SYS-CON MEDIA Authors: Pat Romanski, Elizabeth White, Glenn Rossman, Cynthia Dunlop, Peter Silva

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Brainlab: First Patient Treatment with Revolutionary New Radiosurgery Software for Multiple Brain Metastases

New Automatic Brain Metastases Planning* software by Brainlab has been clinically used to successfully deliver fast, efficient radiosurgery treatment to a patient with metastatic brain cancer. The procedure was performed at Assuta Hospital in Tel Aviv, where clinicians treated a patient with multiple metastases during a single fraction, 20-minute radiosurgery session with only six minutes of ‘beam-on’ time, establishing a new benchmark in treatment consistency, conformity and efficiency.

Assuta Hospital used the Brainlab software to plan and deliver treatment to a 62-year-old female patient with breast cancer. The breast cancer had metastasized to the patient’s brain and she previously responded to treatment with whole brain radiotherapy (WBRT). Nine months later, her metastases recurred and her radiotherapy team at Assuta was able to use Brainlab Automatic Brain Metastases Planning software to treat all four of her metastases in a single twenty-minute session.

“The Brainlab software is unparalleled in the market,” explained Roberto Spiegelmann, MD, Neurosurgeon and Senior Advisor in Radiosurgery, Assuta Hospital. “The automated planning and delivery streamlines the entire process while the proprietary treatment algorithm allows us to treat simultaneously a number of metastases with optimal dose to the tumors and extremely limited dose spill to surrounding healthy tissue. This multiple metastases software will impact the way brain metastases are treated with radiosurgery from now on.”

The Brainlab Automatic Brain Metastases Planning provides a very fast planning and delivery solution resulting in a very conformal and ‘monitor-unit-efficient’ treatment of multiple metastases. Through intelligent manipulation of linear accelerator ‘leaf’ mechanics, the time-efficient technology allows for precision targeting of several metastases in a single session, taking full advantage of the rotation of the machine to deliver a conformity-optimized plan. Clinicians can achieve very tight dose conformity around each tumor, helping reduce side effects that can occur when healthy tissue is exposed to excess radiation.

“I wish I had this tool months ago and not had treated this patient with whole-brain radiation,” said Dr. Spiegelmann. “Her cancer is evidently aggressive enough and managed to come back despite the hope of disease spread prevention under a simple WBRT paradigm. With the help of this software, we can now offer our patients a new way of treating their tumors locally, with aggressive curative doses, regardless of how resilient the disease may be and irrespective of the tumor numbers. I am confident that offering more upfront stereotactic radiosurgery treatments will increase our patients' functional preservation and retain quality of life, and that we could push WBRT further out in their treatment cycle and use it only when and if necessary.”

"This new planning software complements other Brainlab innovations of recent years, in particular frameless stereotactic radiotherapy and ExacTrac®1 positioning which have allowed our patients precision brain radiosurgery without requiring a rigid frame screwed into the skull2,” explained Raphael Pfeffer, MD, Director of the Oncology Institute at Assuta and longtime partner with Dr. Spiegelmann and physicist, Daphne Levin, PhD, in neuro-radiotherapy. The new software improves the planning of radiosurgery for multiple brain metastases such that each treatment arc covers many metastases, thereby also helping to improve patient comfort by shortening the treatment delivery time. For our patient with four metastases, treatment was completed in 20 minutes compared to more than 60 minutes duration previously. This new software is opportune and comes at a time when the paradigm of treatment of multiple brain metastases is shifting from whole brain radiotherapy to stereotactic treatment of the metastases whilst reducing toxicity to normal brain. This week we are already treating our third patient with multiple brain metastases with the new software."

“Clinical use of this technology represents a significant paradigm shift for patients with brain metastases,” said Stefan Vilsmeier, CEO and Founder, Brainlab. “The Automatic Brain Metastases Planning software effectively articulates the Brainlab vision of indication-specific and highly automated software applications aimed at transforming practice patterns in radiosurgery. We are continuously building on our 25 years of experience in rethinking radiosurgery and this is one of many more innovations to come."

To learn more, visit Brainlab.com/brainmets.

About Assuta Medical Center

Assuta is Israel’s largest and leading private medical services center, comprising eleven clinics and hospitals across Israel and providing innovative surgeries and diagnostic procedures in all fields of medicine, including cardiology, oncology, gynecology, urology and more.

Assuta Hospital in Tel-Aviv was established in 1934, and over the past 70 years has become renowned as the most advanced hospital in the Middle East.

About Brainlab

Brainlab, headquartered in Munich, develops, manufactures and markets software-driven medical technology, enabling access to and consistency of advanced, less invasive patient treatment.

Core products revolve around information-guided surgery, precision radiation therapy, and information and knowledge sharing that fosters interdisciplinary collaboration. Brainlab technology currently powers treatments in the fields of neurosurgery, radiosurgery/radiotherapy, orthopedics, ENT, CMF, spine, and trauma.

Privately held since its formation in 1989, Brainlab has more than 5,000 systems installed in about 95 countries. Brainlab employs 1,150 people in 17 offices worldwide, including 290 research & development engineers, who form a crucial part of the product development team.

To learn more, visit www.brainlab.com.

* FDA clearance pending

1 Registered trademark of Brainlab AG in Germany and the US

2 Some doctors may opt for a minimally invasive head frame depending on the specific treatment and patient.

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