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IMRT Radiotherapy Treatment Used for Base of Tongue Tumor

By MedImaging International staff writers
Posted on 06 May 2010
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One of the first hospitals in England to introduce intensity-modulated radiotherapy (IMRT) treatments has now carried out its first procedure on a 66-year-old male tongue cancer patient from Suffolk, delivering the treatment many times faster than would have been possible using traditional treatments.

Ipswich Hospital carried out the pioneering treatment. "The procedure went extremely well and the patient has commented on the speed of delivery compared to the IMRT plan he started his treatment with,” said Ros Perry, senior on-treatment radiographer at Ipswich Hospital. "He certainly noticed how much less time he needed to lie on the couch.”

Instead of the nine-field IMRT procedure originally delivered, the patient received the RapidArc image-radiotherapy treatment, developed by Varian Medical Systems, Inc. (Palo Alto, CA, USA), in two rotations of the treatment machine, taking only over two minutes. Previous treatments had taken four times as long.

"RapidArc will hugely improve the treatment experience for head and neck cancer patients because of this significant reduction in delivery time,” added Hayley James, operational head of radiotherapy physics. "The other major advantage is the reduction in delivered monitor units which leads to a reduction in whole body effective dose to the patient.”

RapidArc delivers a volumetric intensity-modulated radiation therapy treatment in a single or multiple arcs of the treatment machine around the patient and makes it possible to deliver advanced image-guided IMRT two to eight times faster than is possible with conventional IMRT. As well as making treatment a more comfortable experience for patients, faster delivery reduces the chance and extent of patient motion during treatment and enables more precise dose distribution while helping to protect nearby healthy tissue and critical organs. Since its introduction, Varian has installed more than 340 RapidArc systems in cancer centers globally.

Ipswich Hospital began pioneering work in delivering Varian's IMRT for patients in 2001 and now uses it routinely for all large volume head and neck cancer cases, thereby optimizing the delivery of the radiation to the tumor and limiting the exposure of surrounding healthy tissue. RapidArc takes IMRT to the next level by delivering such treatments continuously instead of the "step and shoot” approach of fixed beam treatments.

"We are a busy hospital and we are under constant strain to deliver advanced IMRT treatments within our standard treatments slots,” stated Andy Poynter, head of radiotherapy physics at Ipswich Hospital. "With RapidArc, that will no longer be a problem as we will be able to offer advanced treatments to more patients.” The hospital intends to begin treating all head and neck cancer patients with RapidArc IMRT and then expand it to include prostate and pelvic node treatments.

"Ipswich Hospital was one of the U.K. pioneers when they introduced high resolution sliding window IMRT into routine clinical use with a completely integrated Varian solution in 2001,” said David Scott, Varian's U.K. sales director. "It's excellent to see the same dedicated team repeating this with RapidArc and ensuring that Ipswich Hospital continues to be at the forefront of advanced radiotherapy delivery.”

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