RapidArc Radiation Therapy

A leader in comprehensive patient care and cutting-edge technology, the Department of Radiation Oncology at Montefiore Medical Center launched as one of the earliest of its kind in the nation and was the first hospital in the New York Metropolitan region to employ image-guided radiation therapy (IGRT). The Department continued its pioneering cancer-fighting efforts in the fall of 2008, when it became one of only a few across the country to acquire Varian Medical Systems' revolutionary RapidArc radiotherapy technology and began treating cancer patients in March 2009, two months after the FDA approved it.

About RapidArc Treatment Therapy and Its Patient Benefits

RapidArc radiotherapy technology is revolutionizing care for cancer patients. It's more precise than conventional radiotherapy and reduces what used to be a 10-15 minute treatment period to two minutes - up to eight times as fast. "Patients barely realize they are being treated," Department chairman Shalom Kalnicki, MD, FACRO, observes. "They walk in and walk out as if nothing has happened. In addition to providing a more efficient treatment time span and less discomfort to patients, RapidArc reduces the chance of tumor movement during treatment, decreases the actual dose of radiation and the scattering of radiation outside the tumor and preserves more healthy tissue than with conventional radiotherapy."

The equipment entails upgrading Varian Medical Systems' Trilogy linear accelerator with two panels and a multifaceted X-ray tube, which greatly enhance imaging capabilities. Montefiore has upgraded two Trilogy units with RapidArc. Using technology developed by Varian, RapidArc uses specialized software algorithms to deliver image-guided intensity modulated radiation therapy (IMRT) rapidly to the tumor location in a single 360-degree rotation of the machine around the patient. During treatment, a beam with pinpoint accuracy delivers the dose, with the pre-programmed algorithms controlling the speed of rotation, the shape of the aperture and the dose delivery rate.

"It's the most sophisticated technology we've ever had for cancer," Dr. Kalnicki states. "With 180 possible stops around the 360-degree arc and customized doses at various angles, the number of possible treatment solutions becomes infinite. Thanks to its precision, outcomes are already demonstrating a 25% increase in quality of life and we've barely scratched the surface with this tool."

Our Team

RapidArc is an extremely valuable advancement but one that requires a highly specialized team to maximize its use. The Department is comprised of 20 physicians, physicists and technicians dedicated to advancing radiation therapy and working in a multidisciplinary fashion. Dr. Kalnicki is internationally recognized for his expertise in IMRT, frameless body stereotactic radiosurgery and prostate and breast cancers. A recipient of several awards, he's authored numerous articles and abstracts and is actively engaged in multiple research projects.

One of the pioneers of seed implantation and IGRT, William Bodner, MD leads the RapidArc team and has more than 15 years experience dedicated to prostate cancer. The physics team is lead by Dennis Mah, PhD, who is widely known for his motion management expertise and Linda Hong, PhD, is our Deputy Director with vast experience in computer algorithms and proton planning for optimizing radiation planning.

Dr. Kalnicki and his team have adopted RapidArc research as part of the Department's agenda and are continuously studying patient cases and measuring outcomes to identify areas of improvement. Together they are pioneering efforts to enhance patient treatment and deploy the RapidArc technology for other cancers, including head and neck, pelvic malignancies and brain.

Unparalleled Care

"Our personal experience with cancer at Montefiore is our patients' experience," Dr. Kalnicki explains, noting that every patient is treated with the utmost care, understanding and respect. Unlike many other facilities, Montefiore offers an all-encompassing, holistic approach to patient care, coordinating everything from patients' transportation to appointments with multiple experts to save them time to scheduling treatment and participation in lifestyle programs that pertain to nutrition, exercise and relaxation.

Patients are also pleased to come to our comfortable, state-of-the-art facilities, spanning 15,000 square feet, and interact with our nurturing staff. The exceptional patient care is what strongly distinguishes Montefiore from other facilities near and far, which may also offer RapidArc technology. Specifically:

Montefiore's process of quality assurance, technology calibration, safety and outcome measurement is extremely rigorous.
Our multidisciplinary approach enables patients to be seen by a cohesive "orchestra" of experts all at once to ask questions about treatment options. This coordinated care not only benefits patients for convenience of scheduling, but also the expertise of an entire team who discuss and analyze every treatment plan possible.
Patients are seen within one or two days of contacting us, unless he or she prefers to delay. Our expert scheduling system navigators offer rapid response - informing patients when treatment will start and scheduling activities (i.e. blood tests, X-rays, etc.) within a perfectly coordinated time frame with no delays.
Nurse practitioners and physicians offer continuum of care, catering to patients' needs every day of treatment.
Our comprehensive complimentary and alternative therapy programs is a holistic approach, offering guidance with nutrition, diet, healthy living at home, yoga and relaxation, distress management sessions (painting, crocheting, writing, etc.), and transportation.
Survivorship programs follow patients after treatment to avoid the long-term effects of therapy. We do everything possible to ensure the cancer does not return.

Our focus is always on the patient and the pursuit of radiation therapy improvement through clinical expertise, research and the employment of the most advanced technology available. We are a humble team who ask each other every day: ‘What can we do better?'