Novel Treatment Approach for Lung Cancer at the University of Pittsburgh Medical Center (UPMC) Cancer Centers Targets Tumors While They Are Moving | Varian

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Novel Treatment Approach for Lung Cancer at the University of Pittsburgh Medical Center (UPMC) Cancer Centers Targets Tumors While They Are Moving

PITTSBURGH, Aug. 16 /PRNewswire-FirstCall/ -- Clinicians at the University of Pittsburgh Medical Center (UPMC) Cancer Centers successfully treated a lung cancer patient in her mid-fifties using a new more precise technique that combines image-guided radiotherapy (IGRT) with respiratory gating to zero in on her tumor while adapting for breathing motion. The new tissue sparing procedure was made possible using advanced imaging and treatment technology from Varian Medical Systems (NYSE: VAR) of Palo Alto, California.

The UPMC medical team specially designed the patient's sophisticated treatment to protect her heart and esophagus as well as the healthy parts of her lung. The Dynamic Targeting® IGRT treatment was delivered using Varian's powerful Trilogy™ linear accelerator equipped with an On-Board Imager® for monitoring tumor motion and the RPM™ respiratory gating system for synchronizing beam delivery with the patient's natural breathing cycle.

"We had to be concerned about compromising this patient's ability to breathe," said Dwight Heron, MD, vice chairman of clinical affairs, department of radiation oncology, UPMC Cancer Centers. "As a result, it was vitally important to minimize the exposure of radiation to the surrounding healthy lung tissue." Typical side effects from lung cancer treatments include inflammation of the esophagus or healthy lung tissue, but the new procedure has made it possible to reduce the risk of complications while increasing the chances of eradicating the tumor.

Using Images to Fine-Tune Patient Positioning

To position the patient for treatment each day, the UPMC clinical team used the On-Board Imager to generate high-quality radiographic X-ray images of the targeted area immediately before each treatment session. With the push of a button, the patient was then repositioned, based on changes detected in the daily images. Periodically, the UPMC team also generated three-dimensional cone-beam CT images, to further verify that the patient had been moved into the best position for the ultra-precise treatment.

Dealing with Tumor Motion

An imaging study of the patient revealed that her tumor moved 1.2 centimeters with every breath she took. Traditionally, Heron said, tumor motion of this magnitude would have compelled him to treat an additional margin of about 1 to 1.5 centimeters around the tumor, in order to ensure that the treatments fully encompassed the tumor. In this patient's case, he felt that this would have meant irradiating too large a volume of healthy tissue in the upper lobe of her left lung. RPM™ respiratory gating technology helped him solve the problem.

"We set our RPM respiratory gating system to deliver the treatment beam only during a particular part of her respiratory cycle, when her tumor moved the least," Heron said. "This happened when she was about halfway through her exhalation -- the tumor was virtually motionless at that point, so we could target it very accurately. Using this approach, we were able to decrease the treatment margin to half a centimeter," Heron said.

"Technologies like the Trilogy™ machine, with the On-Board Imager and respiratory gating make it possible for us to adopt a truly personalized approach to cancer care," Heron added. "With these tools, we can make individual adjustments each day based on what we're seeing that day. To have all of these capabilities fully integrated with the treatment machine has given us the power to truly tailor cancer treatment for each and every patient."

Heron and his clinical team at UPMC Shadyside have treated over 100 lung cancer cases using Dynamic Targeting IGRT technology since December of 2005. According to the American Cancer Society, there are approximately 174,000 new cases of lung cancer diagnosed in the U.S.each year, and surgery has been the most common form of treatment for localized tumors. "Up to now, most early stage lung cancer patients have been treated with chemotherapy or surgery -- very few received radiation, because accurate targeting was difficult to achieve,'' said Dow Wilson, president of Varian's Oncology Systems business. ''The success of this work at UPMC suggests that more and more patients can benefit from noninvasive radiotherapy procedures for some forms of lung cancer.''


UPMC Cancer Centers, one of the largest integrated community networks of cancer physicians and health care specialists in the country, allows patients to receive the highest level of cancer care without having to leave their communities. Working in tandem with the University of Pittsburgh Cancer Institute (UPCI), UPMC Cancer Centers offers patients the latest advances in cancer prevention, detection, diagnosis and treatment at locations throughout Western Pennsylvania and sounding areas.


Varian Medical Systems, Inc., of Palo Alto, California is the world's leading manufacturer of integrated cancer therapy systems, which are treating thousands of patients per day. 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 3,300 people who are located at manufacturing sites in North America and Europe and in its 55 sales and support offices around the world. Additional information is available on the company's investor relations web site at


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  University of Pittsburgh Medical Center
  Clare Collins (412) 647-3555

  Varian Medical Systems
  Meryl Ginsberg (650) 424-6444

SOURCE: Varian Medical Systems

CONTACT: Clare Collins of University of Pittsburgh Medical Center,
+1-412-647-3555, or; or Meryl Ginsberg of Varian Medical
Systems, +1-650-424-6444, or

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