Collaboration between neurosurgeons and radiosurgery team contributes to success
Varian’s HyperArc® high-definition radiosurgery, delivered on the Edge® platform, is helping the radiosurgery program at Good Samaritan, a 408-bed community hospital in West Islip, NY, succeed in the highly competitive New York City (NYC) area market. Good Samaritan Hospital is unique in that it is it one of only two treatment centers in the New England and mid-Atlantic regions with a combination of HyperArc on the Edge platform. It was also the first cancer treatment center in New York to offer stereotactic radiosurgery (SRS) treatment utilizing HyperArc technology.
This is the second article in a two-part series.
As a member of Catholic Health Services of Long Island, Good Samaritan Hospital operates on a more limited marketing budget. “When we had an opportunity to upgrade our equipment, we chose HyperArc on Edge, because we wanted to be able to compete with the Cyberknife® and Gammaknife® programs at these larger healthcare systems,” said Johnny Kao, MD, chairman of the department of radiation oncology at Good Samaritan. “The HyperArc on Edge platform allows us to compete on quality. Our neurosurgeons also have an excellent local reputation that allows us to maintain an active radiosurgery program without the marketing that the larger, more nationally known health systems can afford.” Good Samaritan Hospital competes for patients with several large and highly reputable healthcare systems in the densely populated NYC area. Some of them market radiosurgery services directly to patients through television and radio ads.
At Good Samaritan, HyperArc is used to treat a wide variety of conditions, including primary brain tumors and brain metastases, as well as benign conditions like meningiomas and arteriovenous malformations. The Edge platform can also treat tumors throughout the body. ”The HyperArc mode on the Edge system has the flexibility to serve our community’s needs,” noted Dr. Kao.
An Edge system equipped with HyperArc is ideal for helping smaller community hospitals implement SRS programs on a smaller, more cost-effective scale, while still offering high quality treatment. The Edge system is a turn-key solution designed to deliver radiosurgery treatments with tremendous speed and accuracy. It is optimized for delivering highly conformal dose distributions to tumors of the lung, brain, spine, and other areas of the body where radiation is indicated.
“The Edge system has some amazing technologies, such as optical surface monitoring; a high-definition multileaf collimator; a very high-dose-rate, cone-beam computed tomography (CBCT); and a six-degree robotic couch,” said Dr. Kao. “It is really a phenomenal suite of technologies to have in one system.”
HyperArc provides time and cost savings when delivering single-isocenter treatment of multiple metastases in the head or neck. Its simple “one-click” workflow automates much of the process, significantly increasing efficiency and allowing clinicians to typically finish a HyperArc treatment—even for multiple mets—within a 15-20 minute time slot. “As a community hospital, we don’t have all the resources that a university hospital does,” noted Xuemin Ren, PhD, radiation physicist at Good Samaritan. “HyperArc is very straightforward and substantially automated, so SRS treatment with HyperArc is easy to implement. Planning is quick and easy, and treatment is even faster.”
The efficiencies that HyperArc offers can also benefit patients. Symeon Missios, MD, a neurosurgeon at Good Samaritan with a subspecialty in Neurosurgical Oncology and the radiosurgical management of brain tumors, explained, “We’ve had patients with as many as 15 metastatic brain lesions. The level of precision with HyperArc is excellent and the length of treatment is significantly decreased—these patients can be treated in as little as one 20-minute session, whereas it would take up to four hours to treat as many targets using a different SRS platform. Long treatments are uncomfortable for the patient; you often have to sedate them or stop treatment to give them breaks,” Dr. Missios added. “I tell patients that with HyperArc, they don’t need to be placed in a frame, which is another benefit."
According to Dr. Kao, despite being in a highly competitive market, the HyperArc on Edge platform has contributed to the recent growth of Good Samaritan Hospital’s community-based radiosurgery practice, particularly with regard to single fraction treatments. The number of single-fraction procedures grew more than 500% from 2018 to 2019. “Before, patients had to come in for 3 or more visits. Now, with HyperArc, we’ve been able to increase access to single-dose SRS, which is obviously more convenient,” said Dr. Kao.
Many patients with brain cancer are referred to the Good Samaritan radiosurgery center by neurosurgeons or medical oncologists. After the HyperArc on Edge platform became operational in May 2019, referrals by neurosurgeons increased by more than 50 percent. Other physician specialties within the Catholic Health Services of Long Island also refer patients to the radiosurgery group.
In 2019, the Catholic Health System of Long Island built a new cancer institute at Good Samaritan Hospital Medical Center, focused on a multidisciplinary approach and improving treatment outcomes.
The Brain Tumor Center at Good Samaritan, led by Dr. Missios and Dr. Boramir Darakchiev, two neurosurgeons with fellowship training in Neurosurgical Oncology, offers cutting-edge surgical and radiosurgical technologies. “Our neurosurgeons are extremely engaged and they are spearheading an ongoing quality improvement initiative to elevate the brain tumor program,” said Dr. Kao.
Dr. Missios, whom Dr. Kao describes as being very “hands on, involved in contouring, and always in the radiosurgery department,” similarly describes the collaboration with the radiosurgery team as being a symbiotic relationship. “We take a team approach to treating patients,” he said. “I pinpoint the targets and the brain structures to avoid and discuss the prescription and fractionation plans with the radiation oncologist. The medical physicist—an integral part of the team—generates the treatment plans and runs quality assurance tests. The radiation oncologist and I review the treatment plan together. There is constant collaboration and communication between all members of the radiosurgery team.”
The information captured herein represents the genuine experience of the attributed individuals and may not necessarily represent the views of Varian or the above referenced institution. Individuals were not compensated for their participation.