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RapidArc™

radiotherapy technologyVasthi Wilson, MD, MScNew Jersey Health NetworkEgg Harbor Township, NJ

The Evolution of Arc Therapy

Unshaped Arcs

I M P R O V I N G P R E C I S I O N A N D S P E E D

19651965RapidArc™

radiotherapy technology

2008200820002000Dynamic Conformal Arcs

20032003Slice Based Arcs

RapidArc Single Arc IMRT

RapidArc Objectives• Dose conformity • Tissue sparing

• Plan complexity• Treatment time• Risk of secondary

cancer

RapidArc Dose Conformity - Prostate

RapidArcSingle arc IMRT

Conventional5-field IMRT 719 MU589 MU

RapidArcSingle arc IMRT

Conventional5-field IMRT 719 MU589 MU

RapidArc Dose Conformity - Prostate

RapidArc (solid) IMRT (dashed)PTV

BladderRectum

RapidArc Dose Conformity - Prostate

RapidArc Dose Conformity - Spine

RapidArcSingle arc IMRT

SBRT11-field IMRT 3072 MU2174 MU

VARIAN Medical

Systems

RapidArc Dose Conformity - Spine

RapidArcSingle arc IMRT

SBRT11-field IMRT 3072 MU2174 MU

RapidArc Dose Conformity - SpineRapidArc (solid) IMRT (dashed)

PTV

Spinal Cord

Lungs

• Dose conformity • Tissue sparing

• Plan complexity• Treatment time• Risk of secondary

cancer

RapidArc Objectives

RapidArc Tissue Sparing – H&N

RapidArcSingle arc IMRT

Conventional7-field IMRT 1685 MU496 MU

RapidArc Tissue Sparing – H&N

RapidArcSingle arc IMRT

Conventional7-field IMRT 1685 MU496 MU

RapidArc Tissue Sparing – H&NRapidArc (solid) IMRT (dashed)

PTV 1PTV 2

Brainstem

CordLt Parotid

Rt ParotidRt SMG

LarynxMandible

• Dose conformity • Tissue sparing

• Plan complexity• Treatment time• Risk of secondary

cancer

RapidArc Objectives

RapidArc Plan Simplicity

• Single IMRT arc• 15-30 minutes

to optimize• 10-20 minutes

to calculate• Eclipse™ treatment

planning system module

• Dose conformity • Tissue sparing

• Plan complexity• Treatment time• Risk of secondary

cancer

RapidArc Objectives

RapidArc Treatment Time

• Treat in 2 minutes or less

• Efficient in monitor units (MU) < 600 MU/ 2Gy

RapidArc Treatment Time

• Speed is accuracy– Greater patient comfort– Reduced external motion (wiggle factor)– Reduced internal motion (peristaltic motion)

RapidArc Treatment Time

• Economics– Treat 16 more patients per day

• Increase from 32 to 48 treatments• 15 minute standard treatment schedule• 10 minute RapidArc treatment schedule• Make time for more complex treatments• SRS, IGRT, DART™ dynamic adaptive radiation

therapy

• Dose conformity • Tissue sparing

• Plan complexity• Treatment time• Risk of secondary

cancer

RapidArc Objectives

RapidArc Reduced Risk

• 30-60% fewer monitor units– Lower risk of secondary

cancer induction– Less head scatter– Less MLC leakage

RapidArc Summary

• Treat in under 2 minutes• Reduce out of field dose• Simple planning and treatment• Large treatment volume• No compromises

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