Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, July 11, 1993 TAG: 9307090014
SECTION: CURRENT PAGE: NRV-2 EDITION: NEW RIVER VALLEY
SOURCE:
DATELINE: LENGTH: Medium
Pulaski Community Hospital has contacted the representative from Varian Oncology Systems to discuss the two linear accelerators' capabilities, their similarities and differences. The most easily recognizable difference is that Radford's proposal called for a "remanufactured" machine that is approximately 10 years old. While Varian does replace many of the component parts in the machine during the "remanufacturing" process and it comes with a "new machine warranty," it does NOT make the machine new again and does NOT update it to give it the same features as the machine proposed by Pulaski.
As far as technical capabilities of the machines are concerned, both machines use the same type of electron radiation beam and both have photon beams. However, Pulaski's machine has TWO photon energy levels, while Radford's machine has only ONE photon energy level.
Clinically, the electron ranges are not significantly different. However, beyond the claims made by Heath showing similarities between the two machines, there are VERY significant differences.
The machine proposed by Pulaski possesses technology that is, in the words of the Varian representative, "way beyond their machine." The proposed Pulaski machine is computer controlled, unlike Radford's, which utilizes older technology. This fact makes Pulaski's more user-friendly and allows shorter treatment times due to the machine's computerized functions. It also has more capabilities for future upgrades.
Heath made a claim that Radford's machine "could operate at two different radiation levels, the same as the one proposed by Pulaski; but the center's planners have chosen not to have the higher radiation capability of the machine turned on until it's determined that it's needed." According to Varian, Heath made an oversimplification.
In fact, in order for Radford's machine to be upgraded to the treatment capabilities of Pulaski's, they first would have to spend approximately $100,000 to add the higher photon energy level. In addition, Pulaski's machine has the added technology of a "multi-leaf collimater," which, when combined with the higher photon energy level, allows the machine to treat deep-seated tumors such as those of prostate cancer. It allows the machine to hit the tumor from more angles and limit the radiation hitting surrounding tissue more effectively.
This technology has been shown to have the BEST clinical results in the current literature on prostrate cancer. The same technology also is used on head and neck tumors. It is a "leading edge technology," according to Varian. For Radford to adapt their machine to allow the addition of the multi-leaf collimator, they would have to spend a minimum of an additional $200,000. According to Varian, the "multi-leaf collimator technology is way beyond their [Radford's proposed] machine." That is hardly as simple as "turning it on," as Heath puts it.
He claims that only 10 percent to 15 percent of the patients from the New River Valley would need the higher photon energy level for their treatment. This information was presented as fact, with no supporting evidence to corroborate the statement. With Lewis-Gale Hospital's cooperation, Pulaski has obtained the results of a survey performed by Lewis-Gale of actual New River Valley patients who received treatment between October 1987 and December 1992.
In the study of 402 patients from the New River Valley, receiving a total of 940 treatments at Lewis-Gale Hospital, 41.7 percent used the high photon energy level, 41.5 percent used the lower photon energy level, and only 16.8 percent used the electron beam energy.
There IS a DIFFERENCE between the two machines, as much as Heath and Radford Community Hospital would want people to believe otherwise.\ Chris Dux\ Administrator\ Pulaski Community Hospital
by CNB