*Translated by Sara Pasino
VARESE – The Radiotherapy department of the Circolo Hospital in Varese has welcomed a new linear accelerator. The machine came into operation last August, with the treatment of the first patients for prostate and lung cancer. On Friday, October 7, the machine was officially introduced to the presence of the Councillor for Welfare and Vice-President of the Lombardy Region, Letizia Moratti.
To attract the best clinicians
The General Director of Asst Sette Laghi, Gianni Bonelli, opened the presentation, also mentioning other news concerning the Hospital of Varese. «In mid-October the surgical robot will come into operation and the call for tenders for the hybrid room has closed. Technologies create a qualified and stimulating work environment,» said Emanuele Monti, President of the Health Commission of the Lombardy Region. «We are investing a lot in this hospital, the goal is to attract the best clinicians and professionals».
Moratti: «A practical reform»
On the occasion of her visit to the Varese Hospital, Vice-President Letizia Moratti did not wish to make any statement on the still evolving issue of the candidates for the regional elections. She spoke only of the sanitary system, remembering first of all the work done for the regional health reform and thanking the president Attilio Fontana, the entire Regional Council and the president of the Health Commission, Emanuele Monti. «This is a real and practical law with an equally practical process and precisely defined time frame and resources. 40% of the facilities (homes and community hospitals) will be activated by 2022, another 30% in 2023 and the last 30% in 2024. Already 25 community houses and 8 community hospitals have been activated, they will become 75 houses and 10 hospitals. We are perfectly on time». As far as the budget for investment is concerned, «there are 2 billion euros available for territorial health, of which 1.2 billion from Pnrr and 800 million from Lombardy Region».
Specific training
Then the focus shifted to the linear accelerator, which was the reason of the visit by the Councillor Moratti and the Asst leadership (picture below). From the day the machine frist arrived, staff have extended the use for therapies of other anatomical sites and have attended specific training, to fully exploit the potential of the machine, which is equipped with an instant patient monitoring system based on the simultaneous acquisition of two X-ray images. In this way it is possible to detect movements or changes of organs and structures inside the patient’s body during the delivery of the treatment, ensuring maximum protection of surrounding tissues and organs from the target.
The potential of the accelerator
«Thanks to the potential of the new linear accelerator – explains Dr Paolo Antognoni, director of radiotherapy – it is possible to provide procedures that require very high geometric accuracy, such as stereotactic radiotherapy and radiosurgery treatments. The instant monitoring system is independent from the accelerator and makes it possible to check, even for angled positions of the bed and the accelerator head. The test, based on the comparison of the internal anatomy of the patient with the one provided by the CT images used for the study of the treatment plan, automatically detects changes that could compromise the treatment and immediately alerts the operator. In fact, the new equipment allows the possible interruption of the radiant beam, in the event that the threshold of tolerance of organ movement is exceeded, and therefore the target is not properly irradiated. The result of the fusion of the acquired images with the ones for reference leads the geometric correction».
Much quicker
The system is also equipped with an infrared camera, which detects the position of a series of reflective markers placed on the patient’s skin, to assist operators in the initial positioning of the patient at each therapy session, reducing operation time and ensuring maximum precision. «The high geometric and dosimetric accuracy of the treatment techniques, made possible by this new equipment – adds Dr Fabio Tanzi, Director of Health Physics – requires a specific protocol of quality control both in the phase of development, both in that of exercise: this is ensured by the team of Health Physics that supports daily the team of radiotherapy in clinical activity».
The advantages
Thanks to the introduction of this particular system of instant monitoring of the movements of the internal organs of the patient and, with them, of the tumour itself, it will be possible to carry out safely, with significant clinical benefits, some of the most sophisticated and demanding stereotactic radiotherapy treatments, such as those for pancreatic and liver neoplasms, as well as those based on ultra-hypofractionation regimens for prostate cancer, with significant reduction in the duration of the radiotherapy cycle from the current 5 weeks to less than two weeks. Between 2023 and 2024 also the other two linear accelerators provided for radiotherapy will be replaced, following the appropriations of the second component of PNRR’s mission: more than 14 million euros will be available to Asst Sette Laghi for the purchase of major technologies. In fact, Region Lombardy has approved the use of the funds, which will allow the purchase of the equipment identified.