ASTRO 2017: The four top takeaways
October 04, 2017
by Lisa Chamoff, Contributing Reporter
The radiation oncologists, engineers and software developers in San Diego for the 59th American Society for Radiation Oncology (ASTRO) meeting last week all had a main goal of treating and curing cancer with increasingly precise, cutting-edge therapies.
However, the focus of this year’s meeting, with a tagline of “the healing art and science of radiation oncology,” went beyond tumors and technology and included the overall well-being of the patient — more specifically, their comfort and mental health when grappling with a terrifying diagnosis. Here are our four key takeaways from the booth tours, presentations and abstracts presented at the show, brought to you by the letter ‘P.’
1. Planning
“Plan twice, irradiate once” may well be the radiation oncologist’s mantra. Radiotherapy planning tools, such as Accuray’s PreciseArt adaptive radiation therapy planning software and Philips’ new RTdrive MR Prostate with MR-based auto-contouring, were a big focus of the show. These tools promised a faster way for clinicians to determine the adequate dose while sparing the surrounding healthy tissue.
“Without this, normally what we did in the past was a manual process,” X. Allen Li, chief of medical physics in the Department of Radiation Oncology at Medical College of Wisconsin, told HCB News about his experience with Accuray’s PreciseArt solution, used with the company’s Radixact radiation therapy system. “Before it probably took easily a half hour or an hour, now it just takes a few minutes.”
While changing course during treatment may seem like a thing of the future, ViewRay is already there with its MRIdian Linac, a linear accelerator-based MR-guided radiation therapy system that allows MR imaging for adaptive planning during treatment. It is already showing results in treating pancreatic cancer patients with higher doses of radiation. Elekta also displayed a system, called the Unity, that combines MR and linear accelerator technology, though it has not been submitted for FDA clearance.
2. Precision
Along with planning, the radiation therapy equipment on the market also promises more precise targeting of tumors. Varian showed off its FDA-cleared Halcyon image-guided volumetric intensity-modulated radiotherapy (IMRT) system, which has an innovative beam shaping system that allows clinicians to modulate the radiation beam to the tumor; its FDA-pending HyperArc high-definition radiotherapy (HDRT) system treats individual metastases in the brain, instead of the whole brain, to help patients maintain cognitive ability.
3. Proton therapy
Proton therapy continues to move into the mainstream. On the show floor, P-Cure showcased its gantry-less proton therapy system, which delivers the therapy in a seated position. This is more comfortable than a supine position and allows some patients to breathe more easily. One P-Cure customer has moved their lung cancer and head and eye patients to the gantry-less room; head and neck and breast cancer are the next frontiers, said P-Cure Chief Executive Officer Michael Marash.
Elekta announced a collaboration with proton therapy company Ion Beam Applications to develop new functionality for proton therapy treatment in Elekta’s Monaco treatment planning system and MOSAIQ oncology information system, integrating IBA’s products into Elekta’s software solutions.
Varian is also in the process of planning to install a proton therapy center, The New York Proton Center, in Manhattan.
4. Focus on the whole patient
Patient comfort is always paramount during treatment, but several studies, as well as the keynote by ASTRO President Brian Kavanagh, focused on the mental health issues that arise during cancer treatment.
One study found that nearly half of all patients who reported having severe distress subsequently missed one or more radiation therapy appointments, compared with fewer than 20 percent of patients who reported lower levels of distress. Another study showed that of the 40 percent of patients at an urban cancer center in Newark, New Jersey, diagnosed with depression, three in four had not previously been told they had depression.
Kavanagh shared his experience with one of his former patients, Dee-Anna, showing how, through poetry, she processed her feelings on having a terminal illness, giving him a glimpse into her journey that he might not have otherwise seen through their regular appointments.
However, the focus of this year’s meeting, with a tagline of “the healing art and science of radiation oncology,” went beyond tumors and technology and included the overall well-being of the patient — more specifically, their comfort and mental health when grappling with a terrifying diagnosis. Here are our four key takeaways from the booth tours, presentations and abstracts presented at the show, brought to you by the letter ‘P.’
1. Planning
“Plan twice, irradiate once” may well be the radiation oncologist’s mantra. Radiotherapy planning tools, such as Accuray’s PreciseArt adaptive radiation therapy planning software and Philips’ new RTdrive MR Prostate with MR-based auto-contouring, were a big focus of the show. These tools promised a faster way for clinicians to determine the adequate dose while sparing the surrounding healthy tissue.
“Without this, normally what we did in the past was a manual process,” X. Allen Li, chief of medical physics in the Department of Radiation Oncology at Medical College of Wisconsin, told HCB News about his experience with Accuray’s PreciseArt solution, used with the company’s Radixact radiation therapy system. “Before it probably took easily a half hour or an hour, now it just takes a few minutes.”
While changing course during treatment may seem like a thing of the future, ViewRay is already there with its MRIdian Linac, a linear accelerator-based MR-guided radiation therapy system that allows MR imaging for adaptive planning during treatment. It is already showing results in treating pancreatic cancer patients with higher doses of radiation. Elekta also displayed a system, called the Unity, that combines MR and linear accelerator technology, though it has not been submitted for FDA clearance.
2. Precision
Along with planning, the radiation therapy equipment on the market also promises more precise targeting of tumors. Varian showed off its FDA-cleared Halcyon image-guided volumetric intensity-modulated radiotherapy (IMRT) system, which has an innovative beam shaping system that allows clinicians to modulate the radiation beam to the tumor; its FDA-pending HyperArc high-definition radiotherapy (HDRT) system treats individual metastases in the brain, instead of the whole brain, to help patients maintain cognitive ability.
3. Proton therapy
Proton therapy continues to move into the mainstream. On the show floor, P-Cure showcased its gantry-less proton therapy system, which delivers the therapy in a seated position. This is more comfortable than a supine position and allows some patients to breathe more easily. One P-Cure customer has moved their lung cancer and head and eye patients to the gantry-less room; head and neck and breast cancer are the next frontiers, said P-Cure Chief Executive Officer Michael Marash.
Elekta announced a collaboration with proton therapy company Ion Beam Applications to develop new functionality for proton therapy treatment in Elekta’s Monaco treatment planning system and MOSAIQ oncology information system, integrating IBA’s products into Elekta’s software solutions.
Varian is also in the process of planning to install a proton therapy center, The New York Proton Center, in Manhattan.
4. Focus on the whole patient
Patient comfort is always paramount during treatment, but several studies, as well as the keynote by ASTRO President Brian Kavanagh, focused on the mental health issues that arise during cancer treatment.
One study found that nearly half of all patients who reported having severe distress subsequently missed one or more radiation therapy appointments, compared with fewer than 20 percent of patients who reported lower levels of distress. Another study showed that of the 40 percent of patients at an urban cancer center in Newark, New Jersey, diagnosed with depression, three in four had not previously been told they had depression.
Kavanagh shared his experience with one of his former patients, Dee-Anna, showing how, through poetry, she processed her feelings on having a terminal illness, giving him a glimpse into her journey that he might not have otherwise seen through their regular appointments.