The document discusses helical tomotherapy, a form of radiation therapy that uses a rotating x-ray beam. It summarizes a study of 150 patients treated with tomotherapy between 2006-2007 for reasons such as complex tumor geometry or need for image guidance. Setup corrections were often needed based on pretreatment MV CT scans. Treatment times were typically under 25 minutes with minimal increases over time. Tomotherapy allows conformal dose distributions and image-guided radiation for difficult cases near critical organs.

1. Helical Tomotherapy Sterzing, Schubert, Sroka-Perez, Kalz, Debus, Herfarth. Strahlentherapie und Onkologie. 2008 Jan 11;184(1):8-14. Presenter: Dr Santam Chakraborty Date: 21.02.08

4. Overview of IGRT Techniques

6. Patients and Methods

8. Site Distribution

14. Results

16. Time Effort

17. Time Effort

19. Discussion

22. Design Characteristics

25. Machine Interior Fenwick JD, Tome WA, Soisson ET, Mehta MP, Rock Mackie T. Tomotherapy and Other Innovative IMRT Delivery Systems. Seminars in Radiation Oncology. 2006 Oct ;16(4):199-208.

28. Machine Head configuration

35. Planning Process

39. Generated H&N Plan

40. Generated Plans

42. MV-CT Imaging and Adaptive RT

47. MV-CT Images

52. ART: Why ? Due to a change in the contours (e.g. Weight Loss) the actual dose received by the organ can vary significantly from the planned dose despite accurate setup and lack of motion.

54. ART: Problem Real time adaptive RT is not possible “today”

55. ART: Steps..

56. ART: Steps

57. Clinical Planning and Treatment Experience

60. Craniospinal Radiation Penagaricano JA, Papanikolaou N, Yan Y, Youssef E, Ratanatharathorn V. Feasibility of cranio-spinal axis radiation with the Hi-Art tomotherapy system. Radiotherapy and Oncology. 2005 Jul ;76(1):72-78. Results : When considering D50% and D10%, CSA-TOMO has a dosimetric advantage over CSA-RT for most organs at risk. The body integral dose was higher for the CSA-TOMO plan by approximately 6.5% .

61. Dosimetric Comparison Fiorino C, Dell'Oca I, Pierelli A, Broggi S, Martin ED, Muzio ND, et al. Significant improvement in normal tissue sparing and target coverage for head and neck cancer by means of helical tomotherapy. Radiotherapy and Oncology. 2006 Mar ;78(3):276-282.

62. Dosimetric Comparison Fiorino C, Dell'Oca I, Pierelli A, Broggi S, Martin ED, Muzio ND, et al. Significant improvement in normal tissue sparing and target coverage for head and neck cancer by means of helical tomotherapy. Radiotherapy and Oncology. 2006 Mar ;78(3):276-282.

63. Clinical Results: Bauman et al Bauman G, Yartsev S, Rodrigues G, Lewis C, Venkatesan VM, Yu E, et al. A Prospective Evaluation of Helical Tomotherapy. International Journal of Radiation Oncology*Biology*Physics. 2007 Jun 1;68(2):632-641.