Elekta: Linac replacements in a French clinic increase productivity and enable advanced techniques


Elekta Harmony and Versa HD Systems Combine to Transform Center’s Patient Volume and Ability to Treat Complex Cancer Indications

In 2016, U2R, an international cancer management company, acquired an underperforming cancer clinic in Clermont-Ferrand, France, and set it on the path to greater success by replacing the two linear accelerators ( center’s existing linacs) by Versa HD™ and Elekta Infinity systems. . The new linacs have proven to be productivity workhorses; year on year, and the number of new patients has increased steadily – from 775 in 2017 to 980 in 2020 – an increase of more than 25%. Managers at the Clermont-Ferrand unit, knowing however that they could do even better, replaced their Infinity in 2021 with Elekta Harmony, a system designed for maximum productivity, precision and versatility.

The Clermont-Ferrand team with its linac Harmony Pro

“With Versa HD and Infinity, we were basically dealing with one and a half systems, not two, because the Infinity ran from 8:00 a.m. to 2:00 p.m. each day, with the rest of the day spent on quality control,” says Vivien Fung, MD, radio-oncologist from Clermont-Ferrand. “So we were only able to treat 30 patients a day on Infinity and were limited to breast treatments and prostate cases with gold marks.”

On the other hand, the Versa HD compensated by operating from 8 a.m. to 6 p.m., providing an average of 60 sessions per day and allowing treatment of all disease areas (e.g. lungs, liver, head and neck and bone metastases). The Versa HD system also allowed the use of SRS and SBRT techniques and was equipped with a beam in high dose rate mode (without a flattening filter).

“We had significantly improved our case volume over the past four years, but we knew a system like Harmony would allow us to treat even more patients.”

“We had significantly improved our case volume over the past four years, but we knew a system like Harmony would allow us to treat even more patients. Additionally, it would give us more clinical bandwidth to use both systems to meet the growing demand for SBRT,” says Dr. Fung. “We also wanted to match the Harmony beam with Versa HD to facilitate simpler workflows and easy transfer from machine to machine if needed.

“Having two matched-beam linacs with similar workflows ensures that the entire department is familiar with the processes of both machines, reducing the risk of human error,” he continues. “We also wanted the Harmony to have a high dose rate mode, like our Versa HD, to allow for efficient stereotaxic delivery. Our goal was to increase the number of stereotaxic treatments we perform.”

Harmony Pro turn up the volume

Clinicians in Clermont-Ferrand began using Harmony in the clinic on October 13, 2021 – a patient with locally advanced head and neck cancer – and the following month had a daily workload of 70 patients for a 12-hour working day (7:30 a.m. – 7:30 a.m.) involving two RTT teams.

“From the start, we were able to treat all major tumor indications on Harmony.”

“From the start, we were able to treat all major tumor indications on Harmony,” he reports. “In addition, thanks to our internal management software, we estimate the average duration of a conventional treatment slot at nine minutes. Management software is really the backbone of our center-wide business. It provides a personalized RFID card for each patient. , which lets us know exactly when the patient entered the unit and entered the locker room, and it monitors how long the patient is set up.”

Treatment data is also automatically collected in the management software and used for analysis. Data points acquired include actual arrival time, scheduled treatment time, therapy start and end time, location and delay on each linac.

“Data analysis shows that in the areas of IGRT, imaging analysis, beam on time, and patient exit, the times are exactly the same between Versa HD and Harmony” , notes Dr. Fung. “However, it also shows that between the two linacs, there is a significant reduction in patient setup time of 20% for Harmony. We believe that with more experience on Harmony, we can reduce the patient set-up time.”

Clermont-Ferrand RTT attributes the Harmony’s quick patient setup to the ergonomic design features of the system’s in-room FastTrack experience.

“Harmony FastTrack provides new tabletop and handheld controllers, allowing RTTs to focus on patients during setup and it’s easy to use.”

“They appreciate the central hub screen for patient positioning, as they can view all the information they need while standing next to the patient,” he observes. “In addition, FastTrack provides new tabletop controllers, allowing RTTs to focus on patients during setup and it’s easy to use. For example, on the left side of each controller there is a button to the laser, another for the jaw and one for lighting the light.”

A new realm of greater productivity

By adding Harmony, the Clermont-Ferrand clinic has injected much-needed speed and treatment versatility into its radiotherapy department.

“We have significantly improved our efficiency in managing clinical workload with two matched beam linacs and increased our productivity,” says Dr. Fung. “The center will add Harmony Auto Verify to facilitate facial recognition, as well as automatic accessory verification to further increase productivity. In addition, our next Harmony project will be to add Surface Guided Radiation Therapy [SGRT] to achieve faster, more streamlined patient positioning and setup.”

To learn more about Harmony, click here.

Elekta Harmony is CE marked and FDA 510(k) cleared. Not available in all markets.

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