Helical Tomotherapy : Most Advanced form of Image-Guided Intensity Modulated Radiation Therapy
By M. D. Anderson Cancer Center Orlando
Mar 15, 2005, 18:19

M. D. Anderson Cancer Center Orlando is among the first centers in the world to possess and treat cancer patients with the TomoTherapy HI·ART ® system.

Considered to be the most advanced form of image-guided intensity modulated radiation therapy (IMRT), the system will be used to treat head, neck, prostate, lung and breast cancer.

“Helical tomotherapy is the future of image-guided IMRT and is an important step forward in cancer treatment,” said Dr. Patrick Kupelian, radiation oncologist and project leader for the tomotherapy project at M. D. Anderson - Orlando. “Some patients currently ineligible for radiotherapy may be candidates for treatment because of tomotherapy’s enhanced precision.”

Tomotherapy means “slice therapy” and gets its name from tomography, or cross-sectional imaging. The system is the first device to provide 3-D imaging immediately before treatment to verify the location of a patient’s tumor.

Tomotherapy delivers a very sophisticated form of IMRT while integrating treatment planning, patient positioning and treatment delivery in one system.

“With this groundbreaking technology, treatments become more precise so that radiation can be altered to compensate for patient movement and the changing shape of the tumor being treated,” explained Dr. Clarence H. Brown III, president/CEO of M.D. Anderson - Orlando. “This translates into fewer side effects and may allow patients to complete their course of treatment in a shorter period of time.”

“Radiation therapy is typically delivered over many days, and a constant concern is daily changes that can affect the position of the target areas within the patient” said Kupelian.

“For example, special concerns for lung cancer patients include moving the slightest amount while breathing, even a couple of centimeters, as well as lung tumors that can progress within days, may change the anatomy of the target areas. Also, bladder or rectum filling might affect the position of the prostate gland during treatment for prostate cancer. This raises concerns that radiation meant for a tumor might accidentally hit and harm normal tissues. In addition, the tumor areas might get undertreated due to misalignment.”

However, because the physician can accurately visualize the target areas, position adjustments can be made just prior to treatment.

Before beginning treatment, 3-D images from a CT scan and special computer software enable physicians to verify the position of a tumor and adjust a patient's position if necessary to make sure the radiation is directed to the correct location.

“In addition, tomotherapy has the unique ability to record the dose and location of the radiation given to a patient, so physicians know what took place in the previous session, and can make adjustments if necessary” elaborated Kupelian. “Currently, that kind of information isn’t available in any form of radiotherapy.”

TomoTherapy, Inc., a University of Wisconsin (UW) technology transfer company, created helical tomotherapy. In addition to M. D. Anderson – Orlando and UW, helical tomotherapy is slated for use in a limited research capacity at Cross Cancer Institute at the University of Alberta in Alberta, Canada, and at London Regional Cancer Center in Ontario, Canada.

Tomotherapy will be available at two other facilities in the U.S., including Thompson Cancer Survival Center in Knoxville, Tennessee, and Rapid City Regional Hospital, Rapid City, South Dakota.

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