Healthcare Industry News:  Stereotactic 

Devices Oncology Neurosurgery

 News Release - September 19, 2006

Physicians at the University of California, San Diego Deliver Non-Invasive Neurosurgery Using Image-Guidance Tools From Varian Medical Systems

Clinicians Offering Cancer Patients Frameless Stereotactic Radiosurgery That is Planned and Delivered in a Single Day

SAN DIEGO, Sept. 19 (HSMN NewsFeed) -- Carolyn Steele, 62, was at the dentist having her teeth cleaned when her right leg and foot began shaking uncontrollably. The dental hygienist called paramedics, and minutes later, she was at the hospital, where clinicians suspected she had suffered a stroke. As it turned out, she had lung cancer that had metastasized to the brain. Two small tumors in her brain had caused a mild seizure on her right side.

"I'd never been in the hospital before, except twice to give birth to my two sons," she said. "I'd never had my tonsils or appendix out. If I hadn't had that seizure at the dentist's office, I might never have known I had cancer."

Several days later, Steele found herself at the Moores Cancer Center of the University of California, San Diego (UCSD), seeking a second opinion about her situation. Doctors at the first hospital she had visited offered her whole-brain radiation, and Steele, along with her 32-year-old son -- himself a survivor of testicular cancer -- didn't like what they read about the side effects of such a procedure.

"We figured that something so serious needed a second opinion. So my son got on the phone to see what else was out there." He discovered that clinicians at UCSD had recently begun offering cancer patients a new, non-invasive brain tumor treatment that is delivered in a single day without the use of invasive immobilization devices or surgical incisions. Moreover, the treatment, which is delivered using the Trilogy(TM) medical linear accelerator from Varian Medical Systems (NYSE: VAR ), sends precisely focused, high-energy radiation beams directly to brain tumors, sparing the surrounding healthy tissues.

"A medical oncologist brought Carolyn's lung cancer under control using chemotherapy," said Kevin T. Murphy, MD, medical director and chief of the Stereotactic radiosurgery program in the Department of Radiation Oncology at UCSD. "I felt that we could address her brain lesions using local radiosurgery and then watch her closely. We could always resort to whole-brain radiation if the localized treatment approach wasn't successful."

On June 6, 2006, Murphy and his colleague, John Alksne, MD, professor of neurological surgery at UCSD, treated Steele with "frameless Stereotactic radiosurgery," delivered with the Trilogy machine along with Varian's FramelessArray(TM) optical guidance system. This emerging technology uses an optical camera to continuously monitor the patient, ensuring proper positioning throughout the half-hour treatment. "We were able to treat both brain tumors-a large one and a small one-at the same time," Alksne said. "Conventional radiosurgery technologies would have required us to treat each lesion separately, taking at least two hours."

To help ensure treatment accuracy, doctors were able to precisely locate the tumors at the time of treatment with 3D cone-beam CT images generated using a new On-Board Imager(TM) device on the Trilogy machine.

The UCSD team also used Varian's optical positioning device to properly position the patient for treatment and avoid having to immobilize her with a traditional radiosurgery head frame that is screwed into the skull. "Instead we use a custom-fabricated headrest, a removable mask, and a bite block that fits in the patient's mouth," Murphy said. "There is a set of reflective markers attached to the bite block, and these are tracked by the optical camera system, allowing adjustments in positioning to be made with sub-millimeter accuracy. This is much more comfortable than invasive forms of immobilization, and equally accurate as bolted head-frame systems."

The entire process, from physician consultation through treatment delivery, is completed in a single day -- usually within four hours. "The actual treatment time is only about 30 minutes," Murphy said. "Carolyn's experience was typical: She walked out of here half an hour after she was put on the treatment couch and positioned for treatment."

"After the treatment, Dr. Murphy's nurse, Michelle, wanted to know how I was feeling," Steele recalled. "I told her, 'I feel great!' My sister and my husband took me home and my husband barbecued some steaks for dinner."

Steele returned to UCSD recently for a follow-up scan. The smaller of her brain tumors is completely gone and the other one has shrunk to less than five millimeters in size. That one will probably continue to shrink, according to Murphy. "Most important, she shows no sign of swelling in either area, and has had no symptoms or side effects. So far, things are looking good."

In addition to frameless Stereotactic radiosurgery, a Trilogy machine can also deliver other more standard forms of radiotherapy. "We can finish a radiosurgery treatment for a brain tumor, and then immediately deliver state-of-the-art image-guided radiotherapy for prostate, lung, breast, and other forms of cancer. No other system is as versatile, allowing treatment of up to 40 other patients the same day," said Murphy.

Arno J. Mundt, MD, professor and chair of the department of radiation oncology at UCSD is particularly pleased with the versatility of Varian's On-Board ImagerŪ device, an attachment on the Trilogy machine that enables his team to generate images of the targeted area and to make any needed final adjustments to the patient's position just prior to treatment. "Trilogy affords a wide variety of in-room imaging options, from planar X-rays to volumetric cone-beam CT images, all of which are routinely used in optimizing treatment delivery to our patients."

Each year more than 200,000 people in the United States are diagnosed with a primary or metastatic brain tumor, according to the Brain Tumor Society (http://www.tbts.org/ ).

ABOUT THE MOORES CANCER CENTER AT UCSD

Founded in 1979, the Moores UCSD Cancer Center is one of just 39 centers in the United States to hold a National Cancer Institute (NCI) designation as a Comprehensive Cancer Center. As such, it ranks among the top centers in the nation conducting basic, translational and clinical cancer research, providing advanced patient care and serving the community through outreach and education programs.

ABOUT VARIAN MEDICAL SYSTEMS

Varian Medical Systems, Inc., of Palo Alto, California is the world's leading manufacturer of medical technology for treating cancer with radiotherapy and neurological conditions with radiosurgery. The company is also a premier supplier of X-ray tubes and flat-panel digital subsystems for imaging in medical, scientific, and industrial applications. Varian Medical Systems employs approximately 3,600 people who are located at manufacturing sites in North America and Europe and in its 56 sales and support offices around the world. Additional information is available on the company's web site at http://www.varian.com/ .


Source: Varian Medical Systems

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