TomoTherapy Next Generation Image-guided-Intensity-modulated Radiation Therapy
TomoTherapy is an emerging modality of Radiotherapy which controls and destroys malignant cells with high-intensity radiation. Unlike conventional system it delivers radiation in a helical pattern, and is generally used for the management of malignant cells with uneven profile, or cases with lesions widely distributed throughout the whole body. The synchronized move of the 360 degree rotating gantry and the moving couch enables radiation to attack the malignant cells from different angles and in different intensities, thereby increasing accuracy in targeting the malignant cells, and minimizing the harm done on normal organs.
BLK Super Speciality Hospital is the only Hospital in North India to offer the most advanced configuration of Tomotherapy which features 3-dimensional on-board Megavoltage Computed Tomography (MVCT) and the latest configuration of Image Guided Radiation Therapy (IGRT).
As a result of weight loss and reduction in tumuor size and as Radiotherapy treatment progresses, it is common that the position of the tumour relative to other organs change during the treatment period or there is reduction in tumour size. MVCT is used to correct any positional discrepancy, which may be caused by a change in body shape, internal organ movement etc. This is called Adaptive Radiotherapy which is the hallmark of this machine. IGRT allows accurate radiation delivery, thereby reducing treatment margins and improving dose and tumour control. The combined use of the two technologies enhances precision in the treatment process and minimizes impact on healthy organs.
Key Features of TomoTherapy
- High precision attack of Cancer cell: The combined use of MVCT and IGRT ensure patients are set up accurately based on the internal anatomy on the day of treatment
- Minimise exposure to healthy tissues nearby: With radiation delivered in a helical pattern and from different angles, the impact on healthy tissues and side effects caused are reduced to the minimum level
- Non-invasive modality: As painless as having a Computed Tomography (CT) scan or an X-ray
- Faster treatment delivery: 66% faster in image acquisition and 18% faster in treatment delivery when compared with the old technology
- More versatile: With treatment range up to 135 cm, it can treat a wide range of Cancer from a simple case, irregularly-shaped tumours, upto cases involving lesions that are widely dispersed throughout the whole body
TomoTherapy can be used as the only Radiotherapy treatment or in combination with surgery and / or Chemotherapy. With upto 135 cm treatment range, TomoTherapy can treat multiple Cancer sites in one go.
Types of Cancer
TomoTherapy is particularly useful in addressing Cancer types such as:
- Breast Cancer
- Prostate Cancer
- Head and Neck Cancer
- Metastatic Cancer
- CNS Tumour
- Lung Cancer
- Cancer of Esophagus / Liver / Stomach
- Cancer of Cervix / Endometrial
Process (3DCRT, IMRT, IGRT, SBRT, Radiosurgery)
A typical course of TomoTherapy takes from several days to weeks, subject to individual conditions. During this period, daily visit to the treatment centre may be required. The process that one needs to go through in each treatment session include:
- The patient will be made to lie on the couch in order to take 3D MVCT images
- A Radiation Therapists will base on the daily MVCT data and match it with the original plan. Adaptive Radiation Therapy (ART) may be required in case of significant shrinkage of tumour size or change of contours due to weight loss
- Simple TomoTherapy treatment takes around 10 - 20 minutes, including treatment verification and treatment delivery
- Certain Tumour types can be treated with a very high dose of radiation and treatment can be completed in 1-5 days. Process control planning is followed by treatment delivery under image guidance.