Clinicians at the START Center in San Antonio, Texas, decommissioned their Cyberknife® in May of 2017, in favor of the Edge™ system, having determined that Edge radiosurgery is faster, has new and improved technology, and is more comfortable for the patient.
“The Edge system allows us to treat our radiosurgery patients in a shorter amount of time, which is important for accuracy and patient comfort,” noted Ardow Ameduri, MD, radiation oncologist. “We can now treat radiosurgery patients in 30-minute time slots as opposed to the one to one-and-a-half hours required for Cyberknife treatments. Edge also enables us to treat non-radiosurgery patients, which increases our efficiency.”
A community-based private practice, the START Center has had a radiosurgery program in place for more than 11 years. Addressing up to six radiosurgery patients a day, START clinicians target tumors in the brain, lung, prostate, liver, pancreas, and spine using image-guided radiosurgery (IGRS) and image-guided SBRT. Radiotherapy cases receive intensity-modulated radiotherapy (IMRT) that are delivered using RapidArc® technology.
“Some of our patients are not candidates for conventional surgery,” said Melissa Blough, PhD, director of medical physics at the START Center. “The Edge system provides them with a noninvasive treatment option they would not otherwise have. Using the Edge system, we have been able to treat several patients who were not in the best of health and who would have had difficulty tolerating treatment on the Cyberknife due to the long treatment times.”
Dr. Blough shared a case where the Edge made a significant difference in the life of a patient dealing with five brain metastases. Using Cyberknife, START clinicians would have treated each tumor on separate days using five separate treatment plans. With their Edge system, they were able to treat all five lesions using one treatment plan delivered over three fractions.
In addition, the Edge system is also enabling START clinicians to deliver hypofractionated image-guided radiation therapy (IGRT) for prostate cancer patients.
“The acute side effects are similar to conventional IMRT treatments for prostate cancer,” stated Dr. Ameduri. “However, hypofractionation decreases the duration of treatment, which positively impacts the patient’s quality of life.”
Reducing Dose to Organs-At-Risk
An important feature of the Edge system, according to Dr. Blough, is its high-definition, multileaf collimator with 2.5 millimeter collimator leaves, which allows the team to create highly conformal plans. Dr. Blough related a case where the high level of conformality enabled the radiation oncologist to retreat a patient with spine metastases.
“The patient had already been treated to a maximum spinal cord dose of 27 Gy, making it difficult to retreat due to radiation dose tolerance on the cord,” Dr. Blough said. “However, we were able to retreat him on the Edge using RapidArc. Because of the smaller MLC leaves, we were able to create a much more conformal plan, and to minimize the additional dose to the spinal cord.”
The information captured herein represents the genuine experience of the attributed individuals and may not necessarily represent the views of Varian or the above referenced institution. Individuals were not compensated for their testimonials. Radiation treatment may not be appropriate for all cancers. Individual results may vary.