT:48Gy in 8 fractions over three weeks
SRT for a solitary relapse lung cancer with on-line correction using Elekta Synergy®
Consorcio Hospitalario Provincial de Castellón
Authors
Radiation Oncologist: Carlos Ferrer, Angel L. Sanchez
Physicist: Agustin Santos
Nurses-Technicians: Marisa Miró, Mercedes Broseta, Laia Arzo, Raquel Suarez
Patient history and diagnosis
A 52-year-old man was diagnosed in 2001 with a T3 N0 M0 NSCLC (epidermoid) in left lung. This was primarily treated with induction chemotherapy (CDDP-Taxotere) 3 cycles, followed by pneumonectomy and mediastinal lymphadenectomy. The pathology suggested a 4cm epidermoid carcinoma with 22 lymph nodes negative.
The patient was followed-up in November 2007 and was found to have haemoptysis. A CT scan showed a solitary 2.5cm nodule in the right hilum. Fibrobronchoscopy detected infiltration of the epidermoid carcinoma. A PET/CT showed a mass of 2.6cm with a SUV of 25. Following evaluation the patient was re-staged and no other relapse sites were detected. Respiratory function was: FEV-1: 1,76 l, with VC 57%.
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Parietal Meningioma
Patient history and diagnosis
A 51 year-old male presented with enlarging lump on the top of his head, a short history of increasing headaches and some numbness affecting his left limbs. He also had bilateral blurring of the optic disc but no long tract deficits. A CT scan showed a large right parietal parafalcine mass and MR angiogram confirmed obstruction of the anterior and middle parts of the superior sagittal sinus. The tumor was removed leaving a large skull defect which was later closed with a titanium cranioplasty in November 2001. Histology showed an atypical meningioma with numerous mitosis. The patient had a recurrence of this tumor in December 2002 which was eventually resected again in May 2004. Further surgery was required in November 2004 for a recurrence posteriorly, after which the patient was referred for post-operative radiation therapy in view of his rapid recurrence.
Planned treatment
The patient was treated using HeadFIX® stereotactic head frame to accurately reproduce the daily treatment position. A three-field treatment technique was used comprising right and left lateral and a superior oblique treatment field, all with MLC beam shaping and wedges. The treatment was planned at 6MV using the Philips Pinnacle® planning system to deliver a total tumor dose to the isocenter of 50cGy in 25 fractions, with great care being taken to avoid any unnecessary dose to the eyes, optic nerves and brainstem.
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RTP and VolumeView Images
Read more about Elekta Synergy here
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Institution: The Christie Hospital NHS Trust, Manchester, UK – Wade Centre for Radiotherapy Research
Patient: Female, 37 years
Diagnosis: Left atrium myxoid sarcoma
Plan: Five-field IMRT
Image guidance: Elekta VolumeViewTM on-line correction
Positioning: In-house immobilization
Treatment: 60Gy in 33 fractions , V20 <25%, Spinal cord dose <45Gy
Patient history and diagnosis
A 37 year-old female developed right-sided chest pain which rapidly worsened and lead to the patient’s collapse. A cardio echo scan revealed cardiomegaly with a filling defect in the left atrium extending through to the left ventricle. The patient went on to have open-heart surgery, where a tumor arising in atrial septum was discovered measuring 6cm x 3cm. Histology revealed the tumor to be a pleomorphic high-grade myxoid sarcoma. The initial concern was to gain local control of the disease, and taking into consideration the patient’s age and otherwise excellent physical health, a course of radiation therapy was planned. The intention was to deliver a reasonable dose of radiation to a limited volume of the heart.
Planned Treatment
The clinical target volume (CTV) was identified as the left atrium, and a margin of 2cm was applied in all directions to generate the planning target volume (PTV). The dose limiting regions were the left ventricle and lung. A total dose of 60Gy in 33 fractions was prescribed. The V20 (volume of lung receiving >20Gy) was kept below 25%. The ventricle dose was kept as low as was reasonably practical and the dose to the spinal cord was maintained <45Gy. Due to the high degree of dose conformity required to avoid critical structures while delivering the planned dose, a standard conformal plan was not suitable (an initial standard conformal plan produced a V20> 25% and resulted in a high dose to the ventricles) and a five-field intensity modulated radiation therapy (IMRT) plan had to be employed. Mega-voltage imaging was deemed as unsuitable for verification purposes due to the location of the target volume and Elekta VolumeViewTM 3D imaging was requested as an alternative.
VolumeView™ transverse plane reconstruction
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Radiotherapy, the treatment of cancer with radiation, is a very important element of curative treatment for cancer, and is also important for maintaining and/or improving patients’ quality of life. It is anticipated that it will retain a key role in cancer treatment for the next 10-20 years and will continue to make a significant contribution to improved treatment and palliative outcomes.
Radiotherapy owes its pre-eminent position in the treatment of cancer to its ability to deliver, with precision, a lethal radiation dose to each cancer cell situated within a chosen area of the body. The main aim of treatment is to give a sufficient radiation dose to the tumor to cause destruction without producing unacceptable damage to surrounding normal tissue. The higher the differential between the dose to the tumor and that received by the normal tissue, the better the chance of a cure. This high differential hinges on the precision with which the size and position of the tumor can be ascertained and, equally importantly, on the accuracy with which the required dose of radiation can be delivered to the chosen site. Radiation can be delivered in a variety of ways, depending on the nature of the cancer. The most commonly used method is called external beam therapy, which directs high energy X-ray radiation at the tumor. Although the radiation affects both cancer and normal cells, because of the nature of the cancer cells it has a greater effect on them. Treatment aimed at cure will give the highest possible dose of radiation, within safe limits, to attempt to kill all the cancer cells. Sometimes smaller doses are used, where the aim is to reduce the size of a tumor and/or relieve symptoms. Radiotherapy treatment is given using either a machine called a linear accelerator or, for some skin tumors, a superficial X-ray unit. To receive the radiotherapy, the patient lies on a couch under the machine, and is asked to remain still during the actual treatment. Every course of radiotherapy treatment is designed to suit the particular needs of the person receiving it, so prior to treatment the patient will make a preliminary visit to the hospital for the course of treatment planned. A typical treatment will last six weeks, with the patient visiting the hospital every day.
The Elekta Synergy with VMAT Animation
Re-treatment of a recurrent brain tumor using Elekta Synergy® S
Institution: Temple University Hospital, Philadelphia, USA
Patient: 63-year-old male
Diagnosis: NSCLC
Plan: Nine-field IMRT/SRT
Image guidance: VolumeView™ on-line
Treatment: Target – 1200cGy – single fraction
Patient diagnosis and history
A 63-year-old man with a six-month history of weight loss underwent a chest X-ray which revealed a right upper lobe mass. The patient later had a generalized seizure and was admitted to a local hospital, after which he had an MRI scan which revealed three metastatic lesions.
A CT scan of the chest revealed a 9cm right upper lobe mass with hilar and mediastinal lymphadenopathy. The patient had a fine needle aspirate biopsy of the right upper lobe mass that was compatible with non-small cell carcinoma of the lung (NSCCL). A bone scan revealed increased activity in the T6 vertebral body and the right intertrochanteric area of the right femur.
Previous radiation therapy
The patient had previously received whole brain irradiation, a total dose of 3500cGy was delivered in 14 fractions through parallel-opposed lateral fields.
Treatment
A step-and-shoot IMRT/stereotactic radiation therapy (SRT) plan (figure 1) for simultaneous treatment of multiple brain metastases (two cerebellar and a right temporal). Treatment planning was carried out using Philips Pinnacle®3 IMRT/SRT techniques. The patient was immobilized in a reinforced AcQuaPlast head mask. No sedation was employed.
Read more of the Re-treatment of a recurrent brain tumor using Elekta Synergy® S
Institution: Universitätsklinikum Würzburg, Germany
Treatment planning system: ADAC Pinnacle V7.6
Positioning: Stryker® Leibinger STX frame
Record-and-verify: Nucletron Oncentra™ 2.1 SP1
Image guidance: VolumeView™ and HexaPOD™
Treatment system: Elekta Synergy® S
Medical Physicist: Dr. Jürgen Meyer
“The combination of Elekta Synergy® S and the HexaPOD™ robotic treatment couch enables more precise treatment of tumors due to better control and increased awareness of the accuracy of the treatment. With Beam Modulator™ a high degree of conformity can be achieved even for intracranial stereotactic treatments”.
Read more on Cranial Stereotactic Radiation Therapy
Cranial Stereotactic Radiation Therapy
- Largest Neurosurgical Center in Russia Acquires Elekta’s Leksell Gamma Knife Perfexion February 6, 2012Russia’s first Leksell Gamma Knife® Perfexion™ system has found a home at the renowned N.N. Burdenko Neurosurgical Institute, just a five-minute car ride from Moscow’s Red Square. On June 2, 2011, a 59-year-old woman was the first Perfexion patient, receiving Gamma Knife® radiosurgery to treat tumor tissue that remained following open surgery. Now, eight mon […]
- Largest Neurosurgical Center in Russia Acquires Elekta’s Leksell Gamma Knife Perfexion February 6, 2012N.N. Burdenko Neurosurgical Institute improves treatment of patients with multiple metastasesRead more... […]
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