TomoTherapy Treatment at Robert Wood Johnson University Hospital

Robert Wood Johnson University Hospital (RWJUH) now offers the TomoTherapy Hi Art system, a revolutionary radiation therapy treatment for cancer. Unique in its combination of CT imaging technology and precise radiation delivery in one physical unit, this system allows members of the RWJUH Radiation Oncology Team to more accurately target tumors and deliver a higher dose of radiation while minimizing side effects and treatment time.

Imaging

Using this treatment system, RWJUH clinicians acquire 3D images of the patient immediately before treatment. With these images, physicians check the size, shape and location of tumors. They can compare the day’s image with a baseline image used for planning to make sure that radiation is directed to where it should be. These daily images can also be used to analyze, and if necessary, modify a patient’s treatment at any point during the treatment course.

Precision

While conventional radiation therapy machines deliver a wide beam of radiation from only a few angles, the Hi Art treatment system uses its unique CT scanner design to continuously deliver radiation from all angles around the patient. And, it features technology that divides a single beam into many smaller, narrow beamlets. More angles and more precise modulation result in dose distributions that conform to tumors like never before, resulting in less damage to surrounding healthy tissue.

Cancers Treatable with TomoTherapy

The RWJUH Radiation Oncology Team uses TomoTherapy to treat a wide range of cancers, including:

• Brain
• Bone
• Gastrointestinal (colorectal) cancer
• Gynecological
• Head and neck
• Lung
• Prostate
• Soft tissue

The Process

Behind the Scenes

Before beginning a TomoTherapy treatment, your physician develops a plan using 3D images from a combination of scanning technologies (such as CT and MRI) and special software to establish the precise contours for each tumor and surrounding sensitive organs or tissues.

The doctor then prescribes how much radiation the tumor should receive, as well as acceptable levels for healthy tissue nearby. The system calculates the appropriate pattern, position and intensity of the radiation beams to be delivered, based on the doctor’s prescribed dose.

The Day of Treatment

After checking in for a daily treatment, the patient will be taken to the TomoTherapy treatment room where a radiation therapist will help him/her onto the system’s couch. The patient will most likely lie on his/her back, and the therapist may fit him/her with a special device to help hold still during treatment.

First, the couch will move the patient through the machine once for daily imaging. Based on these images, the therapist may fine tune the patient’s position via small couch adjustments. Then the couch will move the patient through the machine once again, this time more slowly, as the system delivers the daily treatment.

What You Can Expect

A typical course of radiation therapy involves a daily process, Monday through Friday. The number of treatments varies by case. On the average, the full daily TomoTherapy procedure takes 20 minutes from when the patient enters the treatment room until he leaves. This includes about five minutes for the daily CT to be performed and another five minutes for treatment to be delivered (“beam-on time”). The remaining time is used for patient set-up and image registration for proper positioning. TomoTherapy treatments are completely painless. The experience is similar to having a CT scan or an x-ray taken. You may hear a clicking noise and the hum of the machine, both of which are normal sounds that the machine makes.