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Treatments & Technology
Radiation therapy is often recommended after surgery to increase the effectiveness of treatment. Chemotherapy and radiotherapy are often given after surgery to increase the likelihood of a cure. At NMMC, physicians, including surgeons, medical oncologists and radiation oncologists, work together to develop the best course of treatment for each patient.
Radiation oncologists use high-energy radiation to destroy cancer cells. External beam radiation therapy uses radiation delivered from outside the body that is focused on the cancer. Patients do not actually feel radiation treatments.
NMMC on the Forefront of Cancer Treatment with TrueBeam
In a promising development for cancer patients in north Mississippi, North Mississippi Medical Center Cancer Care recently acquired the TrueBeam system, an innovative system that enables a radically different approach to treating cancer with image-guided radiotherapy.
The TrueBeam system from Varian Medical Systems was engineered from the ground up to deliver more powerful cancer treatments with pinpoint accuracy and precision. It integrates new imaging and motion management technologies with a sophisticated new architecture that makes it possible to deliver treatments more quickly while monitoring and compensating for tumor motion.
“TrueBeam is a real game-changer that will enable us to treat even the most challenging cases with unprecedented speed and precision,” said radiation oncologist Ray Reed, M.D. “With a broad spectrum of new capabilities, TrueBeam makes it possible for us to offer faster, more targeted treatments to tumors even as they move and change over time.
With dose delivery rates that are 40-140 percent higher than earlier generations of Varian technology, the TrueBeam system can complete a treatment commensurately faster. This makes it possible to offer greater patient comfort by shortening treatments, and to improve precision by leaving less time for tumor motion during dose delivery. “Intelligent” automation further speeds treatments with an up to fivefold reduction in the number of steps needed for image guidance and dose delivery.
Simple treatments that once took 15 minutes or more can be completed in less than two once the patient is in position. “These are significant reductions in treatment time,” said Dr. Reed. “Patients will spend a whole lot less time lying still, immobilized on a hard surface.”
The precision of the TrueBeam system is measured in increments of less than a millimeter. This accuracy is made possible by the system’s sophisticated architecture, which synchronizes imaging, patient positioning, motion management, beam shaping and dose delivery, performing accuracy checks every ten milliseconds throughout the treatment. Critical data points are measured, ensuring the system maintains a focal point of treatment.
For lung and other tumors subject to motion when the patient breathes, TrueBeam offers gated RapidArc radiotherapy, which makes it possible to monitor and compensate for breathing while quickly delivering treatment.
“During the last decade, lung cancer became the leading cause of cancer death for men and women in the United States,” Dr. Reed said. “With TrueBeam, we can treat a moving lung tumor as if it were standing still. We expect this to make a meaningful difference for lung cancer patients.”
TrueBeam imaging technology can produce the three-dimensional images used to fine-tune tumor targeting in 60 percent less time with 25 percent less X-ray dose.
NMMC was the first in Mississippi to offer treatment using RapidArc™ radiotherapy technology from Varian Medical Systems. RapidArc is a fast, precise form of treatment that is delivered eight times faster than is possible with conventional radiation therapy technologies. By delivering radiation doses more quickly and with great accuracy, NMMC clinicians can simultaneously improve the quality of care while making patients more comfortable.
RapidArc makes it possible to deliver highly-precise intensity-modulated radiotherapy treatments quickly. These treatments target tumors accurately while sparing the surrounding healthy tissues.
RapidArc is an image-guided IMRT treatment that takes about 90 seconds to deliver once a patient has been positioned for treatment. This is markedly faster than other forms of treatment, which sometimes take up to 20 minutes or longer per session. During a RapidArc treatment session, which is completed with one or multiple rotations of the treatment machine around the patient, the radiation beam is continually shaped and reshaped according to the size, shape and position of the tumor in the body. As a result, the delivery of radiation is many times faster than with conventional treatment technologies.
Because the treatment is fast, it is also easier on the patient. Patients who had difficulty holding still for long periods of time are now able to receive their treatment in less time, allowing us to improve quality of care while making patients more comfortable.
Image-Guided Radiotherapy (IGRT)
Physicians at NMMC use image-guided radiotherapy (IGRT) treatment for cancer patients that offers advanced imaging to more precisely locate tumors at the moment of treatment.
This technology from Varian Medical Systems combines imaging and treatment on one machine, providing fast and accurate adaptive radiotherapy treatments that deliver high doses of radiation directly to cancer cells while minimizing the dose to surrounding healthy tissues. Radiation oncologists have previously had to deal with variations in patient position and target motion by including a margin of healthy tissue around the tumor to account for variation in daily positioning.
Intensity Modulated Radiation Therapy (IMRT)
This radiotherapy system, which includes two linear accelerators, is capable of delivering IMRT (Intensity Modulated Radiation Therapy).
NMMC’s clinicians use the SmartBeam® IMRT system from Varian Medical System to treat patients with certain types of cancer with precisely placed beams that can be focused to carefully target tumor cells.
The enhanced doses increase the likelihood that a tumor will be completely eradicated. Also, the technology enables clinicians to use radiation to treat areas that would have been considered too risky just a few years ago.
Each of the linear accelerators stand approximately nine feet tall by nearly 15 feet long and weighs about 18,700 pounds. The units generate high energy X-rays by using microwave energy to accelerate electrons to nearly the speed of light. As the electrons reach maximum speed, they collide with a metal target to release photons (or X-rays). The accelerator rotates around the patient to deliver the radiation treatments from nearly any angle. The equipment is housed in treatment rooms with lead-lined walls.
An important component of the linear accelerator is the multi-leaf collimator. The device’s 120 computer-controlled mechanical “leaves” or “fingers” are used to shape the beam of radiation so that it conforms to the three-dimensional shape of the tumor.
The technology compliments NMMC’s 3-D computer software that clinicians use to plan, simulate and deliver IMRT and other kinds of ultra-precise cancer care.
On average, radiation therapy treatment regimes average five days per week for approximately four to six weeks. Once the patient is on the treatment table, a treatment typically takes about five to 10 minutes.
Stereotactic Body Radiation Therapy (SBRT)
Stereotactic Body Radiation Therapy (SBRT) is a radiation treatment technique in which high dose radiation can be delivered to a precise target area in a few treatments, usually up to 5.
The SBRT technique requires minimal motion to the target area and precise radiation beam placement. This is accomplished through careful immobilization techniques, complex planning, and a well-communicated team approach. The physician recommends this technique based on tumor size and location; and patient’s ability to tolerate treatment.
At NMMC, a Varian Medical Systems Truebeam® linear accelerator is used to deliver SBRT. The Truebeam® allows for faster treatment times while still providing the accuracy of image-guided radiotherapy.