Clinicians from the U.S., Europe, and Asia report promising results during
medical meeting in Taiwan
TAIPEI CITY, Taiwan, Sept. 3, 2013 /PRNewswire/ -- Clinical experts outlined
promising new approaches to treating liver cancer using radiosurgery with
advanced imaging and motion management technology. Presentations on non-invasive
radiosurgical approaches to treating hepatocellular carcinoma (HCC) were made by
leading clinicians here last week at a meeting organized by the Taiwan Society
for Therapeutic Radiology and Oncology and Taiwan Liver Cancer Association.
HCC, the most common type of liver cancer, is globally the third leading cause
of cancer mortality after lung and stomach cancer, and a significant problem in
Taiwan, mainland China, and other parts of Asia.1
"Most patients with HCC are not eligible for surgery or liver transplant," said
Theodore Lawrence, M.D., Ph.D., professor and chairman of the Department of
Radiation Oncology at the University of Michigan. "Historically we couldn't do
much for them with radiotherapy because we lacked the ability to focus the dose
on the tumor and minimize exposure of the rest of the liver. That has changed
with advanced approaches like stereotactic ablative radiotherapy (SABR)."
Stereotactic ablative radiotherapy (SABR) is a type of radiosurgery that
involves the careful use of modern technologies for 3-D image guidance, motion
management, and beam shaping. Dr. Lawrence and his clinical team customize their
use of SABR for each patient according to a predictive model they have developed
based on treatment data from over 400 HCC cases. This model helps them determine
the optimal radiation dose to use given the volume of liver to be treated. "High
doses can be given safely if enough normal liver can be spared," he explained.
Single-Dose Image-Guided Treatments
Carlo Greco, MD, professor and director of clinical research at the Champalimaud
Foundation in Lisbon, Portugal, discussed advances in imaging and biological
targeting that enable high precision single-dose image-guided radiotherapy
(SD-IGRT) for treating metastatic lesions in the liver as well as elsewhere in
the body. "These treatments depend on our ability to accurately position
patients for treatment, use imaging for precise targeting, and manage motion
during treatment," said Dr. Greco.
The TrueBeam(TM) platform from Varian Medical Systems (NYSE: VAR), with its high
dose delivery rate, enables fast completion of these otherwise time-consuming
treatments. "Since we installed the TrueBeam machine in early 2012, we have
treated over 400 metastatic lesions with high dose SD-IGRT," Dr. Greco said.
"Lung, bone, liver, adrenal gland and lymph node lesions have been the focus of
our experience. Based on follow-up imaging studies, we're seeing outstanding
early local control rates, with 95% of lesions free of relapse at twelve months
Encouraging Outcomes Reported From Milan
Marta Scorsetti, M.D., director of the Department of Radiation Oncology and
Radiosurgery at the Humanitas Cancer Center in Milan, Italy, presented her work
evaluating the feasibility and efficacy of SABR in the treatment of both
inoperable primary liver cancer and liver metastases. She reported on the
results obtained with 67 patients treated for metastatic lesions, and 18
patients with primary HCC lesions.
While specific local tumor control and overall survival results varied, after a
median follow-up of 12 months all groups showed acceptable rates of local tumor
control and very little treatment related toxicity. No radiation induced liver
disease (RILD) was detected, Dr. Scorsetti reported.
Gated RapidArc for Treating Liver Cancer
Po-Ming Wang, M.D., chief radiation oncologist at Cheng Ching General Hospital
in Taichung, Taiwan, summarized his experience using Varian's TrueBeam STx
system to deliver gated RapidArc radiosurgery in the treatment of liver cancer.
RapidArc speeds up highly precise radiosurgery treatments by constantly shaping
and reshaping the treatment beam to match the shape of the tumor while
delivering dose continuously as the treatment machine rotates around the
patient. Gated RapidArc makes it possible to monitor patient breathing and
compensate for tumor motion during a RapidArc treatment.
"With the TrueBeam STx, we are able to image the tumor during the treatment and
adapt the treatment delivery in 'real time' based on observable changes," said
Dr. Wang. "This helps us to better target the liver tumor and minimize the
impact on surrounding critical organs like the duodenum or stomach. The gated
RapidArc technique also helps to preserve more of the patient's normal liver
"Varian was pleased to provide financial support for this important meeting,
which was the first liver-specific SABR meeting to take place in the Asia
Pacific region," said Clif Ling, Ph.D., director of advanced clinical research
for Varian. "The meeting was attended by radiation oncology and hepatology
professionals and designed to provide a platform for liver cancer experts in
Taiwan to begin to form a consensus about how to use SABR--a relatively new
capability in radiation oncology--to treat HCC. We hope that better
understanding of the use of SABR for HCC will lead to improved treatment
1World Cancer Report 2008, Boyle P & Levin P eds., World Health Organization:
International Agency for Research on Cancer; Lyon, France
The presentations summarized here were made by researchers at a scientific
society meeting sponsored by Varian and its local distributor designed to share
clinical experience using modern radiotherapy technology to treat hepatocellular
carcinoma with stereotactic ablative radiotherapy (SABR). Treatment outcomes
described in the presentations are generally preliminary and limited to a single
institution and are not intended to represent typical outcomes in a general
patient population undergoing SABR treatment. Varian's devices that deliver SABR
treatments, including the TrueBeam(TM) machine, have been cleared by the U.S.
Food and Drug Administration (FDA) for treating lesions, tumors, and conditions
anywhere in the body when radiation treatment is indicated.
Important Safety Information: Radiation treatments may cause side effects that
can vary depending on the part of the body being treated. The most frequent ones
are typically temporary and may include, but are not limited to, irritation to
the respiratory, digestive, urinary or reproductive systems, fatigue, nausea,
skin irritation, and hair loss. In some patients, they can be severe, and can
include but are not limited to radiation induced liver disease (or radiation
hepatitis), fractured ribs and persistent nausea. Treatment sessions may vary in
complexity and time. Radiation treatment is not appropriate for all cancers.
Cancer patients should discuss the potential for side effects and their severity
as well as the benefits of radiation with their doctors to determine if
radiation treatments are right for them.
About Varian Medical Systems
Varian Medical Systems, Inc., of Palo Alto, California, is the world's leading
manufacturer of medical devices and software for treating cancer and other
medical conditions with radiotherapy, radiosurgery, and brachytherapy. The
company supplies informatics software for managing comprehensive cancer clinics,
radiotherapy centers and medical oncology practices. Varian is a premier
supplier of tubes, digital detectors, and image processing workstations for
X-ray imaging in medical, scientific, and industrial applications and also
supplies high-energy X-ray devices for cargo screening and non-destructive
testing applications. Varian Medical Systems employs approximately 6,350 people
who are located at manufacturing sites in North America, Europe, and China and
approximately 70 sales and support offices around the world. For more
information, visit http://www.varian.com or follow us on Twitter.
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