Cutting-Edge Radiotherapy: TomoTherapy at Willis-Knighton
Since opening its doors seven years ago, the Willis-Knighton Cancer Center, in Shreveport, LA, has been committed to offering state-of-the-art treatment options for cancer patients. This philosophy made the TomoTherapy Hi·Art System® a natural choice for the doctors and physicists in the Radiation Oncology Department.
“TomoTherapy was the next evolution in our IMRT process,” explains Dr. Lane Rosen, Director of the Radiation Oncology Department. “We already had extensive experience with rotational RT as well as step-and-shoot systems. We liked the conformality of rotational IMRT, but often had to sacrifice the positioning accuracy you could get with step-and-shoot. Our experience demonstrates that the Hi·Art System’s TomoImage capability gives you even better visualization and accuracy of patient positioning than the step-and-shoot systems, while the helical treatment delivery provides better localization of the target than you got with previous rotational IMRT systems.”
The Willis-Knighton Cancer Center is a Center of Excellence for TomoTherapy Incorporated, and has been using the TomoTherapy Hi·Art System® to treat cancer patients since the unit was installed in December 2003.
Dr. Lane Rosen and Dr. Sanford Katz (Radiation Oncologists); Dr. Hsinshun (Terry) Wu and Ms. Jackie Walker (Medical Physicists)
Dr. Rosen and his colleagues have been using the TomoTherapy Hi·Art System® to develop intensity modulated stereotactic radiotherapy-that is, using extremely high doses of carefully targeted radiation in a single treatment fraction.
The department has performed several intracranial and extracranial treatments for patients with brain and liver metastases, and is working with the Biomedical Research Foundation in Shreveport on a research project designed to verify their TomoTherapy accuracy and results with PET scans. “Our first treatment was for a patient with liver metastases,” Dr. Rosen notes. “Six weeks later, the PET scan showed no sign of tumor.”
PET scan showing (on left) metastatic colo-rectal cancer and (on right) the same area six weeks after high-dose hypo-fractionated stereotactic radiotherapy.
Dr. Rosen and his colleagues have also used a conformal avoidance approach in some cases, such as treating a patient with advanced endometrial cancer. Conformal avoidance radiotherapy is used for cases where the tumor boundary can not be easily defined: rather than trying to map the precise area to be treated, clinicians can map out critical structures that must be avoided. “We treated the entire abdomen from diaphragm to vagina, and were able to protect the kidneys and liver, as well as the bone marrow of the spine and pelvis,” Dr. Rosen points out. “That’s something you just couldn’t do before.”
Planning images for total abdominal treatment with the TomoTherapy Hi·Art System®.
Dr. Rosen hopes to work with TomoTherapy to enhance the stereotactic radiotherapy components of the Hi·Art System. “We see [the Hi·Art System] as an opportunity to expand our IMRT horizons, and our niche is to push the limits of the system.”
Dr. Rosen notes that the Willis-Knighton Cancer Center is receiving referrals from all over the US. “Our goal is to make Shreveport a destination site for tertiary referral.”
12 Mar 2004
