BALTIMORE — For the past three or four decades, radiation treatments have been made by electricity through a linear accelerator and targeted to tumors and patients' bodies.
With more beams going at that tumor, the more conformal you can be and at the same time, you can hopefully avoid normal tissues. As the ability to deliver radiation has changed, doctors have been able to increase the dose of radiation to the tumor with much less to the normal tissues.
"This is translating into much less side effects for either the same or in many cases, more dose of radiation to the tumor, which has given better results," Dr. Paul Fowler, a radiation oncologist and chief of Radiation Oncology at MedStar Good Samaritan Hospital.
In the past few years, Halcyon radiation technology has been used to treat cancer in patients, and MedStar was among the first few to implement the machines.
The unit they have at MedStar was installed a little more than two years ago in October 2018. Fowler said this is the second version of the brand new machine and they've had people from all over the world come to Baltimore to see what they're doing with the machine and how it's working.
He says they're on the cutting edge of this particular technology.
The difference between the new and old technology is that it not only makes the process more comfortable for the patients, but it also allows the doctors to do the treatment more quickly which allows for increased formality around the tumor because the patient doesn't have to hold still as long.
"The more the patient's actually on the table getting a treatment, the more a tumor can move and the more tumor moves during treatment, the more margin you have to get to make sure you're treated every day," Fowler explained.
Even the machine itself is more comfortable. The couch where the patient lays actually is a lot more adjustable and movable than a traditional linear accelerator.
"The patient is placed on the machine and then the patient has moved into position as they're going to be treated," Fowler detailed. "Images are taken of the tumor and the patient at the same time with a cone beam CT, which is actually CAT scan slices that are done on the treatment machine."
As soon as those images are processed the computer, the therapist and the doctor look at those images and make sure they're exactly the way it was planned.
In what would usually take about 15 minutes for treatment, can then be cut down in about half the time. Fowler said for the patients, they're in a lot less discomfort because they're not having to hold themselves in positions that may not be very comfortable.
He calls it a revolution in terms of the comfort level. localization of the tumor and the ultimate outcome of treatment.
"It's shorter imaging, it's shorter positioning and more comfortable positioning and shorter treatment time," Fowler said. "So all the parts that are part of a standard radiation treatment, they're the same parts, they're just done much more efficiently. And ultimately I think that leads to improvement and patient comfort as well as outcome."