A Medical Device Daily

Varian Medical Systems (Palo Alto, California) has been selected to supply advanced radiotherapy equipment for a major project that will bring state-of-the-art radiotherapy treatments closer to hundreds of thousands of Dutch cancer patients.

Dr. Bernard Verbeeten Institute (BVI; Tilburg, the Netherlands) placed an order with Varian in July to acquire five medical linear accelerators, which are used to deliver radiotherapy treatments. The new machines — including a Trilogy accelerator, which Varian characterizes as “the most advanced of its kind” — will be situated at the institute’s Tilburg headquarters and at two new satellite centers being constructed in the nearby cities of Breda and Den Bosch.

Jack Venselaar, medical physicist at the oncology clinic, said, “Both these cities have large populations but they have never had any radiotherapy facility in the city-based hospitals and patients have had to travel more than 30 kilometers to Tilburg. We want to support our patients by bringing radiotherapy closer to them, especially [since] treatments are fractionated and require multiple visits. It is time to build satellites for these cities and reduce travel times and costs.”

A Trilogy linear accelerator will be installed at the Tilburg site in December. The company said a fully-accessorized Trilogy accelerator, equipped with Varian’s On-Board Imager for fast and effective image guidance, “is capable of offering all standard radiation therapies as well as the most advanced treatments such as intensity modulated radiotherapy, image-guided radiotherapy and whole-body stereotactic radiosurgery.”

Each of the two new satellite clinics will be equipped with two Varian Clinac iX accelerators.

Work will begin in early 2008 to construct new radiotherapy treatment rooms alongside the new hospital site in Den Bosch and the existing hospital in Breda. Both new radiotherapy departments will remain part of the Dr. Bernard Verbeeten Institute.

It is expected that all machines will be installed and operating clinically by the summer of 2009.

BVI currently has six linear accelerators at Tilburg, some of which will be replaced as part of the project. “We wanted five new machines to take us into the future and it was evident after the tender process was completed that Varian would be the most attractive partner for us going forward,” said Venselaar. He said the institute is aiming to become the third-largest radiotherapy center in the Netherlands, offering treatments to the 1.2 million residents in the Noord-Brabant region.

Varian Medical supplies informatics software for managing comprehensive cancer clinics, radiotherapy centers and medical oncology practices and is a supplier of tubes and digital detectors for X-ray imaging in medical, scientific and industrial applications. It also supplies X-ray imaging products for cargo screening and industrial inspection.

‘Promising’ results with Aspire system

Physicians at Antwerp University Hospital (Antwerp, Belgium) have successfully treated patients with obstructive sleep apnea (OSA) with a novel surgical procedure involving Aspire Medical’s (Sunnyvale, California) Advance System, which consists of an implant in the tongue and lower jaw to prevent upper airway collapse during sleep.

The company said the preliminary results of this new procedure in the first 10 patients treated are “promising.”

Earlier this year, an Antwerp University Hospital team headed by ENT surgeon. Evert Hamans, MD, performed the procedure successfully for the first time worldwide. Results of the follow-up examinations on the first 10 patients became available this week. A “significant improvement of apnea index was achieved in all the patients,” Aspire said, and snoring and daytime sleepiness were “significantly reduced.”

OSA-related airway obstruction results in a shortage of oxygen and fragmentation of sleep. In Western Europe and the U.S., 4% of men and 2% of women suffer from OSA, according to the company.

“The most common complaints include loud snoring, excessive daytime sleepiness and cognitive impairment,” Aspire said in a statement. “In some patients the sleepiness is pronounced and potentially dangerous, as it could result in car-accidents. Long-term, these patients have a higher risk of cardiovascular disease.”

The current “gold standard” treatment for OSA is continuous positive airway pressure (CPAP), which includes the use of a ventilation mask during sleep. “Although this treatment is effective,” Aspire said, “a number of patients find it intolerable and/or are non-compliant. Some CPAP users seek alternative solutions.”

The company said that other surgical treatments for OSA can be highly invasive and have high morbidity rates requiring long hospital stays. “The efficacy of these surgical treatments for moderate or severe OSA also is limited, [and] a lot of patients are not willing to undergo such surgery.”

Aspire’s Advance procedure is short, has a low morbidity and currently requires one night of hospital stay. “The innovative aspects of this new procedure include the ability to prevent the tongue from obstructing the upper airway, the ability to adjust the implant to the need of the patient under local anesthesia and the low morbidity of the procedure,” the company said.

According to Aspire, the department of otorhinolaryngology and the sleep center at Antwerp University Hospital have “an international expertise in innovative research for surgical and non-surgical treatment of obstructive sleep apnea.”

Awareness of choice grows in UK

The sixth UK patient choice survey commissioned to assess the implementation of patient choice at the Primary Care Trust level indicates that the percentages of patients aware of choice, offered choice and offered copies of the Choice booklet continues to rise.

The latest survey, conducted in March and reported on last week, indicated that more patients recalled being offered a choice of hospital for their first outpatient appointment, 48% in March, up from 45% in the January survey and 30% in the first survey, conducted in May/June 2006.

The series of surveys, conducted by Ipsos MORI on behalf of the Department of Health, monitored patient awareness of choice and recall of having been offered a choice of hospital for their first outpatient appointment. In all, some 75,290 responses were given to the surveys.