NOVAC
20Pages

-Time zero b^twe^n surging and nadicallon “In tra Operative Radiation Therapy (I0RTJ j'n Its broadest sense defers re the delivery of Irradiation at the time of an operation. I CRT evolved as an attempt to achieve higher effective doses of irradiation while dose-limiting structures are surgically displaced" “In tra Operative irradiation OORT) refers to dell very of a single dose of Irradiation to a surgically exposed tumor or tumor bed white the notmai tissues ana protected from the Irradiation either by retracting the mobilized tissue or by shielding the anatomically fixed tissues. I0RT...

NO LONGER MOVING THEz PATIENT: the system follows the treatment, thus avoids the need of moving patients from the surgical table. FLEXIBLE & EASY TO USE THE HAND PENDANT: it is equipped with a bar code reading system used to recognize the selected applicator. EIGHT WEIGHT OE MOBILE UNIT: the impact in the operating room is minimal, no structural changes are necessary. TRANSPORT INTO STRETCHER ELEVATOR: the dimensions are such that NOVAC 11 can be easily transported to the operating room through the use of any stretcher elevator. FUNCTIONALITY IN MULTIPLE OPERATING ROOMS: the system can be...

HARD-DOCKING PROCEDURE: - fast and easy procedure that can be performed by expert teams in less than five minutes; - safe and executable in any clinical configuration, thanks to the NOVAC11 architecture and the wide range of accompanying applicators; - a reliable system that provides an accurate and repeatable beam collimation on the target. G> DEGREES OF- FREEDOM: - 2 independent degrees of freedom of the articulated arm: ■ elevation, that allows to change distance of the radiant head from the floor; ■ azimuth, which controls the articulated arm rotation around the axle perpendicular to...

NOVAC11 is able to treat any clinical volume in the lOeRT environment. By selecting the correct applicator/energy combination, it is possible to treat any neoplastic disease effectively and safely. The 1007o PMMA (polymethylmethacrylate) applicator allows: - implementation of the safest and fastest hard-docking technique; - direct visualization of the surgical breach, thanks to the transparency of the material and the length of the terminal applicator; * full compatibility with x-rays imaging; - increase of the surface dose, thus avoiding the need of any bolus. Applicators are available in...

The lOeRT technique ensures reduction of dose exposure of the healthy tissue during the irradiation. In breast cancer treatment, the use of a radioprotection disc temporarily inserted between the target and the chest wall fully protects the healthy tissue underneath. The disc is a medical device made of steel and Tecapeek' (Polyetheretherketone), biocompatible and sterilizable materials; is available in the following diameters: 50,60. 70.80.90 and 100 mm.

One of the limits to the easy and cheap implementation of an lOeRT program is represented by radiation protection. NOVAC11 has been specifically designed in order to minimize stray radiation. RADIO PROTECTION PERFORMANCE Any thickness and material under radioprotection standards requirements. NOVAC 11 is provided with a specific barrier to be placed under the operating table, the beam absorber. Beam absorber proper positioning is guaranteed by its alignment system that provides its correct position respect to the NOVAC 11 Mobile Unit. A specific interlock prevents the irradiation in case of...

- SINGLE DOSE, a single treatment which replaces the entire external radiotherapy cycle. (ELIOT protocol for breast cancer) - BOOST, followed by a reduced external radiotherapy cycle. (HIOB protocol for breast cancer). lOeRT SINGLE DOSE F-or a se»le=ctpd class of patients HYPOERACTIONATED EXTERNAL RT CYCLE f-or a selected class or patient EXTERNAL STANDARD RT CYCLE lOeRT BOOST + HYPOF-RACTIONATED EXTERNAL RT CYCLE ADVANTAGES OF- THE IO e RT TECHNIQUE EOR PATIENTS: ^ Reduction of the entire cycle to a single day! ^ Elimination of side effects caused by conventional therapy. - Decrease in...

Waiting time between lumpectomy and radiation therapy External radiation therapy treatment ONLY 1 TREATMENT DELIVERED DURING EURCjERY 7/9wppks waiting time 7/9wpeks weiting time1 /=3=3 F-reactions dplive^rpc) in b>/~7 wpeki 7/9wppkb waiting time3 IB/lEo P reactions dPl^redriTTHP BEzST ACHIEVABLE: _D /_D LOCAL CONTROL THANKS^ J TO IO e RT BOOST ^ - DELIVERED AT TIMS ZERO FOR CLINICAL PRACTICE: • Improvement of local control is a conditio sine qua non for disease free and overall survival. • Reduction (in the case of boost) and elimination (in case of single dose) of the external radiotherapy...

ASTRO GUIDELINES UPDATE: broader selection criteria In September 2016, ASTRO published the Update of the Accelerated Partial breast Irradiation (APBI) Consensus Statement in order to provide a guidance on use of I0RT for Partial Breast Irradiation (PBI) in early stage breast cancer [7]. On the basis of the published evidence and the mature results obtained thanks to the 5.8 years follow-up of the ELIOT trial, it has been recognized the efficacy of performing the I0RT with electrons. In details, the ASTRO society stated the following recommendations: • I0RT with electrons (lOeRT) can be used...

REMARKS / IOERT effects I0RT (applicator« 8cm), Charlson comorbidity index < 3 and chemotherapy improve OS Median survival: 23 m RO vs 10 m R2/unresectable 987o local control with lOeRT boost I0RT with neoadjuvant CT and CRT improve survival. No toxicity incremented by lOeRT lOeRT significant improvement of LC Favourable effect of I0RT in pts with stage II and III Any stage lOeRT promoted local control Prognostic index for risk-adapted treatment. No toxicity increment by lOeRT lOeRT and Preop CRT improve OS lOeRT advantage in pts with R1 and R2 resection No increase of acute and long-term...

NOVAC II COMMISSIONING The NOVAC 11 commissioning is performed in accordance with primary international protocols through the use of standard dosimetric instrumentation, as well as use of a proprietary software based on a Monte Carlo Simulation. The use of such software allows to dramatically reduce (3 working days) the dosimetric characterization of the accelerator already during its acceptance test performed at the main factory. The clinical dosimetry is immediately available, thus allowing to overcome the need for execution of the whole experimental characterization. The software results...