1 (edited by PCL1029 Sat, 14 Jan 2012 16:19:10)

Topic: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

Hi, everyone,

Additional info: for the difference bettween EBRT and IMRT
Its differenence in that IMRT use 3D radiation planning the treatment and utilizes VARIABLE,computer controlled intensities within each beam,in contrast to the uniform doses,which is FIXED, in each 3D-CRT beam such in  the treatment with EBRT.
Compare to most other treatment techniques,IMRT can achieve a higher degree of accuracy to the planned tagget-the tumor,while sparing normal tissue. it is similar to Cyberknife (Robotic Linac IMRT) But  Cyberknife provides  more flexibility than EBRT and tomoptherapy IMRT.-from uptodate.com  IMRT literature review ver.19.3 Sept.2011

Below is the info for tomotherapy provided by  www.tomotherapy.com

What is TomoTherapy?

TomoTherapy is a new way to deliver radiation treatment for cancer. TomoTherapy literally means "slice therapy," and gets its name from tomography, or cross-sectional imaging. The TomoTherapy Hi·Art System® delivers a very sophisticated form of intensity-modulated radiotherapy (IMRT), and combines treatment planning, CT image-guided patient positioning, and treatment delivery into one integrated system.

The equipment used for TomoTherapy looks much like a computed tomography (CT) system: the patient lies on a couch that moves continuously through a rotating ring gantry. The gantry houses a linear accelerator, which delivers radiation in the shape of a fan beam as the ring is turning. With the couch moving at the same time the gantry is rotating, the radiation beam makes a spiral (or helical) pattern around the patient, targeting tumors with optimal levels of radiation while minimizing the dose to healthy areas.What is the advantage of TomoTherapy?

The advantage of TomoTherapy is having a radiation treatment beam projected into the tumor continuously as it rotates, rather than having a limited number of fixed beams, each providing only a fraction of the dose necessary to irradiate the tumor. With the TomoTherapy Hi·Art System®, physicians can adjust the size, shape, and intensity of the radiation beam to target the radiation to the size, shape, and location of the patient's tumor.

In addition, the new TomoTherapy Hi·Art System® integrates imaging with radiation treatment, which provides physicians with full three-dimensional information for accurate daily patient positioning. Its TomoImage® capabilities allow physicians to verify the position of the tumor before each treatment session, so adjustments can be made on the spot to make sure that radiation is delivered exactly where it should be.

How does TomoTherapy work?

The Tomo® Process combines treatment planning, CT image-guided patient positioning, and treatment delivery into one integrated system:

    Treatment Planning

    Before beginning TomoTherapy treatment, the physician uses three-dimensional images and special software to define the precise contours for each tumor. The physician also decides how much radiation the tumor should receive, as well as acceptable levels for surrounding structures. Then the TomoTherapy Hi·Art Planning Station calculates the appropriate pattern, position, and intensity of the radiation to be delivered.

    CT Image-Guided Patient Positioning

    Precise patient positioning is crucial for effective radiation treatment. With the TomoTherapy Hi·Art System®, physicians can take a special CT scan, called a TomoImage®, just before each treatment to verify the tumor's location and adjust the patient's position, if necessary. This is extremely useful since a patient's position may change slightly from session to session and certain types of tumors, such as prostate cancers, can change shape or shift from day to day. With the TomoTherapy Hi·Art System®, physicians can make sure that the radiation is directed precisely from one session to the next.

    Radiation Delivery

    TomoTherapy combines intensity modulated radiation therapy (IMRT) with a spiral delivery pattern. Photon radiation is produced by a linear accelerator (or linac), which rotates multiple times around the patient. The linac moves in association with a device called a multileaf collimator, or MLC. The computer-controlled MLC has two sets of interlaced leaves that modulate radiation beam while the patient, located on the treatment couch, moves slowly through the center of the gantry ring.
God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

Percy, WOW, you were reading my mind, which is not easy to do! I was wondering if IMRT  was anything like Cyber Knife. Cyber Knife worked so well for Teddy and yet I have not seen anyone else on here who even had it suggested. I am assuming (which I should not do) that it is because most everyone has multiple tumors or they are too large. Teddy's was over 7 cm and must be 6 or under for C.K. However, he had 25 radiation treatments then the C.K. We could not get over that C.K. was only 4 treatments and he had no side effects! It did buy him 3 more years!

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

My mom will receive IMRT soon, I will post on progress.  I hope it works.  Have you head of anyone else that has received this treatment?

Anna

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

Thanks for the info Percy!!  I received Tomotherapy after resection if anyone ever has any questions. 

Best wishes!
Susie

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

I am having sterio tactic radiosurgery, does anyone know if this is similar? Lisa

This Information Is Not Intended Nor Implied To Be A Substitute For Professional Medical Advice. You Should Always Seek The Advice Of Your Physician Or Other Qualified Health Care Provider

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

Hi,
Yes ,Stereotactic radiosurgery (SRS)  and SBRT is similiar to the above.
attach is a link for more info.

www.radiologyinfo.org/en/info.cfm?pg=stereotactic

God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

Is the radiation combo with chemotherapy more effective than the chemo alone?

Anna

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

Hi,
I think IMRT followed by 6 month of Gemzar is an appropriate course of treatment for patient who cannot have surgery due to the location of the relatively small size of the tumor that RFA cannot be performed.

due to the limited knowledge that I had, It is difficult to answer your question. I think the benefit of radiation alone or in combination with chemotherapy(either before ,concurrently or after radiation) depends on the patients' general health,the disease state of the tumor and the judgement of the attending medical oncologist,surgeon and radiation oncologist as a team.
For myself,less is always better.
God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

9 (edited by PCL1029 Tue, 24 Jan 2012 15:35:11)

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

Hi,
You are in luck to day,Tim just put up abstract # 268  from his volunteer work in attending  the GI ASCO 2012 convention for us and that will give you some evidence based answers to your questions.

•    (Abstract #268) Cholangiocarcinoma: A joint cancer database analysis. Presenting Author: Yehuda Ethan Deutsch, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL

God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

I will start IMRT on April 23. I will receive it 5 days a week for 5 1/2 weeks at MD Anderson. Dr Daas is my interventional radiologist, Dr Javle is my Gastro dr. I was at MD Anderson last week for a biopsy as on my PET scan about 3 weeks ago showed my tumor had slightly grown and I had 2 lymph nodes showing brightness. The biopsy further concluded they were cancerous. So, I went from starting a new chemo regimen today to cancelling it and making flight arrangements to get the CT scan and planning treatment instructions on March 13. I will fly home the same day, then return a week later to start treatments. I am scared of the radiation side effects and what they might do to the rest of my organs. I will miss my daughters college graduation, my Walk n' Roll day where we donate some to The Cholangiocarcinoma Foundation. Any one out there with words of advise, experience of IMRT, I appreciate any and all responses.  I am in good shape and still work full time. I was diagnosed in Feb. 2011 but had the cancer for over 3 years without a diagnosis. I recently had the honor of meeting Catherine Simms Dunnegan at one of my fundraisers. She drove over two hours to meet me and support our cause. Sorry to ramble on....just couldn't leave that last part out. God Bless~

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

Dear Patty, I am so sorry you will be missing so many monumental events but your getting the CC reduced or even gone is the most monumental event right now. You are very courageous and I know we are going to hear good things come out of this.
You already know that you are with one of the very best with Dr. Javle and gee, Teddy was taken care of by a Dr. Daas in September of 2005 at Columbia Hospital in Milwaukee. I wonder if it could be the same, he was in his Residency then. Please keep us posted, you know the routine and best wishes to you.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

Hi Patty,
My husband is currently getting IMRT as he had a Left radical nphrectomy for cancer already and they had to protect the right kidney during radiation.  He is in his 4th week of radiation and they are radiating a large area, as he had a positive surgical margin fron the right hepectomy done jan 25 of this year and a positive lymph node.  He is doing well with it and is working.  He is 47 and is also taking xeloda during this 5 1/2 week stint.  He is however very tired and his side is bothering him, although remember he just had a big surgery too.  I think you will do fine, the treatments are precise and quick.  Its the positioning that takes a few minutes!!  Good luck and stay strong.  I would like to hear how you do!!
a caring friend
~Amy

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

I had my planning appointments for IMRT and they are also putting me on Xeloda along with an allergy pill as Xeloda has already broke me out in hives. I will take two pills in the morning and two in the evening while getting IMRT 5 days a week for 5 1/2 weeks. My first treatment is April 23rd. I have also been introduced to a Dr. Kelly who is such a calm, caring man. He works under Dr. Das in the radiation oncology department. I will keep you posted after a few treatments to keep you updated.

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

Well, time has came and gone....I have 3 days left of IMRT. My only symptoms were tiredness starting about day3 and lasting to Saturday evening. I also has some side pain where liver is located on right side. I also had a feeling that my belly was on fire about Thursday to Saturday so I just drank ALOT of water which is key anyway with this cancer. I have never had nausea or diarhea during the treatments. My care at MD Anderson and the radiation team I saw every day.....5 days a week, is what kept me so positive!!
So ready to start home this coming week. I will return in 6 weeks to see if it did any good at all.
Somethings I learned after starting treatment:
1. IMRT only treats the mass/tumor so it can spread to other parts of the liver or body
2. It might not work at all but to hope for stabilization to buy me more time
3. Do NOT eat for 3 hours before your IMRT and there is a less chance of getting sick.
4. Drink LOTS of water before treatment up to minutes before the treatment helped me to NOT get the "belly burn" feeling.
5. Hope and pray for the best!!
Patty in Illinois

Re: Tomotherapy-An Intensity-Modulated Radiation therapy(IMRT) Treatment

Dear Patty, it is so very good to see you againand to know you only have 3 days left of IMRT . I am praying and wishing so hard for the best results for you.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.