A Medical Device Daily

Doctors in the Netherlands have used RapidArc technology from Varian Medical Systems (Palo Alto, California) to treat four early stage lung cancer patients in what is believed to be among the world's first treatments of their kind.

Clinicians at VU University Medical Center (Amsterdam) now plan to replace conventional stereotactic radiotherapy treatments with RapidArc for all such patients.

A 57-year-old male, diagnosed with a 1.2 cm-diameter non-small cell lung tumor in the right upper lobe and deemed unfit for surgery as a result of severe emphysema, was the first patient to receive the pioneering radiotherapy treatment at the hospital in early September.

"We normally use ultra-precise stereotactic radiotherapy in these cases and we have now treated more than 400 such patients in this way," said Ben Slotman, MD, chairman of the hospital's department of radiation oncology. "But RapidArc offers some real time-savings over stereotactic radiotherapy and its use in this case is a real breakthrough for us and our patients."

The pioneering treatment was delivered in less than 15 minutes vs. the 30 to 45 minutes normally needed by the team at VU University Medical Center to treat lungs with image-guided intensity-modulated radiotherapy (IMRT). The treatment was delivered using six arcs — or rotations — of the treatment machine around the patient. RapidArc delivers a volumetric radiotherapy treatment in a single or multiple arcs of the treatment machine around the patient.

"We were very pleased with how the treatment went," said Suresh Sunan, MD, professor of clinical experimental radiotherapy. "The online patient setup using cone beam CT scans allowed direct visualization of the tumor just prior to fast treatment delivery using RapidArc, all of which greatly increased the confidence of the treatment team in the precision of delivery. The high dose radiation area was restricted to the tumor and the surrounding healthy tissue and critical organs received very low doses.

"Due to the high precision and the speed of treatment delivery, and the associated increase in patient comfort, RapidArc will eventually replace all conventional' stereotactic treatments for early stage lung cancer at our hospital," Sunan said.

RapidArc was introduced by Varian earlier this year and to date more than 30 hospitals around the world are using this new technology for advanced, precise and fast treatments. Non-small cell lung cancer treatments require extremely precise radiotherapy delivery to avoid affecting surrounding critical organs. Worldwide, lung cancer is the leading cause of cancer death in men and the second leading cause of cancer death in women.

Reliant 2.0 in European launch

Cheetah Medical (Tel Aviv, Israel/Portland, Oregon) reported the European launch of its Reliant 2.0 system.

In addition to core hemodynamic parameters — including cardiac output, cardiac index and stroke volume — the Reliant 2.0 adds new parameters to provide a comprehensive suite of information for hemodynamic monitoring, all without the need for invasive modalities with the associated potential costs and risks.

The new parameters include noninvasive blood pressure, total peripheral resistance, stroke volume variation, cardiac power, and change in thoracic fluid content.

"Accurate continuous hemodynamic monitoring to support real-time decisions on fluids and drugs is today a critical component of diagnosis and treatment in many acute conditions, thanks to substantial improvement in patient outcomes," said Cheetah CEO Yoav Avidor, MD. "We believe that the Reliant monitor provides the accurate, noninvasive monitoring solution physicians need in order to implement cutting-edge clinical protocols across a wide array of patients in a cost-effective fashion."

The Reliant hemodynamic monitoring platform is powered by Cheetah's Bioreactance technology, which has been used in more than 2,000 patients in various clinical settings, including medical and surgical intensive care, perioperative care, emergency medicine, heart failure, hemodialysis and exercise testing.

Pre-filled saline syringes from Baxa

Baxa Ltd. (Bracknell, UK) reported adding a line of pre-filled saline intravenous flush syringes for catheter care in UK health systems.

Baxa ZR sterile, pre-filled saline IV syringes provide a safe and effective alternative to flushes drawn from multi-dose vials or filled manually. The company said ZR syringes "provide ease of administration, convenience, reduction in the risk of errors, increased assurance of sterility, lower costs and less shelf-space than their alternatives, while promoting best practice in IV care."

Terry Aston, managing director of Baxa Ltd., said, "The time is right for pre-fills in the UK. Research and industry best practice widely acknowledges that the greater the number of procedures in preparation of medication, the greater the risk of cross-contamination. ZR pre-filled syringes reduce risk and are far more convenient to use."

The new flush syringes are available as 10mL and 5mL units. Each syringe is clearly labeled to reduce liquid medication errors. Their clear syringe barrels assist visual inspection prior to use; a pull-off tip cap indicates whether the seal is broken and also prevents syringe re-use. Each ZR syringe has a two-year shelf life. Expiration dates are clearly visible to nursing staff.

Baxa said that to date, the UK healthcare community has been relatively slow to adopt pre-filled syringes, yet they are widely used elsewhere in Europe. "With fear of contracting an infection high on the list of patients' concerns as they enter hospitals as day patients and with new guidance and compliance governing the administration of liquid and IV medication," it said, "it is expected that safer, more convenient, pre-filled syringes will become an everyday method for flushing IV lines."

The product launch is a result of a distribution agreement between Baxa and Excelsior Medical (Neptune, New Jersey).

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