The Clínica Universidad de Navarra has acquired, and already applied in cancer patients, the most advanced linear accelerator for external radiotherapy treatments. It is the first model Elekta Versa HD to go into operation in Spain. The main advantages of the new equipment include a treatment speed up to ten times faster than that of any conventional accelerator, as well as the reduction of the number of sessions issue . It also offers greater precision in the administration of the radiation dose with the acquisition of images in 4 dimensions, which avoids the risk to healthy organs adjacent to the lesion as much as possible. And, as a whole, it provides greater comfort for the patient.

Thus, while a normal intensity-modulated external beam radiation therapy (IMRT) session lasts between 20 and 40 minutes, with the new linear accelerator the session is reduced to about 10 minutes and the time dedicated exclusively to irradiation is estimated to be between 1 and 2 minutes.

Regarding the new linear accelerator, Dr. Rafael Martínez Monge, director of the Clinic's Radiation Oncology Service, emphasizes that the technology incorporated in this state-of-the-art equipment "will allow us to individualize the treatment of all oncology patients much more precisely. In this sense, he warns that current oncology "is very different from what was done 10 or 20 years ago and the multiplicity of surgical, chemotherapy, hormone therapy or targeted therapy treatments, make it absolutely necessary that the administration of radiation can be done in a much faster, more precise and versatile way within the management of the oncology patient, multidisciplinary ".

Real-time tumor testing, 4D technology

Among other advantages of the new equipment, it is worth highlighting the obtaining of CT images (scanner) of higher quality than those of conventional accelerators. This minimizes the movement of the tumor at each moment and therefore the uncertainties in the administration of the treatment.

To achieve this goal, the CT scanner incorporated in the accelerator uses 4D technology, "which means that when we reconstruct the images we can observe the real movement of the tumor and check whether the radiation treatment is adapted to the tumor's movement, which is a great advantage over what we already had," points out Dr. José Javier Aristu, a specialist in the Service. This technology is very useful for treating larger tumors mobility, such as lung tumors, since it makes it possible to visualize the respiratory movement volumetrically and adjust the distribution of the radiation dose to adapt it to the real movement of the tumor, thus avoiding toxicity.

The equipment acquired by the Clinic also adds the possibility of radiotherapy with ultrasound-guided imaging, a technique that allows real-time visualization of a specific organ during treatment. "This system brings great benefit, for example, in the treatment of prostate cancer, as it allows us to monitor its exact location at all times. This makes it possible to further adjust the distribution of radiation and thus exclude a larger volume of healthy Structures from the high doses of irradiation," Dr. Aristu points out.

Research

The new accelerator provides the Clinic's team with the possibility of researching new treatments. Specifically, the incorporated imaging system will make it possible to develop treatment strategies that allow the radiotherapy plan to be adapted to the variations that the tumor and/or the patient may experience. " This option will also make it possible to develop faster treatments, not only in terms of irradiation time during each fraction, but also in terms of treatments that are really adapted to the movement, changes or deformations that the tumor may undergo over time," says Dr. Diego Azcona, radiophysicist at the Service.

Thus, the line of research that will be developed at the Clinic aims to offer patients more effective, faster and more comfortable treatments.