Positioning breast cancer patients in the prone position (I.e., on their stomachs) rather than supine (on their backs) for radiotherapy could lead to better outcomes in some cases. Growing evidence shows considerable advantages to treating many breast cancer patients in the prone as opposed to the supine position. Studies suggest that prone breast cancer treatment can often significantly reduce the amount of dose reaching the heart and lungs, minimize the effects of respiratory motion and help to reduce skin toxicity. Trials conducted at the New York University School of Medicine and other sites have shown that using a prone position for treatment can enable a significant reduction in the volume of lung and heart tissue exposed to radiation for women with breasts of all sizes — not just large-breasted women, as was commonly believed. The researchers found that prone positioning was optimal in sparing the lungs in virtually all right breast cancer cases and for 85 percent of left breast cancer cases. The prone setup also reduces the amount of respiratory motion of the chest wall, which may further enhance the accuracy of targeting during treatment. Varian’s new Pivotal treatment solution for prone breast care combines the prone treatment technique with an innovative couch top device — the kVue Access 360 insert. (Formenti S et al. Results of NYU 05-181: A Prospective Trial to Determine Optimal Position [Prone versus Supine] for Breast Radiotherapy. Int J Radiat Oncol Biol Phys. 2009; 75 Supplement, S203-S204)
Varian’s TrueBeam platform can deliver a Gated RapidArc treatment that compensates for tumor motion while quickly delivering dose during one or more continuous rotations around the patient. This enables the use of RapidArc, or volumetric modulated arc therapy, to target lung tumors with precision by "gating" the beam — turning it on and off — in response to tumor motion. Now, with the addition of Intrafraction Motion Review (IMR), clinicians can actually obtain continual visual verification that a tumor is being accurately targeted during a Gated RapidArc treatment. Using IMR, clinicians can trigger the TrueBeam imager to generate images between “beam on” periods during a treatment to ensure that the tumor hasn't moved out of range due to changes in the patient's breathing pattern.
"By introducing intrafraction treatment imaging and combining it with the millisecond response time of the TrueBeam machine, we can minimize the effects of changes in tumor motion during treatment," said Chris Toth, senior director of marketing for the company.