Trilogy precisely targets tumors with high-dose radiation, spares normal tissue
The University of Maryland Marlene and Stewart Greenebaum Cancer Center is the first cancer center in Maryland to treat patients with Trilogy, a powerful new image-guided radiation therapy system that delivers high-dose radiation to even the smallest tumors. The equipment can target an area as small as a pencil point, minimizing the damage to healthy tissue. It also delivers radiation doses more than 60 percent faster than conventional linear accelerators used to treat cancer, which means that patients can receive treatments in much less time.
“Trilogy is the newest and latest advance in radiation treatment technology. This state-of-the-art system combines the individual strengths of previous-generation technology, such as Novalis, Cyberknife and TomoTherapy, in one machine. It gives us maximum flexibility in developing the most effective treatment plans for our patients,” says William F. Regine, M.D., professor and chairman of the Department of Radiation Oncology at the University of Maryland School of Medicine and chief of radiation oncology at the University of Maryland Medical Center.
Unlike other systems, Trilogy can deliver all forms of external-beam radiation therapy – from conventional radiation treatment and intensity modulated radiation therapy (IMRT) to the newest and most advanced techniques, such as image-guided radiotherapy (IGRT) and stereotactic body radiotherapy (SBRT). Trilogy’s built-in imaging system can pinpoint the size and location of a patient’s tumor moments before each treatment, and a "respiratory gating" component automatically synchronizes the radiation beam to the patient’s breathing.
"With Trilogy, we can choose the best treatment option for each patient, whether the cancer is in the chest, abdomen, or head-and-neck area. Patients who come to our cancer center now have all of the latest radiation therapy options available in one place," Dr. Regine says.
Nearly two-thirds of cancer patients receive radiation therapy, either alone or combined with chemotherapy or surgery. Traditional radiation therapy is delivered in small daily doses over the course of weeks. With Trilogy, radiation oncologists can target even the smallest tumors with stereotactic radiotherapy, which is given over a period of several days. Stereotactic procedures deliver concentrated, high-dose radiation directly to the tumor with the help of sophisticated imaging and a three-dimensional coordinate system to map the treatment area.
“For some patients, this type of targeted, high-dose radiation therapy is a very effective, noninvasive alternative to surgery,” says Mohan Suntharalingam, M.D., associate professor and vice chairman of the Department of Radiation Oncology and associate director of the cancer center. “With Trilogy’s advanced technology, we can now treat tumors that are close to vital organs without destroying nearby healthy tissue.”
He notes that the University of Maryland Medical Center is already a leader in performing stereotactic radiosurgery on the brain, opening the first Gamma Knife center in the mid-Atlantic region in 1992. Since then, more than 2,000 patients with brain tumors and brain disorders have been treated with this system, which targets tumors with 201 beams of radiation.
The Trilogy linear accelerator, made by Varian Medical Systems, rotates around the patient to deliver radiation treatments from virtually every angle and sculpts the beam to the shape of the tumor. High-tech imaging equipment in robotically controlled arms mounted on the machine provides real-time images used to automatically adjust the patient’s position. The system provides several kinds of images, including three-dimensional CT (computed tomography) scans.
"We can give higher doses of radiation to a smaller area over a shorter period of time. This not only allows us to treat cancers when they are small and most curable, but it also reduces side effects and makes the whole treatment process more comfortable for patients," says Cedric Yu, D.Sc., chief medical physicist and professor of radiation oncology at the University of Maryland School of Medicine.
Dr. Yu heads a nationally recognized team of medical physicists who work with the cancer center’s radiation oncologists to devise the most effective treatment plans for patients. "We assist the physicians in using our technology to the very limits of its capability, which maximizes the options available to patients. Through our research, we are developing new approaches to deliver even higher doses of radiation more safely and efficiently," he says.
Because of the strength and reputation of its radiation oncology program, the University of Maryland Marlene and Stewart Greenebaum Cancer Center is one of four centers in the country to have signed a master research agreement with Varian Medical Systems to develop new radiation technologies.
State-of-the-art radiation therapy is just one of the many medical advances available to patients at the cancer center, which is a national leader in offering innovative approaches to cancer diagnosis, treatment and research.