Department of Radiation Oncology Inova Fairfax Hospital 3300 Gallows Rd. Falls Church, VA 22042
Phone: 703-776-3731 Fax: 703-776-2743
What is TomoTherapy™? TomoTherapy™ is a new and revolutionary way of delivering radiation therapy, making it possible to direct the radiation dose more precisely than with any other technology.
In addition to precision, TomoTherapy™ significantly improves the accuracy of treatment by imaging the target tissue immediately prior to treatment and adjusting for any patient movement or internal organ movement that might negate the advantage of higher precision.
How Does TomoTherapy™ Work? The TomoTherapy™ machine is actually a high-output linear accelerator mounted on a CT-scan gantry, rotating about the patient in a helical pattern. The radiation beam consists of 64 tiny “beamlets,” each of which can strike the patient from a full 360 degrees. In addition, each beamlet can be independently switched on or off at any time, depending on whether its radiation will be helpful or harmful in achieving the prescribed radiation distribution. As an oversimplification, when a beamlet is pointed at the target area it will be switched on. When it is pointed at a normal tissue, it will be switched off. The TomoTherapy™ beam is tuned-down in order to make a diagnostic-type CT scan of the patient just seconds before treatment. Based on the scan the patient is positioned more accurately than would otherwise be possible before the treatment beam is activated and treatment is begun. The entire process including imaging, repositioning and treatment is usually accomplished in about fifteen minutes.
What are the Benefits of TomoTherapy™? Because TomoTherapy™ is so precisely targeted, it: minimizes the radiation dosage to normal tissues adjacent to the tumor, thereby reducing side effects and the risk of complications allows delivery of a higher dosage of radiation to the target area, thereby improving the chance that the tumor will be eradicated
Who Can Benefit from TomoTherapy™? Not every patient will benefit from TomoTherapy™. It is best used when there is a discrete target organ or tumor, adjacent to normal structures that need to be protected from excess radiation. It is particularly useful in cancers of the sinus and pharynx areas, certain brain tumors, prostate cancer and difficult cancer recurrences, especially after prior radiation therapy. It is not useful when there is no discrete target; for instance in breast cancer after lumpectomy. TomoTherapy™ has all of the capabilities of CyberKnife, but without CyberKnife’s limitation on target size, long treatment times, and expense.
Is TomoTherapy™ Covered by Insurance? TomoTherapy™ is covered by insurance plans and medicare whenever intensity modulated radiation therapy (IMRT) is indicated.
Referring a Patient: Radiation oncologists encourage referral phone calls from physicians prior to appointment scheduling so the case can be discussed in advance. The patient’s first visit is a consultation with the radiation oncologist to determine if radiation therapy is necessary and what technology is appropriate to the problem. If the patient and the radiation oncologist agree to proceed, an appointment will be made for “simulation” of treatment, with additional imaging as needed. Except in emergencies, treatment will begin a week or so after simulation.