by Lauren Dubinsky
, Senior Reporter | October 05, 2015
From the October 2015 issue of HealthCare Business News magazine
A significant volume of data has emerged about the effectiveness of SBRT and SRS, and more surgeons are being exposed to it in their training programs. It is now entrenched in educational programs at the majority of neurosurgery departments. The fields of surgery and radiation oncology are starting to merge, and cancer treatment is becoming a multi-disciplinary team approach, says Ma. He estimates that 70 percent of the time neurosurgeons are performing surgery in the operating room and 30 percent of the time they’re performing SBRT or SRS.
Major workflow improvements
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In the past, when a patient came to the radiation oncology department with a tumor, the surgeon would carefully determine how and where to treat them. A dosimetry team would design a plan to make sure the right dose was administered and then quality assurance would be performed after the procedure to make sure everything was done safely.
“Workflow has improved night and day over the years,” says Ma. “The SBRT and SRS workflow is totally different from traditional radiation oncology workflow — the patient comes in and you do it quickly. It’s more like a surgical workflow.” In August, Elekta received 510(k) approval from the FDA for its new Gamma Knife system, Icon. Ma believes that the Icon is a paradigm shift and is going to change the way large tumors are treated.
Gamma Knife systems traditionally have head frames, which attach to the patient’s head with four small screws and ensure that the radiation beams are precisely targeted. But the Icon system is frameless and uses a cone-beam CT (CBCT) workflow that allows the physicians to check the patient’s position against planning images.
During the treatment, patient motion is managed with a motion management system that tracks the patient’s head position. If the patient coughs or moves their head, the system will automatically stop delivering radiation. Other technologies on the market can also account for patient movement. Vision RT’s AlignRT can be used along with the TrueBeam system to customize how much the patient can move before the radiation beam stops, in order to avoid affecting healthy tissue.
Accuray’s CyberKnife M6 Series features its new InCise Multileaf Collimator (MLC) that works by precisely sculpting dose to spare healthy tissue, even for targets that move during respiration. “By minimizing dose to the normal and healthy tissue, side effects are minimized and patients benefit in their quality of life as they go through cancer treatment,” says Kelly Londy
, executive vice president and chief commercial officer of Accuray. The Icon is also optimized to perform microradiosurgery.