Image courtesy of Accuray
Special report: Radiotherapy continues to grow as technology becomes more precise
October 05, 2011
by Joanna Padovano, Reporter
This report originally appeared in the October 2011 issue of DOTmed Business News
Cancer is a word no one ever wants to hear a doctor say to them or a loved one. Yet, the harsh reality is that many people will hear it at some point. More than 1.5 million new cases of cancer will be diagnosed in the United States this year, according to the American Cancer Society. Following heart disease, cancer is the second leading cause of death in the nation and is expected to kill nearly 572,000 Americans in 2011.
Despite such discouraging statistics, there is still hope for victims of the devastating disease thanks to progress that has been made in the field of radiation therapy, a treatment that is received by approximately 50 percent of cancer patients.
The status of the sector
The global radiation therapy devices market—the majority of which includes external beam radiotherapy equipment and treatment-planning systems—was valued at around $2 billion in 2010. The United States was responsible for 30 to 40 percent of that amount, says Akanksha Jain, a GlobalData senior analyst who contributed to the marketing report “Radiation Therapy Devices - Global Opportunity Assessment, Competitive Landscape and Market Forecasts to 2017,” published in March 2011.
Jain mentions that the radiation therapy devices sector has grown, primarily from replacement sales. “A lot of the cancer centers and institutes are looking at replacing their old, outdated technology with newer devices and newer equipment which perform better and give a better ROI,” she says.
Technological trends
“If you look at [radiation therapy] technology, it’s grown by leaps and bounds in the past 10 years,” says Jain.
One of the biggest ongoing trends in the sector has been image-guided radiation therapy, which enables radiation oncologists to pinpoint exactly where a tumor is immediately prior to the delivery of radiation. This helps to minimize the amount of healthy tissue damaged during treatment.
In the past, imaging was a separate process, but advancements in technology over the last decade now allow a patient to be imaged at the exact time of treatment. “That means that you can be more accurate not only in terms of how you set up the patient, and how you can point the beam to the tumor just as the patient has gotten onto the treatment table, but it also means that during the treatment itself, you can monitor the position of the lesion,” explains Dr. Joel Goldwein, senior vice president of medical affairs for Elekta.
“The demand is incredibly high,” says Dr. Omar Dawood, vice president of global medical affairs for Accuray. “Clinicians want to be assured that when delivering doses of radiation, they’re delivered accurately and precisely.”
“The most popular request we get is for IGRT machines,” says John Marquez, president of Therapy Remarketing Group, which is being rebranded as TRG Oncology Equipment. “I think that’s what most people are looking for these days. If they’re going to be replacing a system, or adding a system, everyone’s looking for that image-guidance capability.”
Advanced motion detection is another ongoing trend in radiation therapy that helps to account for the shift in the position of tumors located near organs that move, such as the heart and the lungs.
Manufacturers have also been looking at ways to decrease the amount of time it takes to deliver each treatment. “That is important because during the radiation therapy the patient needs to lie very, very still because any movement in the patient would dramatically impact the results of the radiation,” explains Jain, who estimates that improvements in technology have reduced the time it takes to deliver radiotherapy treatment by up to two-thirds.
What’s new with manufacturers?
Elekta—one of the leading manufacturers of radiation therapy systems—recently acquired Nucletron, who specializes in brachytherapy treatment planning and delivery. “In general, we’re always releasing new products or features that enhance existing products,” says Goldwein. “Mostly that is on the software side because it’s easier to do that. But often it’s devices and accessories that add to existing pieces of equipment, that help to enhance their capabilities and ultimately that help the patients.”
The company recently received clearance to market its Integrity R1.1 in the European Union. The new digital linear accelerator control system has demonstrated treatment time savings of up to 30 percent and is expected to be cleared in the U.S. within the next few months.
Accuray, another key player in the radiation therapy market, recently purchased TomoTherapy, a fellow maker of radiation oncology equipment. Accuray’s most popular system has been the CyberKnife, a robotic radiosurgery system that non-invasively treats tumors located anywhere in the body. Towards the end of 2010 the company received FDA clearance to market its Lung Optimized Treatment, a new component of the CyberKnife VSI System.
TrueBeam, Varian Medical System’s most recently released radiation therapy system, was introduced in April 2010 and it is currently their best-seller. “This has been our biggest selling new machine ever, with more sales in the first year than we’ve seen with previous new product introductions,” says Meryl Ginsberg, the company’s director of public relations.
Within the next year or so, Varian will introduce a software platform that integrates Varian’s treatment planning software and oncology information management systems. “They are becoming part of a single clinical management system that marries up the two so that people don’t need to know which system to access in order to complete a task,” says Ginsberg, who mentions that the product, ARIA version 11, will be featured at ASTRO’s annual meeting in October 2011.
Improving safety
Maintaining safe equipment should always be the number-one priority for radiation therapy equipment manufacturers.
Goldwein mentions that Elekta has been reevaluating their safety-related activities after a New York Times article detailed the rare but fatal mishaps that can occur during radiation therapy. “From within our software, we are incorporating more and more interlocks,” which he explains is “a method to prevent an unsafe condition from existing, or from being implemented by means of some sort of either hardware or software switch that disallows the treatment from being delivered, or whatever the activity is that could be unsafe from happening.”
Accuray has been “continuing to make strives from a patient-safety point of view,” says Dawood. “Our devices are very unique in that they’re completely integrated devices. We use no third-party bolt-on components, so because of that, the imaging system is integrated within the actual delivery system, making the devices on the forefront of advancing patient safety.”
According to Ginsberg, careful post-market surveillance is among the processes that Varian uses for continual enhancement of product safety. “Our product specialists observe and interview early adopters, we survey customers, we monitor the professional communication channels . . . and we analyze all product improvement requests and complaints to spot any trends that reveal that there might be an issue,” she says. “Often we use this information to engineer product improvements. It’s a pretty robust process of continual improvement.”
From a clinical perspective
Eastern Regional Medical Center, based in Philadelphia, Penn., is part of the Cancer Treatment Centers of America. According to Dr. Pablo Lavagnini, director of radiation oncology, the facility uses approximately seven different methods or radiation therapy. The newest machine in the center is the Novac7, a mobile electron linear accelerator for intraoperative radiotherapy.
According to Lavagnini, ERMC is like an “island of ideal conditions,” as compared to other medical facilities, because it has not been negatively affected by the economy or health care reform. “We buy always the first and latest available equipment,” he says. “We don’t follow the national trend in cutting expenses and because of health care and prices and all that. We just give the patients the best available possible treatment.” Patient volume at the center has been growing, says Lavagnini, due in part to the fact that they always have the latest technology.
The future of radiotherapy
“Emerging markets will probably drive the growth,” says Jain, who predicts that more companies will create cheaper equipment that will better meet the needs of growing markets. “Between China and India you have around three billion population and currently the penetration is less than 10 percent, so the major growth will come from there.”
In reference to the economic crisis and health care reform, Goldwein says practices are well aware change is coming. “They all know that the bucket is getting closer and closer to empty and they are going to be looking for ways to be more efficient. They are nervous about reimbursement . . . they will have to manage their practices accordingly.”
“I think the future is going to see gravitation toward treatments that are more tailored to each patient’s needs,” says Dawood. “So rather than just treating in a uniform manner, you actually have technologies that are very flexible, patient-specific technologies, and able to deliver patient-specific treatments.”
GlobalData forecasts that the global radiation therapy devices market will grow at around 8 to 10 percent for the next seven or eight years. Experts in the sector agree: radiotherapy technology will continue to improve and the patient outlook will improve with it.
Names in boldface are Premium Listings.
Domestic
Pete Cawley, Kimtron Medical, LLC, CT
DOTmed Certified
Michaelle Serrano, Platinum Medical Imaging, FL
Alison Fortin, Global Inventory Management LLC, NH
DOTmed Certified
DOTmed 100
Mel Little, The Lennon Group, TN
International
Maged el Sayed, Midlle East Technomed, Egypt
Cancer is a word no one ever wants to hear a doctor say to them or a loved one. Yet, the harsh reality is that many people will hear it at some point. More than 1.5 million new cases of cancer will be diagnosed in the United States this year, according to the American Cancer Society. Following heart disease, cancer is the second leading cause of death in the nation and is expected to kill nearly 572,000 Americans in 2011.
Despite such discouraging statistics, there is still hope for victims of the devastating disease thanks to progress that has been made in the field of radiation therapy, a treatment that is received by approximately 50 percent of cancer patients.
The status of the sector
The global radiation therapy devices market—the majority of which includes external beam radiotherapy equipment and treatment-planning systems—was valued at around $2 billion in 2010. The United States was responsible for 30 to 40 percent of that amount, says Akanksha Jain, a GlobalData senior analyst who contributed to the marketing report “Radiation Therapy Devices - Global Opportunity Assessment, Competitive Landscape and Market Forecasts to 2017,” published in March 2011.
Jain mentions that the radiation therapy devices sector has grown, primarily from replacement sales. “A lot of the cancer centers and institutes are looking at replacing their old, outdated technology with newer devices and newer equipment which perform better and give a better ROI,” she says.
Image courtesy of Varian
Technological trends
“If you look at [radiation therapy] technology, it’s grown by leaps and bounds in the past 10 years,” says Jain.
One of the biggest ongoing trends in the sector has been image-guided radiation therapy, which enables radiation oncologists to pinpoint exactly where a tumor is immediately prior to the delivery of radiation. This helps to minimize the amount of healthy tissue damaged during treatment.
In the past, imaging was a separate process, but advancements in technology over the last decade now allow a patient to be imaged at the exact time of treatment. “That means that you can be more accurate not only in terms of how you set up the patient, and how you can point the beam to the tumor just as the patient has gotten onto the treatment table, but it also means that during the treatment itself, you can monitor the position of the lesion,” explains Dr. Joel Goldwein, senior vice president of medical affairs for Elekta.
“The demand is incredibly high,” says Dr. Omar Dawood, vice president of global medical affairs for Accuray. “Clinicians want to be assured that when delivering doses of radiation, they’re delivered accurately and precisely.”
“The most popular request we get is for IGRT machines,” says John Marquez, president of Therapy Remarketing Group, which is being rebranded as TRG Oncology Equipment. “I think that’s what most people are looking for these days. If they’re going to be replacing a system, or adding a system, everyone’s looking for that image-guidance capability.”
Image courtesy of Elekta
Advanced motion detection is another ongoing trend in radiation therapy that helps to account for the shift in the position of tumors located near organs that move, such as the heart and the lungs.
Manufacturers have also been looking at ways to decrease the amount of time it takes to deliver each treatment. “That is important because during the radiation therapy the patient needs to lie very, very still because any movement in the patient would dramatically impact the results of the radiation,” explains Jain, who estimates that improvements in technology have reduced the time it takes to deliver radiotherapy treatment by up to two-thirds.
What’s new with manufacturers?
Elekta—one of the leading manufacturers of radiation therapy systems—recently acquired Nucletron, who specializes in brachytherapy treatment planning and delivery. “In general, we’re always releasing new products or features that enhance existing products,” says Goldwein. “Mostly that is on the software side because it’s easier to do that. But often it’s devices and accessories that add to existing pieces of equipment, that help to enhance their capabilities and ultimately that help the patients.”
The company recently received clearance to market its Integrity R1.1 in the European Union. The new digital linear accelerator control system has demonstrated treatment time savings of up to 30 percent and is expected to be cleared in the U.S. within the next few months.
Accuray, another key player in the radiation therapy market, recently purchased TomoTherapy, a fellow maker of radiation oncology equipment. Accuray’s most popular system has been the CyberKnife, a robotic radiosurgery system that non-invasively treats tumors located anywhere in the body. Towards the end of 2010 the company received FDA clearance to market its Lung Optimized Treatment, a new component of the CyberKnife VSI System.
TrueBeam, Varian Medical System’s most recently released radiation therapy system, was introduced in April 2010 and it is currently their best-seller. “This has been our biggest selling new machine ever, with more sales in the first year than we’ve seen with previous new product introductions,” says Meryl Ginsberg, the company’s director of public relations.
Image courtesy of Accuray
Within the next year or so, Varian will introduce a software platform that integrates Varian’s treatment planning software and oncology information management systems. “They are becoming part of a single clinical management system that marries up the two so that people don’t need to know which system to access in order to complete a task,” says Ginsberg, who mentions that the product, ARIA version 11, will be featured at ASTRO’s annual meeting in October 2011.
Improving safety
Maintaining safe equipment should always be the number-one priority for radiation therapy equipment manufacturers.
Goldwein mentions that Elekta has been reevaluating their safety-related activities after a New York Times article detailed the rare but fatal mishaps that can occur during radiation therapy. “From within our software, we are incorporating more and more interlocks,” which he explains is “a method to prevent an unsafe condition from existing, or from being implemented by means of some sort of either hardware or software switch that disallows the treatment from being delivered, or whatever the activity is that could be unsafe from happening.”
Accuray has been “continuing to make strives from a patient-safety point of view,” says Dawood. “Our devices are very unique in that they’re completely integrated devices. We use no third-party bolt-on components, so because of that, the imaging system is integrated within the actual delivery system, making the devices on the forefront of advancing patient safety.”
According to Ginsberg, careful post-market surveillance is among the processes that Varian uses for continual enhancement of product safety. “Our product specialists observe and interview early adopters, we survey customers, we monitor the professional communication channels . . . and we analyze all product improvement requests and complaints to spot any trends that reveal that there might be an issue,” she says. “Often we use this information to engineer product improvements. It’s a pretty robust process of continual improvement.”
From a clinical perspective
Eastern Regional Medical Center, based in Philadelphia, Penn., is part of the Cancer Treatment Centers of America. According to Dr. Pablo Lavagnini, director of radiation oncology, the facility uses approximately seven different methods or radiation therapy. The newest machine in the center is the Novac7, a mobile electron linear accelerator for intraoperative radiotherapy.
According to Lavagnini, ERMC is like an “island of ideal conditions,” as compared to other medical facilities, because it has not been negatively affected by the economy or health care reform. “We buy always the first and latest available equipment,” he says. “We don’t follow the national trend in cutting expenses and because of health care and prices and all that. We just give the patients the best available possible treatment.” Patient volume at the center has been growing, says Lavagnini, due in part to the fact that they always have the latest technology.
The future of radiotherapy
“Emerging markets will probably drive the growth,” says Jain, who predicts that more companies will create cheaper equipment that will better meet the needs of growing markets. “Between China and India you have around three billion population and currently the penetration is less than 10 percent, so the major growth will come from there.”
In reference to the economic crisis and health care reform, Goldwein says practices are well aware change is coming. “They all know that the bucket is getting closer and closer to empty and they are going to be looking for ways to be more efficient. They are nervous about reimbursement . . . they will have to manage their practices accordingly.”
“I think the future is going to see gravitation toward treatments that are more tailored to each patient’s needs,” says Dawood. “So rather than just treating in a uniform manner, you actually have technologies that are very flexible, patient-specific technologies, and able to deliver patient-specific treatments.”
GlobalData forecasts that the global radiation therapy devices market will grow at around 8 to 10 percent for the next seven or eight years. Experts in the sector agree: radiotherapy technology will continue to improve and the patient outlook will improve with it.
DOTmed Registered Radiotherapy 2011 Companies
Names in boldface are Premium Listings.
Domestic
Pete Cawley, Kimtron Medical, LLC, CT
DOTmed Certified
Michaelle Serrano, Platinum Medical Imaging, FL
Alison Fortin, Global Inventory Management LLC, NH
DOTmed Certified
DOTmed 100
Mel Little, The Lennon Group, TN
International
Maged el Sayed, Midlle East Technomed, Egypt