City of Hope’s Division of Radiation Oncology has installed its second TomoTherapy machine for targeted radiotherapy, making it the first institution in the world to have two machines dedicated for patient treatment.
Physicians treated their first two patients with the new TomoTherapy HI-Art System on June 21, said Jeffrey Wong, M.D., chair of the Division of Radiation Oncology. Radiation oncologists will use the new system for a variety of radiotherapeutic applications; adding the system allows oncologists to increase their radiosurgical procedures, as well.
“The new helical TomoTherapy system means that we can offer highly precise and effective radiotherapy using CT guidance to even more patients,” Wong said. “We’re excited to be at the leading edge of many new applications for this technology.”
City of Hope’s new system shines as the first step in a marked expansion planned for the Division of Radiation Oncology in the next three years. The division will be housed in the Center for Targeted Therapy, a 28,000-square-foot area of the Medical Center scheduled for refurbishment and build-out.
The future center will include not only two TomoTherapy units, but also a positron emission tomography/computed tomography (PET/CT) simulation unit, two modern linear accelerators for image-guided radiation therapy and stereotactic radiosurgery, a dedicated magnetic resonance imaging unit for radiation planning, a CT simulator, high-dose rate brachytherapy suite and spacious lobby.
For now, however, the new TomoTherapy system will expand on services already in high demand. With the first system, “treatments started at 8 a.m. and easily went past 11 p.m. at times,” said Wong.
Since the TomoTherapy HI-ART System was installed at City of Hope on Oct. 26, 2004, nearly 300 patients have received treatment using the technology. Prostate cancer is the most common application for TomoTherapy, but many patients with myeloma and head and neck, gastrointestinal, lung, breast, brain, gynecologic and other cancers have been treated, as well.
The new system will increase radiotherapy procedures, and also will allow physicians to increase radiosurgery options for lung and brain cancers. Radiosurgery is different from radiotherapy: It focuses tightly conformed beams of radiation directly onto a tumor. Because little healthy tissue is exposed to radiation, oncologists can use high doses of radiation in a drive to destroy the tumor entirely.
Radiosurgery may be a curative alternative that is especially appropriate for elderly patients and patients whose diminished health or complications make them poor candidates for traditional surgery.
TomoTherapy marries two technologies: spiral CT scanning and spiral intensity modulated radiation therapy. As with a CT scanner, the patient moves through the unit - but instead of using X-rays for imaging, the TomoTherapy unit delivers high-energy therapeutic X-rays spirally around the patient, producing a sculpted dose of radiation at the tumor site. This leads to more effective and potentially more curative doses being delivered to the cancer, while reducing radiation doses to healthy tissue.
The image guidance involved in TomoTherapy means physicians can carefully map radiation doses to each patient’s tumors in advance.
City of Hope was the first research and treatment center in the western United States to offer the technology, and City of Hope radiation oncologists are sharing their experiences with colleagues. Their growing expertise with the TomoTherapy system has resulted in invitations from physicians overseas to discuss the fine points of the therapy. Most recently, City of Hope physicians traveled to South Korea to discuss their use of TomoTherapy for total marrow irradiation, among other applications.
