Barretos Cancer Hospital, on the largest public hospitals in Brazil, has acquired a Elekta therapy and planning system, and has also become the first Latin American centre to acquire Clarity soft tissue visualisation software. The Elekta products, which include the Synergy Platform, Monaco and XiO treatment planning systems, were delivered in August 2012. According to the US National Cancer Institute, cancer is the second leading cause of death in Brazil, with lung, prostate and stomach cancers representing the highest cancer mortality rates among males. Cancer mortality rates for Brazilian females are highest in breast, cervical and lung cancers.
The Synergy platform is designed to enable simple integration of the key imaging technologies that will transform an advanced linear accelerator into an IGRT system. This upgrade allows clinicians to bring image guidance into the treatment set up process, with the patient in the treatment position and ready moments before therapy. The integrated imaging workflow process enables clinicians to correct patient setup errors due to organ motion and increase treatment accuracy. Imaging tools include 3D volumetric cone beam imaging for soft tissue visualisation; 2D real-time, fluoroscopic-like imaging for targets that move frequently; and 2D kV imaging for standard planar imaging.
Barretos plans to use the Synergy platform to treat many of its patients employing volumetric modulated arc therapy (VMAT), in which the treatment beam travels in single or multiple high-speed arcs around the patient, significantly reducing beam delivery time. The hospital will use its two Clarity systems to provide image guidance for soft tissue targets. The centre also intends to pursue clinical studies on the planning benefits of integrating 3D ultrasound with CT based planning. This work will explore the local applicability of a relatively low-cost imaging system that could be retrofitted on existing equipment in the region.