Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Innovating to cross the divide: Establishing Stereotactic Radiosurgey in Central West NSW (#421)

Benjamin Newham 1 , Bridgitte Evans 1 , Hayden Sheehan 1 , Denise Andree-Evarts 2 , Ajeet Mishra 1 , Wen-Long Hsieh 2 , Joshua Hiatt 1 , Matthew Fuller 1
  1. Radiation Oncology, WNSWLHD, Orange, New South Wales, Australia
  2. Radiation Oncology, WNSWLHD, Dubbo, New South Wales, Australia

Introduction:

Radiotherapy has been available in the Western NSW Local Health District (WNSWLHD) since the Central West Cancer Care Centre (CWCCC) opened in Orange in 2011, with the Western Cancer Centre Dubbo (WCCD) opening in 2021. Over this time, many complex techniques have been implemented to provide the rural patients with a level of service equivalent to that found in metropolitan centres. However, some types of treatment such as Stereotactic RadioSurgery (SRS) have been confined to larger centres.

SRS treatment for cranial metastases has several benefits including:

  • Non-invasive treatment for single or multiple metastases;
  • Durable tumour control and symptom relief;
  • Decrease in toxicities and hospitalisation rates when compared to whole brain irradiation alone.

In late November 2022 the Varian HyperArc Stereotactic RadioSurgery (SRS) system was implemented in WNSWLHD.

Discussion:

The HyperArc system allows for high quality and seamless SRS treatment using fixed geometry and a single isocentre for multiple cranial targets.  Implementing this technology in the rural setting provides many benefits such as:

  • Reduced travel and financial impact for patients and carers;
  • Increased radiotherapy utilisation as patients are more willing to have treatment if it is closer to home;
  • Decrease the over-reliance on other LHDs;
  • Reduced cost for transport and accommodation schemes.

During the rigorous implementation process some innovative solutions were required:

  • Remote planning and other workflow;
  • Video Calls (VC) for online pre-treatment matching;
  • Computer link with RO to view the CT scan prior to matching in real time.

The implementation of HyperArc in WNSWLHD has already provided many benefits to patients and carers. There was a higher uptake of the technique in the first months of clinical use than initial estimates suggested.  Ultimately this innovation will help improve cancer outcomes in our rural population.