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F E AT U RE S T O RY
TomoTherapy Offers Potential for More Effective
Cancer Treatment
“TomoTherapy is used at UCLA to treat a wide variety of cancers,
but is particularly well suited for challenging cases involving
large areas, or when the dose needs to be specially
shaped to conform to the patient’s anatomy.”
W ith state-of-the-art equipment and
some of the field’s top experts,
UCLA Health has emerged as a
leader in an approach to radiation therapy that
can reduce toxicity and length of treatment
while offering potentially superior tumor control.
Unlike traditional radiation therapy, which
sends wide beams of radiation to the entire
tumor from a limited number of angles,
TomoTherapy does its work slice-by-slice
(tomographically) in a continuous fashion,
operating like a computerized TomoTherapy
(CT) scanner by rotating around the patient
and providing radiation in a spiral delivery
pattern. “By doing that, TomoTherapy is
able to optimize the beam deliveries from
all directions, increasing the precision,”
explains Daniel Low, PhD, professor and
vice chair of medical physics for UCLA’s
Department of Radiation Oncology, who
has contributed to the technology’s quality
assurance innovations.
Before the advent of guided-image radiation
therapy, radiation oncologists had no way to
image the area being treated as the radiation
beam was turned on, notes Patrick Kupelian,
MD, professor of radiation oncology and the
department’s vice chair of clinical operations
and clinical research, as well as one of the
earliest to use TomoTherapy clinically.
“TomoTherapy was one of the first systems
to integrate radiation delivery with an
imaging device, so that you can be sure
that you’re on target and make adjustments
accordingly,” Dr. Kupelian explains.
The ability to more precisely target the
radiation field in a way that avoids critical
structures enables the radiation oncologist
to deliver higher doses during each session,
with the potential to shorten the sessions as
well as the overall course of treatment.
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“For prostate cancer, instead of seven to
nine weeks of treatment, you might have
one to two weeks,” says Dr. Kupelian. “It’s
a tremendous convenience and much less
of a burden for patients.”
The TomoTherapy system also facilitates
so-called adaptive radiotherapy. The size
and anatomical formation of tumors change
during the course of radiation treatment.
“TomoTherapy’s integrated imaging system
acquires scans each day that not only help to
position the patient, but also can be used to
monitor the size and location of the tumor
to determine if there needs to be adjustments
in the treatment plan,” Dr. Low explains.
TomoTherapy is used at UCLA to treat a
wide variety of cancers, but is particularly
well suited for challenging cases involving
large areas, or when the dose needs to be
specially shaped to conform to the patient’s
anatomy. These include head and neck cancers,
lung cancers, abdominal and pelvic cancers,
and gynecologic cancers. For cancers of the
tongue, throat and larynx, TomoTherapy’s
precise delivery can help to avoid damage to
the salivary glands and side effects such as
dry mouth and pain, notes Ke Sheng, PhD,
who helped to develop the first TomoTherapy
system at the University of Wisconsin and
is now an associate professor of radiation
oncology at UCLA. For cervical and
endometrial cancers, he adds, TomoTherapy
can protect the bowel, bladder and rectum and
reduce the risk of troublesome side effects.