Advances in radiation therapy offer more effective cancer treatment
Since its inception at the start of the 20th century, radiation therapy has evolved to become one of the most common — and potent— forms of treatment for all types of cancer, with approximately 67 percent of patients receiving it — either alone or in combination with other treatments. Dr. Henry J. Lee, MD, PhD, Director of the Department of Radiation Oncology at NewYork-Presbyterian Lawrence Hospital in Bronxville and an Assistant Professor of Radiation Oncology at Columbia University Medical Center, discusses radiation therapy and the latest advances, which have raised the bar for more successful patient outcomes.
Q: What is radiation therapy?
A: Radiation therapy, or radiotherapy, is the use of various forms of radiant waves of energy to safely and effectively treat cancer and other diseases. It can be used to cure cancer, control its growth or relieve painful symptoms. Radiation therapy works by damaging cells; normal cells are able to repair themselves, whereas cancer cells cannot.
Q: How is it different from other forms of cancer treatment?
A: Radiation therapy complements the other major forms of cancer therapy — such as chemotherapy and surgery. It is similar to surgery, since both target the tumor, but radiation therapy does not require an incision, operation, or anesthesia. It’s also similar to drug therapy in that it usually requires multiple sessions as an outpatient. The difference is that radiation therapy does not travel throughout the body.
Q: When is radiation therapy used?
A: Most times, it is given with a curative intent, such as eliminating the tumor or preventing recurrence, or to reduce the suffering caused by the cancer symptoms.
Q: What are some of the latest advances in radiation therapy?
A: Technology has greatly improved over the last few years, making the dosage and delivery of radiation much more precise. New techniques also allow doctors to better target the radiation to protect healthy cells. This has given radiation an even bigger role in cancer care. Patients are often surprised with the ease of the radiation therapy experience. In the current era of ‘personalized’ or ‘precision’ medicine, radiation therapy technology is moving beyond simply treating the tumor and toward developing novel ways to harness the cancer-killing powers of an individual’s body. Radiation therapy is an extremely potent enhancer of the body’s immune response toward killing cancer cells. When used in tandem with other therapies that also enhance the immune response, these new combinations of therapies can dramatically shrink some cancers that were not responsive to older therapies.
Q: Are there different types of radiation therapy?
A: There are different types that work in different ways, but by far the most common form, used for 90 percent of cancer patients, is LINAC (linear accelerator-based) radiation therapy. This works by customizing high energy x-rays to conform to a tumor’s shape and destroy cancer cells while sparing surrounding normal tissue. During a typical 30-minute visit, the experience is similar to getting a CT scan. The patient lies on a table, and the staff prepares them for treatment (no IVs are required). The LINAC silently delivers the treatment, typically over two-to-three minutes. Afterward, the patient leaves feeling much the same as they did when they arrived.
Q: What do you think the future of radiation therapy will hold for patients?
A: Each day, research is finding better, more effective ways to identify biomarkers and gene signatures to develop treatment strategies tailored to the individual patient. The challenge ahead is to make such responses cure more cancers — and through continued research and technological advancements, we’re already seeing results as we combine radiation therapy with the new immunotherapies. After all, radiation therapy is one of the most potent agents known to stimulate the immune system, and thus help the body heal itself from cancer.
State-of-the-art treatments at the Cancer Center at NewYork-Presbyterian Lawrence
The Cancer Center is an academic-community partner with the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia University Medical Center, one of only three National Cancer Institute Designated Comprehensive Cancer Centers in New York State. This identifies centers where the highest quality of treatment, innovative research, and resources for cancer care are available. The multidisciplinary cancer team is located on-site, with a complete array of services including radiation, medical and surgical oncology, as well as supportive oncology services that address the needs of patients from cancer screening, diagnosis and into survivorship.
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Finding Linear Accelerator Replacement Parts
Whether you have a Varian, Elekta, Philips, Siemens LINAC, you can always find replacement parts, accessories and various linear accelerator components that met OEM specification to get your radiation device working like new.
A linear accelerator is a medical device used for external beam radiation treatments for patients with cancer through a uniform dose of high-speed electrons and high-energy x-rays that are directed to the affected area of the patients’ tumor to destroy the cancer cells without damaging any healthy tissue.
Importance Of Safety
Patient safety, in this case, is very important and the last thing a radiation oncologist needs is a system malfunction or downtime that will impede a treatment session or cause an overdose of the prescribed treatment volume and dosage.
While modern radiation machines have inbuilt checking systems to provide additional safety and there are measures in place to ensure that the linear accelerator is on point and won’t deliver a higher dose than the radiation oncologist prescribed before the start of every treatment session, through no fault of the radiation oncologist, mechanical mishaps do occur.
Services Offered
Along with the aftercare services, upgrades, and repair parts required to keep a linear accelerator working in top condition, professional LINAC engineers offers the most cost-efficient radiation oncology equipment solutions. They include delivery, installation, acceptance testing, commissioning services, warranty, continuing service, and most importantly, linear accelerator components and accessories that are available in stock for immediate delivery.
In addition to equipment testing, quality assurance assistance and data collection, linear accelerator service providers also offer the following services and linear accelerator components:
- Inspection of equipment to recommend a suitable level of refurbishment options (cosmetic, minor or major)
- In-house refurbishing and live testing
- MLC and table upgrades
- Conventional and CT simulator installations
- Shielded testing vault
- Vault construction and project management
- Patient positioning laser devices
- Water chillers
- Power conditioners
- Air compressors
- Equipment rigging
- Equipment transport and storage
- Specific patient couch
- Spare parts kit
- A set of operational and technical manuals
- Dual Independent Jaws
- IEC Scale Readouts and much more
- Latch accessory mounts
Disposal of Equipment
Oncology clinics can now benefit from replacement parts for some of the top linear accelerator brand names, and the best part of this whole process is that when the life of a linear accelerator comes to an end, there are disposal services that conform to regulatory requirements. The equipment is professionally removed from the clinic using specialized cranes without damaging its structural integrity. The removal specialists ensure that any disposal of radioactive and hazardous materials from the LINAC is carried out through a licensed disposal company.
Upon request, an oncologist can receive an equipment evaluation and appraisal in the event they want to sell their LINAC or replace it with a newer model. Whatever your radiology need is, they can be met in a timely, professional manner at a competitive fee. Do you need any linear accelerator components, replacement parts, accessories, and repair solutions?
Learn more about Radparts and the variety of services and parts they offer to repair medical equipment including: linear accelerators parts, CT scanners parts, linac parts, and radiation oncology equipment at www.radparts.com. To contact one of our medical equipment repair specialists for parts or service call toll free 877.704.3838 for 24/7/365 support.
Refurbished Parts are Important in Linear Accelerator Repair
Medical Equipment and Replacement Parts
Linear accelerators are machines that help in the treatment of cancer. These machines have a multitude of components that keep them running efficiently. Sometimes, large pieces of equipment including those found within the radiation oncology department need maintenance involving replacement parts. There are companies devoted to selling, service, and repair new and refurbished LINAK systems and their replacement parts.
Medical facilities can seek out the help of distributors of both OEM and refurbished replacement parts for a variety of manufacturers that produce radiation oncology equipment. No matter what is needed for your radiation equipment facilities have access to them. One of the main purposes of using refurbished replacement parts over OEM parts is that they offer amazing quality and allow medical facilities to accomplish repairs and service at a lower cost.
Radiation Oncology Equipment Repair and Maintenance
For many medical facilities the decision between purchasing new or refurbished parts for maintenance and repairs on large scaled equipment has been met with some indecisiveness. This should however no longer be the case. Linear accelerator parts and components are met with stringent guidelines throughout the reconditioning process. Refurbished linear accelerator and CT scanner parts are suited for both maintenance and repair purposes.
Another major benefit outside of the stringent testing that is done on refurbished linear accelerator parts is the cost savings that facilities will find by purchasing them. When it comes to the cost of refurbished components verse OEM parts, facilities should expect to pay upwards of fifty percent less for reconditioned parts. Just as refurbished linear accelerators are best for new medical companies or facilities working within a strict budget, so are the refurbished parts and components. This can be super beneficial in low budget, non-profit, and veteran facilities.
Refurbished equipment and replacement parts are important because of the certain advantages which only they can offer. There are many reasons that facilities use refurbished parts in the equipment they use. One of the major reasons is that it helps growing practices. LINAC systems that are refurbished free up resources and reduce costs. This is helpful in new center set ups, purchasing additional or backup equipment, and installing new treatment rooms to accommodate more patients for treatment.
Managing Costs
Refurbished components are important in managing expenses. Linear accelerator replacement parts that have been refurbished can help in managing the investment risk of new equipment which can be quite costly. Thus, in times of financial constraint and tight budgets, refurbished equipment and parts can help you save money while growing your facility. Refurbished equipment can also serve as backup equipment for larger facilities giving another option over rescheduling patients when equipment needs to be repaired.
Learn more about Radparts and the variety of services and parts they offer to repair medical equipment including: linear accelerators parts, CT scanners parts, linac parts, and radiation oncology equipment at http://radparts.com/parts.php. To contact one of our medical equipment repair specialists for parts or service call toll free 877.704.3838 for 24/7/365 support.
Important step towards MR Linac radiotherapy for lung cancer
Ross Lydall, Health Editor of the London Evening Standard (pictured above), becoming the first healthy volunteer to be scanned by the MR Linac.
Researchers working with the MR Linac – a pioneering radiotherapy machine – have successfully developed treatment plans for patients with an advanced form of lung cancer.
The plans suggest that treating patients with locally advanced non-small cell lung cancer using the MR Linac system would be at least as effective as using conventional linac radiotherapy.
The study represents a key step towards bringing MR Linac radiotherapy to these patients in the clinic.
How it works
MR Linac systems use magnetic resonance imaging (MRI) to tailor the shape of the radiotherapy beam in real time, and can accurately deliver doses of radiation even to moving tumours.
However, the addition of the magnetic field can affect the way the beam works, so traditional treatment plans – which detail the areas to be targeted by the beam – need to be adapted accordingly.
Using patient MRIs and computer modelling, the researchers found that in every case it was possible to design an MR Linac treatment plan that gave an adequate dose of radiation to the tumour tissue, while avoiding giving too much to the surrounding organs.
The research was supported by Cancer Research UK and NHS funding to the NIHR Biomedical Research Centre at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust.
Research at the ICR is underpinned by generous contributions from our supporters. Find out more about how you can contribute to our mission to make the discoveries to defeat cancer.
Accurate targeting
Writing in the journal Radiotherapy and Oncology, the researchers from the ICR and The Royal Marsden explained how they prepared the treatment plans.
By analysing MRI scans of 10 patients currently undergoing radiotherapy on conventional linac systems – which deliver pre-planned shapes and volumes of X-rays to areas of the body – the researchers first calculated the volume of the tumours, and included a margin for where the disease may have spread at the microscopic level.
The researchers then added a further margin to allow for patient movement during treatment, simulated for treatment with both linac and MR Linac systems. In standard treatment planning, this margin is usually 7 millimetres.
For the conventional radiotherapy calculation, they used a 7mm plan, but for the MR Linac, they created two plans – one with 7 mm margins and another with estimated 3 mm margins – to allow for the system’s ability to adapt to movement in real time.
For each of the three scenarios, the researchers were able to design a plan to give a high enough dose to the tumour – but using the narrower margin on the MR Linac led to significantly lower doses of radiation affecting the surrounding tissues.
Tailored approach
The research team also designed a second set of treatment plans for an approach called isotoxic intensity modulated radiotherapy (IMRT).
Rather than give every patient a standard dose of radiation, isotoxic IMRT irradiates tumours until one of the surrounding organs reaches an exposure limit. This means that some patients can be given higher doses than they are currently, which can improve their prognosis.
By developing narrow-margin IMRT treatment plans for the MR Linac, the researchers established that it should be possible to target these patients’ tumours with higher doses of radiation than is currently possible, while avoiding more tissue from the surrounding organs.
Study co-leader Professor Uwe Oelfke, Head of the Joint Department of Physics at the ICR and The Royal Marsden, said:
“Current survival rates for patients with locally advanced non-small cell lung cancer are poor, making improvements in disease control essential.
“Our research shows that it is possible to develop treatment plans for these patients using MRI-guided radiotherapy machines, such as our new MR Linac.
“This state-of-the-art technology should enable us to deliver more personalised treatments to patients – increasing the dose to the tumour, while reducing the effect on surrounding tissues.”
Original Source: https://www.icr.ac.uk/news-archive/important-step-towards-mr-linac-radiotherapy-for-lung-cancer
Original Date: Dec 18 2017
Theraview TBI (Total Body Irradiation) Image Guided RadioTherapy System
Bring new confidence, reliability and safety on-line with TheraView®, the cost effective, low-dose, high resolution IGRT digital portal imaging and workstation software solution.
Acceletronics is North America’s full service and sales dealer for Cablon Medical’s latest TheraView Technology IGRT solutions.
The TheraView TargetCheck® IGRT workstation, which connects to your existing OEM portal imaging system, is delivered web-enabled to allow remote access for review and has image management network
options available that bring the full functionality of TargetCheck®, TheraView’s powerful beam alignment verification software, to remote workstations thru-out the department.
The TheraView TBI (Total Body Irradiation) Image Guided RadioTherapy System can help you significantly improve TBI treatment procedures and outcomes. This flexible, mobile stand-alone imager is part of the integrated TheraView imaging product suite and the only commercially available TBI product of its kind today. Faster results, fewer errors. Instead of simply producing a single image, our solution relies on Intrafraction Monitoring in the form of live video capture to provide high quality megavoltage (MV) images. Video captures can be stopped and restarted to accomodate for changes in the patient’s position – so there’s no risk of needing to repeat the entire patient setup procedure. This will deliver significantly greater efficiency, faster results and improved treatment quality.
The TheraView Couch Setup Assist (TCSA), is an optional hardware/software solution that enables a faster, more accurate positioning of your patient. With TCSA, you can enhance patient care by reducing time spent on the treatment table and the number of trips in and out of the room by the Therapist. TCSA helps position the patient quickly with precision, reducing setup misalignments during patient setup. TCSA integrates with most all treatment couches and all movements are retraceable from the main application.
For the department that needs an EPID installed on their existing Linac, the TheraView EPID for IGRT uses high reliability, less costly, radiation hardened, cooled C3D digital X-Ray camera technology for excellent, reliable and stable image quality, with a fiber-optic digital image transmission path to the workstation providing a virtually noise free image. TheraView mounts on any non-beam-stopper linear accelerator and provides
superb real-time portal imaging. TheraView is DICOM-RT compatible with all popular image management systems and has motorized digitally controlled movements for accurate and easy set-up, use and stowage.
Continual development by the experts at TheraView consistently deliver advanced timely solutions with changing treatment protocols. With the Theraview TargetCheck® IGRT workstation, TBI Image Guided RadioTherapy System or Theraview EPID, manufactured by Cablon Medical (www.theraview.com) you can deliver the current and future technology treatments with accuracy, verification and safety. Please contact us to discuss your MV imaging needs and schedule an online demonstration, we can be reached via email at info@acceletronics.com or call us at 800-543-5144.
More information can be found on our website: http://www.acceletronics.com/medical/theraview-igrt-portal-imaging-system.php
and on YouTube Video: https://www.youtube.com/watch?v=R9_UAk8DMt4
December Specials 2017
First-in-human data validate MRI-linac
In May of this year, a research team at the University Medical Center Utrecht performed the first patient treatment using Elekta’s Unity, an MRI-guided radiotherapy system that integrates a diagnostic quality 1.5 T MR scanner with an advanced linear accelerator. Now the team has published details of the first four patient treatments, demonstrating the feasibility and clinical utility of the Unity MRI-linac (Phys. Med. Biol. 62 L41).
The Utrecht team treated four patients with lumbar spinal bone metastases, with a single fraction of 8 Gy prescribed to the target volume while minimizing dose to the spinal cord and the rest of the body. The treatments demonstrated the system’s ability to deliver precisely targeted radiation doses while simultaneously capturing the high-quality MR images that will allow clinicians to visualize tumours at any time, and adapt the treatment accordingly.
The MRI-linac at the University Medical Center Utrecht
The patients were treated with a 3- or 5-beam step-and shoot intensity-modulated radiotherapy (IMRT) plan. Plans were created while the patient was on the treatment table and based on the online 1.5T MR images, with the pre-treatment CT deformably registered to the online MRI to obtain Hounsfield values.
“These study results are very promising and we look forward to further advancing the clinical development of this transformative system, which has the potential to revolutionize the treatment of cancer,” said Bas Raaymakers, professor of experimental physics at UMCU. “These first clinical treatments show an outstanding level of dosimetric and geometric accuracy of the online IMRT planning and the radiation delivery based on the 1.5 T MRI guidance. This approach enables the optimization of dose to the tumour while reducing exposure of healthy tissue. To date, achieving this optimization has been the key challenge in radiation therapy.”
The team chose bone metastases as the first treatment site as these tumours can be clearly visualized on MRI while the surrounding spine bone can be detected on the integrated portal imager. In this way, portal images can be used to independently verify the MRI-based guidance and quantify the precision of radiation delivery.
They validated the geometric accuracy of online MRI guidance by comparing portal images of the IMRT segments with the MRI-based calculated projections. This revealed an average beam alignment of 0.3 mm with the target as defined on the online MRI, demonstrating the stereotactic geometric system accuracy. For each patient, the team performed the same quality assurance procedures for both the pre-treatment plan and the delivered plan, finding a mean difference of 0.4% of the calculated dose.
“These preliminary results are exciting and support the tremendous potential of Elekta’s MR-linac to address some of the historic challenges to improving the safety and efficacy of radiation therapy,” commented Kevin Brown, global vice-president of scientific research at Elekta. “The exceptional dosimetric and geometric accuracy reported in this study support the system as a transformative approach to radiation therapy that may allow more patients to receive optimum cancer care.”
Original Source: http://medicalphysicsweb.org/cws/article/research/70464
Original Date: Nov 15 2017
Original Author: Tami Freeman
Factors That Influence the Service and Maintenance of Radiation Equipment
There are several considerations to take into account when you’re servicing linear accelerators and maintaining radiation equipment. Linear accelerators and radiation equipment are critical and essential in any radiation oncology department but they are also quite expensive and complicated.
One of the biggest decisions to take into account is whether to rely on the Original Equipment Manufacturer (OEM) or to work with a servicing company whose main focus is servicing linear accelerators and maintaining radiation equipment.
While it may seem at first that the best cause of action would be to go with the OEM, there are several factors to consider alternative options such as:
Cost
Cost is a major factor to take into account and due to the complexity of servicing linear accelerators and maintaining radiation equipment; OEMs typically tend to charge a higher premium for service and maintenance.
Servicing companies on the other hand are able to offer a bundle of plans for you to choose from which can help to reduce costs, mitigate risk, or eliminate risk and protect your practice from unforeseen costs.
Focus of Service
The main business of OEMs is the manufacture and sale of equipment and equipment parts thus service and maintenance may not be the core of their business. With a servicing company whose main focus is servicing linear accelerators and maintaining radiation equipment, this facilitates greater efficiency and improved uptime.
Response time
The importance of medical equipment which underlies any medical facility is the optimal functioning of the equipment. Unforeseen machine breakdown can paralyze the operations of a practice. The speed at which medical equipment is returned to normal operating capacity is therefore critical.
For servicing companies, response times to servicing linear accelerators and maintaining radiation equipment is typically higher than OEMs since their services are structured to be available 24/7 with quick turnaround time for onsite responses.
Larger scope of operation
Most servicing companies have employed specialists and experts of different types of devices and brands so as to ensure effective servicing linear accelerators and maintaining radiation equipment. The service engineers are typically trained directly by the OEM manufacturers.
In addition, for practices that use different brands of oncology equipment, a servicing company is able to take care of the different requirements and specifications involved with servicing linear accelerators and maintaining radiation equipment in-house without involving different OEMS.
Flexible service contracts
Servicing companies are able to offer flexible service contracts which ensure comprehensive service for your oncology devices while controlling the service costs. Servicing companies are responsible for maintaining optimal uptime of the devices, carrying out scheduled maintenance and emergency repair service during the contract period.
The benefits of these flexible service contracts for servicing linear accelerators and maintaining radiation equipment include no charges for parts, effective cost control, scheduled preventive maintenance, no travel or call out charges, access to 24/7 support and optimal uptime guarantee for qualified devices. These flexible service contracts are therefore customized to meet the unique specifications and financial needs of your practice.
Learn more about Radparts and the variety of services and parts they offer to repair medical equipment including: linear accelerators parts, CT scanners parts, linac parts, and radiation oncology equipment at www.radparts.com. To contact one of our medical equipment repair specialists for parts or service call toll free 877.704.3838 for 24/7/365 support.
Tips When Purchasing Linear Accelerator Parts
There are several considerations to take into account when you are purchasing parts for radiation equipment including linear accelerators. Radiation equipment is critical and essential in running an oncology department and it is also quite costly and complicated.
One of the major decisions that you will need to make is whether to buy new or refurbished parts to repair and maintain your radiation department’s equipment. Refurbished linear accelerator parts are suited for both repairs and maintenance. The costs of replacement parts for radiation equipment are lower when purchasing refurbished parts. Refurbished equipment is ideal for medical companies that are starting out, purchasing additional pieces, research companies, veterinarians, and industrial purposes.
Advantages of Refurbished
Some of the reasons for buying refurbished linear accelerators and refurbished parts for radiation equipment include:
- To Grow a Practice: Refurbished linear accelerator and refurbished parts free up resources and minimize costs as you upgrade your practice whether that involves opening a new center, a new treatment room, or spare equipment to have on hand.
- Manage Expenses: Refurbished linear accelerators and refurbished parts help manage the risk of investing in costly new equipment during turbulent periods and help you stay afloat in times of financial constraints.
- Flexibility: Refurbished linear accelerators and refurbished parts provide you the flexibility of having a backup system that you can fall back on when your existing system develops a problem.
What To Think about when Purchasing
There are many factors to consider when buying radiation equipment and parts for linear accelerators, CT scanners and other oncology equipment.
- Proper Planning – There are several factors that go into the planning aspect as you make your buying decision. You need to identify and understand what your clinical goals are and what type of technology you will require delivering quality service. Factors to consider include whether you plan on going fully digital to the type of defined treatment field you want to achieve.
Site planning requirements is another factor to consider because installation of linear accelerator parts for radiation equipment requires important considerations such as room dimensions, power, local permits, water supply and future equipment technology.
The timeline for completing your project is critical for planning and executing milestones such as installation dates, equipment acceptance testing dates and going live with the linear accelerator parts. It is important to factor in some level of flexibility in your project timeline so as to account for unforeseen developments and challenges.
Your budget will determine the technology, manufacturer, and age of your equipment acquisition. A limited budget can influence you to go for refurbished linear accelerator parts for your radiation equipment. This also ensures available resources to effectively carry out other essential operations of your practice.
- An Experienced Team – The successful implementation of linear accelerator parts requires good cohesion with various experts ranging from the equipment provider to the physics support team to the IT integration team to the clinical implementation team.
Have A Professional Do Install
It is important to ensure that the experts who are handling this implementation are specialists in their own field and have the requisite experience and expertise to execute. Perform due diligence background on the equipment provider for your linear accelerator parts for the radiation equipment to ensure maximum reliability and vendor accountability. Invest in an equipment provider that not only sells you the equipment but also provides post-installation support.
Learn more about Radparts and the variety of services and parts they offer to repair medical equipment including: linear accelerators parts, CT scanners parts, linac parts, and radiation oncology equipment at www.radparts.com. To contact one of our medical equipment repair specialists for parts or service call toll free 877.704.3838 for 24/7/365 support.