Estonian Cancer Patients Have Access to More Conformal Radiotherapy Treatments for First Time with Unveiling of Advanced Varian Treatment Machine
North Estonia Regional Hospital, which serves two-thirds of Estonia’s 1.4 million population, has doubled its linear accelerator capacity with the acquisition of a Varian Clinac(R) DHX equipped with a Millennium(TM) 120-leaf collimator, enabling more conformal radiotherapy treatment. “We have moved from conventional radiotherapy to conformal radiotherapy for the first time,” says senior physicist Eduard Gerskevitch. “The collimator’s finer leaves allow clinicians to conform the treatment beam tighter to the tumor and limit irradiation of normal healthy tissue.
“This new equipment has enabled us to improve the quality of our treatments while reducing waiting lists. Our waiting times have reduced from five weeks to three weeks, although we’ve achieved this with a heavy workload on our machines.”
This workload increased shortly after the new machine arrived, when an older device at the only other Estonian radiotherapy hospital broke down and all that hospital’s patients were transferred to the North Estonian Regional Hospital. “At present we are the only hospital in the country treating patients with a linear accelerator and we are extremely busy,” said Maire Kuddu, chief radiation oncologist. Staff at the hospital are working double-shift on both machines as they attempt to cope with more than 130 patients a day.
Despite this heavy workload, the team has been able to introduce advanced IMRT for head and neck cancer patients. Intensity modulated radiotherapy enables clinicians to ‘sculpt’ the dose to the shape of the tumor and avoid more surrounding healthy tissue. For head and neck patients, it means more precise treatments and less potential harm to nearby salivary and parotid glands.
The new device was funded by the hospital with support from the International Atomic Energy Agency, which provided additional financing and helped to train staff in the use of the equipment, and the Environmental Investment Centre, which helped to decommission an older Cobalt-based treatment unit and refurbish the bunker for the new accelerator.
“We are delighted to be able to double both our own and the country’s linear accelerator treatment capacity and introduce advanced radiotherapy techniques at the same time,” adds Maire Kuddu. She said the hospital’s future plans include equipping the new machine with an On-Board Imager(R) and introducing Varian’s RapidArc(TM) capability for fast and precise image-guided IMRT.
“It is recognised that this is a major improvement in the country’s cancer treatment capabilities but this is just a start,” added Eduard Gerskevitch. “The number of treatment units is still very low compared with our needs and we will need to see further investment in radiotherapy in the future.”
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