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Home > Cancer Care > Therapies 


TomoTherapy
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St. John's began offeirng TomoTherapy, one of the most sophisticated cancer therapies available, in June 2008.
TomoTherapy is a CT image-guided radiation therapy (IGRT) and intensity modulated radiation therapy (IMRT) delivery system, which can deliver radiation beams in a 360-degree fashion – precisely delivering radiation to a cancerous tumor while sparing the normal healthy tissue around it.

Patients with certain types of lung cancer, head and neck tumors, prostate cancer, recurrent tumors with prior history of radiation therapy and tumors close proximity of normal critical tissues, are all potential TomoTherapy candidates.

Because the radiation source rotates around the patient, it can deliver radiation with extreme flexibility. Built-in daily CT imaging ensures significant precision.

“This allows treatments that are difficult or impossible for conventional radiotherapy machines to deliver, such as treating tumors in the lung while minimizing dose to normal lung tissue, or treating tumors close to the spinal cord while limiting dose to the spinal cord itself. It also allows patients to be treated for multiple metastases (different cancerous sites) simultaneously,” says St. John's radiation oncologist Dr. Nathan Kim.

TomoTherapy treatment times are slightly longer than the regular radiation therapy treatments, going from 10-15 minutes per day to 15-25 minutes per day per patient.

For some tumor sites, such as cancers of the prostate gland, there can be day-to-day movement of the gland due to differences in patient position or anatomical changes due to rectum or bladder distension. The daily CT scan is used to precisely place the radiation beam and allows the operator to modify the treatment.

“This ability is known as image-guided radiation therapy, which is the new standard for radiation therapy for certain tumors,” says Dr. Kim. “The addition of TomoTherapy is a great complement to St. Johns’ radiation and radiosurgery technology, which includes standard IMRT, brachytherapy and the CyberKnife. We anticipate that this new therapy will benefit patients whose cancers are not optimal to treat using IMRT with conventional LINAC-based technology due to the location or position of the tumor, but not appropriate for treatment with the CyberKnife.”

Most patients receive daily TomoTherapy for six to eight weeks, Dr. Kim says. Because TomoTherapy’s radiation delivery is so precise, he anticipates that patients will experience fewer side effects of radiation therapy.

MORE ABOUT TOMOTHERAPY

TomoTherapy shares a lot of technology with CT scanners, otherwise known as computerized tomography. The machine even looks like a CT scanner. Some of its capabilities are:

TomoTherapy will do a quick CT scan before each treatment starts, to ensure the patient is aligned perfectly.

A thin beam is rotated around the body, entering from many directions, while the couch simultaneously moves into the machine. This effectively results in thousands of little beamlets of different intensities entering the body, converging on the tumors.

A very powerful multiple-processor computer calculates the treatment plans and coordinates treatment delivery.

TomoTherapy can treat big or little tumors, single or multiple tumors, one region of the body or several regions, to the same dosage in every area or to multiple dosages.
 


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