Overview

Tomotherapy is an image-guided radiation therapy used to treat cancer. It combines Intensity-Modulated Radiation Therapy (IMRT) with computed tomography (CT) scanning technology to deliver highly targeted radiation to the tumour while minimising exposure to healthy tissue. This technology is ideal for tumours that are hard to reach or next to vital organs. One of the major benefits of tomotherapy is its ability to treat multiple tumours at a time.

Alternate Name

Image-guided radiation therapy

Body Location

Prostate, breast, lung, brain, head and neck cancers

Procedure Type

Non-invasive

Who is a good candidate for tomotherapy?

A good candidate for tomotherapy is someone who has been diagnosed with cancer that can be treated with radiation therapy. Tomotherapy may be particularly beneficial for patients who:

Have tumours that are difficult to reach with conventional radiation therapy techniques.
Have tumours located close to critical organs or structures, where minimising exposure to healthy tissue is important.
Require radiation therapy as part of their treatment plan, either before or after surgery.
Have already received radiation therapy in the past and may benefit from a more precise, targeted approach.
Have tumours that are recurrent or have not responded to other treatments.

Not all patients are suitable candidates for tomotherapy, and the decision to use this treatment should be made on a case-by-case basis by a team of medical professionals, including radiation oncologists, medical physicists, and radiologists.

Preparation

The preparation for tomotherapy typically involves several steps, which may include:

Simulation: Before starting tomotherapy, the patient will undergo a simulation process, which involves creating a 3D image of the tumour and surrounding tissue using a CT scanner. This helps to determine the exact location and shape of the tumour, as well as the position of critical organs and structures in the surrounding area.
Immobilisation: During the simulation process, the patient may also be fitted with a custom-made immobilisation device, such as a mask or body mould, to help keep them still and in the correct position during treatment.
Treatment planning: Once the simulation is complete, the medical team will use the 3D images to create a treatment plan that specifies the radiation dose, beam angles, and other details of the treatment.
Pre-treatment imaging: Before each treatment session, the patient will undergo a CT scan to confirm the position of the tumour and surrounding tissue. This helps to ensure that the radiation is delivered to the correct location.
Positioning: The patient will lie on a table that moves through the tomotherapy machine, and the immobilisation device will be used to help keep them in the correct position during treatment.

Overall, the preparation for tomotherapy is designed to ensure that the radiation is delivered precisely to the tumour while minimising exposure to healthy tissue.

Procedure of tomotherapy

During tomotherapy, the patient lies on a table that moves through a ring-shaped gantry that delivers radiation in a 360-degree arc around the body.

Here are the main steps of the tomotherapy process:

Positioning: During each treatment session, the patient lies on the table in the same position as during the planning scan. The table is then positioned within the gantry so that the tumour is in the center of the radiation beam.
Delivery: The radiation is delivered in a series of "beamlets" that are adjusted in intensity and shape as they pass through the body. This allows for precise targeting of the tumour and sparing of nearby healthy tissue. The gantry rotates around the patient, delivering radiation from different angles as the table moves through the gantry.
Monitoring: During treatment, the patient is monitored using a built-in imaging system that allows the radiation oncologist to check the position of the tumour and adjust the radiation delivery as needed.

Follow up

It has been observed that the side effects associated with radiotherapy often peak within two weeks after the treatment. The effects may continue to develop, and you might require a couple of weeks to resume normal activities. The recovery also depends on the area of the body that has been treated. Based on the type, size and severity of the condition, the radiation oncologist will offer a tailor-made plan for a follow-up to assess the efficacy, recovery after the procedure, recurrence, and side effects of the treatment. The patient will be recommended to undertake imaging tests to determine the effectiveness of the radiation after the completion of therapy sessions. Allergies or side effects, if any, can also be detected in follow-up sessions.

Risks

There could be short-term side effects with tomotherapy, which can often depend on the area of the body being treated. Some side effects of tomotherapy may include:

Redness, skin irritation or peeling
Fatigue
Nausea
Vomiting
Hair loss in the treated area
Headaches
Mouth sores
Difficulty eating
Dry eyes, etc

Most side effects subside after the treatment stops, but some might stay longer and fade away over several weeks to months. Long-term side effects may include skin changes or a slight risk of developing second cancer.

Recovery

You may experience general weakness/tiredness for four to six weeks after the last therapy session. You will recover gradually with the standard care given after completing therapy sessions.

FAQs

What are the benefits of tomotherapy?

Tomotherapy helps with accurate tumour targetting.
Minimal damage to the surrounding tissues.
Fewer side effects than other medications.
It is a painless, non-invasive technique.
It can be used along with surgery, chemotherapy, and/or other drugs.
It is suitable for tumours that are difficult to approach or are located near vital organs.
Each session only takes a few minutes.
It can treat several tumours simultaneously.

How much time does it take for a tumour to shrink after radiation treatment?

A cell cannot expand or spread if it does not divide. After radiation therapy, the mass may decrease in cancers that divide gradually over a long period of time.

Is there any recurrence of cancers after radiation therapy?

There might be a chance of the cancer cells growing back if they have not been totally eradicated by radiation. Certain immunotherapies and targeted cancer medications may help entirely eradicate cancerous cells/tissues. However, others might control the tumour for a couple of months or years before it shrinks.

What is the most common side effect of tomotherapy?

Fatigue is the most common side effect of radiation therapy. Doctors believe that it is caused due to high amounts of energy used by the body to heal itself in response to radiation therapy.

How much does tomotherapy cost in India?

Treatment cost in India depends on consultation charges, basic examinations and tests, treatment costs, and doctor's fees. Some centres for tomotherapy in India charge separately for routine pharmacy, speciality consultations, accommodation, and patient food.

What is the difference between chemotherapy and radiation therapy in the treatment of cancer?

Chemotherapy and radiation therapy are used to treat cancer that causes uncontrolled cell growth and spreads to nearby tissues. Chemotherapy uses specific drugs to shrink or kill cancer cells, while radiation therapy uses high-energy beams such as X-rays or protons to kill these cells.

Which is better, chemotherapy or radiation therapy?

The oncologist takes a call based on the location, type and severity of cancer. While chemotherapy is a systemic treatment, radiation therapy is often localised but may be systemic. Both of these treatments can have side effects, which can differ depending on the patient and type of treatment.

To learn more about tomotherapy and whether it might be a good fit for your unique situation, we encourage you to schedule a consultation with a radiation oncologist who is experienced in using this technology. Don't wait to take the first step in your cancer treatment journey - reach out today to schedule your consultation and learn more about how tomotherapy can help you fight back against cancer.