With HyperArc, which Varian Medical Systems tested and partly developed in collaboration with UAB, clinicians can deliver more compact radiation doses that closely conform to the size, shape and location of brain cancer tumors while sparing more surrounding healthy tissue.
About 20-40 percent of cancer patients will develop brain metastases. More than half of them will have more than one tumor in the brain. The risk of a metastatic brain tumor depends on the kind of cancer and how advanced it is when it is diagnosed. Typically, an increasing number of patients return for retreatment of their disease.“ HyperArc allows us to plan and deliver state-of-the-art radiosurgery to highly complex cases efficiently with a very high degree of dose compactness and conformity, and has made it possible to treat patients with larger numbers of brain metastases very aggressively,” says John Fiveash, M. D., professor and vice chair for academic programs in the UAB Department of Radiation Oncology. He is also a senior scientist at the UAB Comprehensive Cancer Center.
“ Initially five radiosurgery patients were treated with HyperArc therapy that first day,” Dr. Fiveash says.“ Most of these patients had multiple brain metastases. We were impressed with the quality and efficiency of the plan creation and treatment delivery. Patients are excited to be treated in a normal time slot of 15-20 minutes without the requirement of an invasive stereotactic head frame.”
HyperArc contains a prescriptive workflow that includes simulation guidelines, patient immobilization, treatment planning, patient setup, imaging and pre-determined delivery sequence.
“ HyperArc allows us to irradiate multiple tumors at the same time without repositioning the patient, which provides better management of patient movement while saving time for the patient and the clinical team,” Dr. Fiveash says.“ Basically, HyperArc is designed to enable consistent, high-quality planning and seamless one-click delivery,” says Richard Popple, Ph. D., professor and assistant vice chair for Physics in the UAB Department of Radiation Oncology. He is also an expert in novel treatment planning techniques and clinical implementation of new technologies and a senior scientist at the UAB Comprehensive Cancer Center.
HyperArc addresses concerns about complexity, patient safety, cost and human resources that can make radiosurgery inaccessible for many patients and unfeasible for many institutions.
“ Working closely with leading institutions like UAB played an important role in the development of HyperArc,” says Kolleen Kennedy, president of Varian’ s Oncology Systems business.“ We value their continued contributions to the advancement of cancer care, and we are excited that HyperArc treatments have now begun in the U. S.”
Planning Through the Workflow
For the past several years, UAB has been working with Varian to bring HyperArc technology to fruition. UAB has been involved with four other institutions in developing optimization tools to enhance the dose and treatment delivery. They developed dedicated algorithms to ensure efficient workflow, and new ways of looking at multiple targets simultaneously, all while reducing the complexity of the planning process for clinicians. In addition, UAB helped devise metrics to use for single and multiple targets that can be customized.
Maximizing Cost and Efficacy
“ We are able to help more patients without the need to invest in additional or new equipment,” Dr. Popple says. HyperArc capitalizes on the unique capabilities of Varian’ s TrueBeam™ and EDGE™ treatment systems, which UAB already uses.
“ HyperArc allows us to irradiate multiple tumors at the same time without repositioning the patient, which provides better management of patient movement while saving time for the patient and the clinical team.”
John Fiveash, M. D., professor and vice chair for academic programs in the UAB Department of Radiation Oncology
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