Accuray Inc., based in Sunnyvale, Calif., and Erasmus MC, the largest university medical center in the Netherlands, recently announced that the first patient has been successfully treated using an online-adaptive (OA) approach together with the CyberKnife system. The patient, treated for oligometastases in the pelvic region, is part of a new clinical trial conducted at Erasmus MC evaluating OA stereotactic body radiation therapy (SBRT) delivered by the CyberKnife platform. The trial brings the hospital one step closer to its goal of providing individual, personalized medicine.

“At Erasmus MC our goal is to use innovative approaches to provide customized, effective treatments that help extend or improve the quality of life of people diagnosed with cancer, regardless of the stage of their cancer diagnosis,” says J.J. Nuyttens, MD, PhD, radiation oncologist, department of radiation oncology, Erasmus MC. “We initiated this trial because we want to improve local cancer control and minimize toxicities in people with pelvic or intra-abdominal oligometastases.”

Oligometastastic disease occurs when cancer cells from the primary tumor travel to other parts of the body and form a small number (less than six) of lesions. The cancerous cells are in an intermediate state; they are no longer confined to their initial location nor have they spread widely throughout the body. Radiation treatment of oligometastatic disease in the pelvic or intra-abdominal area is challenging because of the close proximity of healthy organs very sensitive to radiation. From one day to the next there can be a significant variation in the position of these organs, and it can be difficult to account for the changes in their location on a daily basis.

To address this issue, Accuray and Erasmus MC are partnering to develop an integrated, advanced, imaging solution tailored for use with the CyberKnife system. The purpose is to enable clinicians to adapt the treatment plan to daily anatomical changes within the patient. According to Nuyttens, “this OA-SBRT strategy provided the treated patient with an optimal combination of dose to the tumor and sparing of the surrounding healthy organs.”

“We are thrilled to have the opportunity to collaborate with Erasmus MC on the first step of a longer-term CyberKnife initiative to enhance the quality of care clinicians can offer to their patients,” says Fabienne Hirigoyenberry-Lanson, PhD, vice president of global medical and scientific affairs at Accuray. “We believe a system that provides clinicians with the ability to tailor the treatment on a daily basis through a fully automated solution, and track and automatically correct for tumor or patient movement throughout the treatment, has the potential to create a paradigm shift in the way radiation is delivered and in cancer care.”