Targeted radiation therapy
Precise forms of radiation therapy give us ways to destroy cancer cells from many different directions. Called tomotherapy, we use this advanced technology to aim small, focused radiation beams at the tumor from thousands of positions. This pinpoints cancerous masses and delivers optimal doses to the specific area. Nearby organs and healthy tissue receive less radiation, unlike conventional methods.
Here at Goshen Center for Cancer Care, we use a PET/CT scan simulator to precisely map the exact location, shape and size of the tumor, which further improves the effectiveness of treatment.
Precise radiation therapy
Our expert radiation oncology team uses tomotherapy to treat cancer that was once considered untreatable. This therapy can treat multiple tumors simultaneously and with such accuracy that nearby organs and healthy tissues remain undamaged. For example, we can use tomotherapy to treat throat cancer, while avoiding the salivary gland. While treating cancer of the pancreas, we can avoid the kidneys. We can treat a spinal bone while avoiding the spinal cord, even when the area had prior radiation treatment. Tomotherapy can treat large or small tumors, one region or several regions, and provides the same dose or multiple, different dosages.
Benefits of tomotherapy
- Minimizes radiation to surrounding healthy tissue and organs
- Causes fewer side effects than traditional radiation
- Requires fewer treatment visits due to more precise, larger doses
- Improves patient outcomes due to accuracy
- Delivers painless and precise radiation to the tumor
- Uses high-energy X-ray beam for clearer images
- Allows adjustments to deliver correct dosing at each treatment
- Treats tumors once considered untreatable due to their location or because they had previous radiation
How tomotherapy works
Tomotherapy combines intensity modulated radiation therapy (IMRT) with CT scanning technology to direct radiation beams at the tumor from thousands of positions. This pinpoints radiation on cancerous masses and delivers optimal doses to the specific area. By using the highest dose of radiation to kill tumor cells, this treatment causes less damage to nearby organs and healthy tissue.
We use sophisticated software diagnostic imaging and patient-positioning devices to develop a treatment plan tailored to each patient's condition. These tools help us plan, implement and revise a precise dose of radiation in three dimensions, based on individual tumor size, shape and location.
To plan treatment, we use 3-D images of a patient’s tumor in conjunction with computerized dose calculations. They allow us to determine a radiation intensity pattern that best conforms to the tumor shape. Tomotherapy directs very small beams of radiation, varying in shape, angle and intensity, hundreds of times to different parts of the tumor. Its precision makes it one of the most accurate forms of external beam radiation therapy available.
The radiation system completes a quick CT scan to ensure the patient is aligned perfectly. Rotating radiation beams, each varying in intensity and direction, converge on the tumor from 360 degrees, while the patient's couch simultaneously moves into the tomotherapy unit. A powerful multiple-processor computer calculates the treatment plan, sculpts the radiation dose and coordinates treatment delivery. To further streamline the process, all of a patient’s records are conveniently stored within the equipment. Tomotherapy is painless, and it usually lasts only a few minutes.
During tomotherapy, it’s important to accurately position and immobilize the patient to ensure the most precise treatment is given. This may be done with special head frames (if the head or brain is being treated), or with advanced imaging devices, such as electronic portal imaging and scanning ultrasound. These positioning tools provide updated, daily information about the location of the tumor in relation to surrounding organs. This is especially important with some organs, such as the prostate, which moves due to normal daily volume changes in the bladder and rectum.
CT/PET scan simulator
For tomotherapy to be effective, the anatomical position of the tumor and surrounding healthy tissues must be accurately defined.
Following the treatment planning process, the patient has a simulation (or practice run) to confirm the location of the tumor. This trial also ensures that the appropriate radiation dosage and delivery have been calculated. The patient is placed in an immobilization device, the treatment plan is entered, and computed tomography (CT) and positron emission tomography (PET) scans are taken. The CT scan shows the body’s anatomic structure. The PET scan shows how the body is functioning. When combined into a PET/CT image, the patient’s complete picture is revealed. And more important, any irregularities or miscalculations can be discovered before the radiation treatment is started. This includes the application of immobilization devices, beam modification devices, approved field arrangements and other treatment variables.
Unlike traditional CT scans or fluoroscopic simulations, PET/CT simulation enables radiation oncologists to use information on both the tumor’s location and activity to precisely pinpoint the radiation to only where it’s needed. PET/CT simulation differs from a conventional PET/CT scan by the use of a special immobilization device that’s necessary for radiation treatment.