VARTAN medical systems VARIANHyperArc'HYPERARCHigh-definition radiotherapy Highlights The HyperArc HDRT treatment technique is designed to enable clinics to: • Offer radiosurgery to more patients • Improve clinical quality of treatments • Enhance SRS revenue and improve cost efficiency Approximately 20 percent of newly diagnosed cancer patients will develop brain metastases.1 For many of these patients, stereotactic radiosurgery (SRS) is recommended as a primary treatment option.2 Concerns about complexity, patient safety, cost, and human resources often make SRS inaccessible for many patients and unviable for many institutions. HyperArc™ high-definition radiotherapy (HDRT) addresses these challenges by introducing key technology and workflow elements that are designed to change the clinical landscape, enabling more clinics to deliver SRS. A prescriptive workflow is a key element of HyperArc HDRT. This workflow includes specified immobilization for imaging and treatment delivery, patient setup, automated one-click treatment delivery, intra-fraction imaging and a predetermined delivery sequence. With HyperArc HDRT, SRS may become a standard offering in your clinic. Simplified reproducible SRS workflow Non-coplanar treatments can be extremely complex. HyperArc HDRT is designed to make non-coplanar SRS delivery easy by automating and simplifying many of the operations. Varian’s goal is to offer treatment reproducibility through a prescribed workflow so that clinicians may focus on the clinical objectives of defining targets and dose prescription, while HyperArc HDRT is designed to optimize the treatment delivery. Our vision is one in which treatment delivery has never been easier, with fully automated robotic motion that allows the radiation therapist to commence and monitor a complete automated treatment without re-entering the room. 1 DeSantis CE, Cancer treatment and survivorship statistics, 2014 CA. 2 Nabors LB et al. Central Nervous System Cancers, Version 2.2014. J Natl Compr Canc Netw. 2014.

Retreatment challenge Due to prolonged survival and higher utilization of radiosurgery without whole brain radiation for patients with brain metastases3, an increasing number of patients return for retreatment of their disease. This trend presents new challenges that require clinicians to deliver more compact and conformal radiation doses than before to avoid overlap with previous treatments. Non-coplanar delivery of radiation may provide more compact dose distributions that spare a larger amount of healthy tissue and may increase the clinicians’ confidence in retreatments.4 Multiple metastases...