Varian Trilogy any experience?

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mr bill
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Date Joined Sep 2010
Total Posts : 709
   Posted 2/17/2011 7:09 AM (GMT -6)   
 
Has anyone here been treated with Varian Trilogy radiation equipment?  Doe you know if the CT scan is in operation at the same time as the radiation is being administered?  In other words does it transmit a real time or live scan to the operator at the same time as RT?  What was your experience?
 
Thank you,
Mr Bill

Steve n Dallas
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Date Joined Mar 2008
Total Posts : 4849
   Posted 2/17/2011 7:14 AM (GMT -6)   
A quick GOGGLE shows->
 
Watch the video:
 
Varian's Trilogy™ system is a major advancement in cancer treatment technology. By using real-time diagnostic data, the sculpted radiation beam pinpoints the tumor and protects the surrounding healthy tissue, while minimizing the patient's time on the treatment table.
Trilogy™ offers capabilities for providing Intensity Modulated Radiation Therapy, Image Guided Radiation Therapy (IGRT), 3D Conformal Radiation, Fractionated Stereotactic Radiation Therapy, and Stereotactic Radiosurgery.

mr bill
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Date Joined Sep 2010
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   Posted 2/17/2011 7:23 AM (GMT -6)   
Thanks Steve,
That pretty much nails it.  From what I understand it delivers either intensity modulated or image guided therapy.  I guess I will just haver to ask what type they are using before I can make any judgement.
 
Bill

Carlos
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Date Joined Nov 2009
Total Posts : 486
   Posted 2/17/2011 7:46 AM (GMT -6)   
Bill,  They ran a quick CT scan before each treatment, adjusted my position as necessary and then started the IMRT treatment. It was just like the video.  I am amazed that I have not had any side effects.  I hope that bodes well for the long term.
 
Carlos
Dx 2/2008, age 71, PSA 9.1, G8,T1c. daVinci surgery 5/2008, G8(5+3), pT2c. LFPF, good QOL. PSA <0.1 for 2 yrs. PSA rose to .2 at 30 months, SRT 12/2010.

compiler
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Date Joined Nov 2009
Total Posts : 7270
   Posted 2/17/2011 8:45 AM (GMT -6)   
I'll be reading this thread with interest as I will most likely be doing the SRT with this equipment early next month
 
Mel

JNF
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Date Joined Dec 2010
Total Posts : 3888
   Posted 2/17/2011 9:43 AM (GMT -6)   
I understand from their literature, a discussion with my rad-onc, and some comments from John T that the main advantage is that the gantry is in constant motion and reduces the time required to complete the radiation doseage.

I had IMRT and the gantry radiated me from nine different positions so there was some time moving from one position to the next. In all I was on the table less than 15 minutes.

One poster earlier surmised that the biggest advantage to the new Varian is to the rad-onc as they can now treat more patients per day.

don826
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Date Joined May 2008
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   Posted 2/17/2011 10:32 AM (GMT -6)   
I was treated with the Varian machine. Trilogy is an upgrade to treat other cancers in addtion to prostate. Basic machine is the same. The Varian that stays in motion through the treatment is the RapidArc. My treatment was IGRT/IMRT. Seven station, 360 degree rotation. Pause at each station. Prior to each session CT scan was done to locate the prostate and the gold seeds known as fiducials. It has been two years and I have had no lingering side effects other than ED.
 
Don

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 2/17/2011 12:07 PM (GMT -6)   
Bill,  JNF is correct.  The main advantage of the rapid arc is the increased number of patients that can be treated.  For SRT my treatment center allocates a 20 minute slot.  For primary RT they allocate 10 minutes.  The machine is booked solid from 7 am to 9 pm.  They treat over 60 patients a day.
 
Carlos

mr bill
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Date Joined Sep 2010
Total Posts : 709
   Posted 2/17/2011 12:08 PM (GMT -6)   
Had my first "experience" this a.m.  about as described, first xray (as RT described it) then the treatment.  Stopping at several positions as it circled around.  RT also said they will be doing a CT scan once a week.  They did not implant any fiducials, only the marks on the outside of the pelvic area.
 
Mr. Bill

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3895
   Posted 2/17/2011 12:53 PM (GMT -6)   
I have just completed 40 treatments on the latest Varian Novalis Triology Rapid-Arc machine.

Step one, you are carefully positioned on the treatment table using laser beams and tattoos placed on your abdomen. The machine then makes a CAT scan pass around you, the entire gantry rotating..The table you are lying on then makes tiny adjustments to compensate for the day to day changes in organ positions. The gantry swings into it's beginning position, in my case below the table, you hear a dull thump as the accelerator and it's cooling system start and the gantry begins a slow rotation around you. In my case, it stopped for a moment on the far (left) side then it began it's second pass over your body, the 'leaves' that focus and direct the beam in a slightly different position.

My last 7 treatments were called "Boost" where the beam was tightly focused on my prostate bed. The first 33 treatments covered a broader area..During those 7 "boost" treatments, a radiologist was always present in the control room..The regular therapists saying "When the beam is this tight, it's above our pay-grade.."

Patients are scheduled 1/2 hour apart. Each treatment takes about 15 minutes total time in treatment room. In Denver, there is a surplus of Linac's and there is nobody waiting on line to use them..

With the Varian RapidArc system, the dose to the targeted area can be achieved while reducing the 'whole body" dose by almost 2/3 over older IMRT equipment. The moving gantry eliminates any "suntan" skin burns common with the stop and go machines..

Side-effects: I noticed none until about half way through. Then urinary frequency and urgency started to increase..No bowel symptoms at all..No fatigue..By the end I needed to pee every 1.5 to 2 hours. No pain or burning, just more frequent urges..Now, 5 days post treatment, I'm back to 2-3 hours between urges..That's it.....R-doc said "See you in May.."

Post Edited (Fairwind) : 2/17/2011 9:57:54 PM (GMT-7)


mr bill
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Date Joined Sep 2010
Total Posts : 709
   Posted 2/17/2011 1:00 PM (GMT -6)   
Even though I am being treated with Trilogy, it is not the rapidarc. As it does top as it rotates around. Somewhat disapointed, as radiation onc. said the only difference was time on table, nothing mentioned about skin rash.  I wonder if it is as pinpoint accurate as the rapidarc?

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 2/17/2011 1:57 PM (GMT -6)   
Fairwind:
 
You just detailed 72 treatments.
 
?????
 
Mel
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .
Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64
Surgery: Dr. Menon @Ford Hospital, 1/26/10.
Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- in progress. PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06; 1/4/11-0.13 CRAP!

hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 2/17/2011 10:14 PM (GMT -6)   
I'm about half way through 39 treatments on the Varian Rapid-Arc machine. My experience is pretty much the same as the others. Three tattoos on my body that are lined up to laser beams.
 
Then the machine does a full circle x-ray or ct-scan. Next slight adjustments and two full rotations of radiation. First counterclockwise, then clockwise. Whole process takes 3 minutes on the table.
 
The Group that I go to, schedules 50 men a day more or less. We are slotted every ten minutes. Two changing rooms so one guy is always waiting. Five minute visit with the Oncologist every Friday where we talk about the weather and then I'm gone.
 
No side effects at all...  
Age 60, PSA 2007 4.1, PSA 2008 10.0
Diagnosed April 2008, Biopsy: 6 of 12 cores positive, Gleason 4 + 5 = 9
CT and Bone Scan negative, Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared, Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th, pT2c, lymph nodes negative
PSA Sept 28, 2008 0.00, PSA Jan 22, 2009 0.00, PSA June 29, 2009 0.00
PSA Sept 2009 0.00, PSA Dec 21, 2009 0.02, PSA March 29, 2010 0.03
ED Status- Currently using Trimix, Levitra daily for increased blood flow.
Noctural Erections have completely returned on a nightly basis, same hardness as before.
Stopped the injections except for "Fun" weekends. Really don't need them anymore.

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 2/17/2011 10:24 PM (GMT -6)   
Just curious-- what do you guys wear  on the table?
 
Underwear and regular pants? Or hospital gown and nothing under that?
 
Mel

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25394
   Posted 2/17/2011 10:32 PM (GMT -6)   
I had to wear a "three arm" hospital gown, no pants, no shoes, but could leave on underwear and socks. During the 39 treatments, was not allowed to wear any jewelry, including my cross.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

John T
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Date Joined Nov 2008
Total Posts : 4269
   Posted 2/17/2011 11:17 PM (GMT -6)   
Mel.
I just lowered my pants and underware to my knees and put a towel over my privates. Never wore a hospital gown or had to take anything off.
Everything worked just fine.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

F8
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Date Joined Feb 2010
Total Posts : 3998
   Posted 2/17/2011 11:40 PM (GMT -6)   
i wore my sweats or shorts, boxers, socks and T shirt. i kept my ring and watch on. all i did was kick my shoes off each day and slide them under the coffee table in the lounge and i was ready.  the guys who came "dressed" had to dress out in a gown and PJs about 10 minutes before their turn.
 
they'd be sitting in a "nook" in back while i was lounging on the loveseat with my wife in front of the big screen cool .
 
ed
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3998
   Posted 2/17/2011 11:46 PM (GMT -6)   
>>I just lowered my pants and underware to my knees and put a towel over my privates.<<
 
really?  i pulled my sweats down to the top of my pubic hair.  occasionally at first one of the gals would pull my pants down if i didn't get it just right.  my privates were never exposed during any of my sessions.
 
ed
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3895
   Posted 2/18/2011 12:19 AM (GMT -6)   
Whoops! I was thinking of Greys..I had 40 treatments, the last seven called boost..Post corrected..

Attire: When I came in, it was straight to a changing room where you put on a "Johnny", the standard hospital gown. I could keep my socks on, but that was it..On the treatment table was a leg mold they had made covered with a warm blanket. Also a headrest. You climb onto the table and they hand you a rubber ring to hold with both hands on your chest. They put a warm blanket over your privates and legs while they pull up the gown to expose the tattoos. I was instructed to just relax and go limp. Then two techs, one on each side tugged on the blanket I was lying on to get me exactly positioned using laser beams in the darkened room..When they were satisfied, they leave the room. The CAT scan arms swing out and the gantry rotates around you. The CAT arms retract, the table makes some very small adjustments...The gantry makes a pass or two..See you tomorrow..Once a week you get a 1/2 hour visit with your R-doc..No treatments are given unless there is an R-doc in the building..
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

mr bill
Veteran Member


Date Joined Sep 2010
Total Posts : 709
   Posted 2/18/2011 7:35 AM (GMT -6)   
Same as John T. - Drop your britches and jockeys. Cover genital area with small towel, and away we go.

hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 2/18/2011 10:47 AM (GMT -6)   
My experience was the same as Fairwind. Except my weekly visit with the doctor and nurse were extremely short. Neither lasted more than 5 minutes.
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