Novalis^® Shaped Beam Surgery
Offers Advanced Radiation
Technology to Treat Tumors

In these brain images, each color is a dose cloud representing a percentage of the total dose that the area would receive.

The Regional Cancer Center at Wellington has added the newest and most sophisticated radiation treatment system available today to their arsenal of radiation therapy technologies, called Novalis Shaped Beam Surgery from BrainLAB. The Regional Cancer Center is the only treatment center in Southeast Florida and one of only 48 treatment centers across the country to offer this advanced radiation technology.

What It's Used For
Novalis^® Shaped Beam Surgery by BrainLAB is a dedicated system for noninvasive stereotactic radiosurgery and radiotherapy. First implemented for the treatment of brain tumors or lesions, where pinpoint precision is required, radiation oncologists are now taking advantage of the accuracy of Novalis to treat other areas of the body and improve the range of a patient's treatment options. Novalis can be used to treat:

• Cancers or benign lesions that have started in the brain or spread to the brain.
• Arteriovenous malformations (a type of vascular disorder) of the brain.
• Functional brain disorders (e.g. trigeminal neuralgia/tic douloureux).
• Relatively small tumors in other areas of the body, such as the head and neck, prostate, liver, spine or certain other areas near bony landmarks or where metallic markers can be surgically implanted.
• Tumors located so close to sensitive normal structures that it would be dangerous to treat the tumor with standard radiation techniques, such as tumors close to the spinal cord. This is exceptionally beneficial in situations where the region has been previously irradiated.

Treatment Options
With this innovative treatment, high-energy radiation beams damage tumor cells and cause them to die. Novalis Shaped Beam Surgery is either applied in a single session with a high dose of radiation, called stereotactic radiosurgery, or in a series of treatments over a period of time, called fractionated stereotactic radiotherapy. Fractionated stereotactic radiotherapy involves similar doses of radiation to stereotactic radiosurgery, but the radiation is delivered in smaller amounts. The radiation oncologist prescribes the most-appropriate technique for the patient based on the size and location of the tumor or lesion.

Novalis^® frameless X-ray positioning according to a patient's anatomy
PHOTO COURTESY OF BRAINLAB AG.

How It Works
With Novalis, micro-multileaf collimation shapes the radiation beams to precisely match the contour of the tumor or lesion. During treatment, Novalis steadily moves around the patient's body so that the radiation penetrates the target from different angles.

Computer software calculates the angles of the beams that will best treat the targeted area. While that area receives the full dose, the surrounding healthy tissue only receives a small percentage of the radiation dose. This reduces potential damage to delicate structures, such as the brain stem and spinal cord.

Novalis also combines multiple advanced technologies for image guidance. Patients are positioned using X-rays and infrared three-dimensional real-time imaging. The X-ray system can use both bony landmarks and implanted metallic markers. The Novalis computer then analyzes these images to move the patient to the precisely intended position.

"This technology is one of the fi rst and is the only one available that incorporates image guidance and precise shaping of radiation beams to conform to the tumor, using X-rays and an infrared localization positioning system," says Kishore K. Dass, MD, Chief Radiation Oncologist and Medical Director of The Regional Cancer Center. "We can now use image guidance to evaluate the movement of the lung or liver with respiration, and adjust the radiation beam to the movement of the tumor."

Novalis is noninvasive, with the exception of the small radio-opaque markers the surgeon implants. Treatment is virtually painless and usually performed on an outpatient basis.

For More Information
At The Regional Cancer Center at Wellington, board-certifi ed radiation oncologists and experienced treatment teams provide comprehensive radiation therapy and follow-up care to thousands of patients each year. For more information about this exciting technology, please call The Regional Cancer Center at 561-793-6500.

Kishore K. Dass, MD, is a board-certified radiation oncologist and Medical Director of The Regional Cancer Center. Dr. Dass is a graduate of the Loyola University Chicago Stritch School of Medicine and an alumnus of the Cleveland Clinic Foundation, Cleveland, Ohio, where he was instrumental in the development of stereotactic radiosurgery.

Wellington Regional Medical Center, 10101 Forest Hill Blvd. Wellington, FL 33414 (561) 798-8500