Tomo at Thompson: On the Forefront of Image-Guided IMRT
Cutting-edge technology is the cornerstone of the Radiation Oncology department at Thompson Cancer Survival Center in Knoxville, TN. Patients considered untreatable at other institutions are routinely referred to Thompson Cancer Survival Center because of their unique, leading-edge treatment options. And since July 2003, TomoTherapy has played an increasingly important role in the department’s arsenal.
“We chose the TomoTherapy Hi·Art System because it makes the most sense for optimizing radiation treatment,” explains Daniel Scaperoth, MD, a Radiation Oncologist at Thompson. Dr. Scaperoth, who also holds a Masters degree in electrical engineering, was particularly impressed with the Hi·Art System’s technology. “It’s really an impressive machine,” he observed. “This is the way it should be done.”
The department treated their first patient with the TomoTherapy Hi·Art System® on July 1, 2003. Since then, “we’ve treated patients for prostate cancer, head and neck tumors, lung cancer, and intracranial lesions,” notes Chester Ramsey, Ph.D., a medical physicist at Thompson.
Isodose distributions for re-treatment of a spinal cord compression.
“We’ve also used TomoTherapy to perform intensity-modulated stereotactic radiotherapy, as well as spinal cord compression re-treats.” Dr. Ramsey adds that the department has been performing an average of 10 treatments per day using the Hi·Art System. “We’ve seen some wonderful responses with lung cancer patients,” observes Ramsey, “where the tumor seems to be responding faster than with conventional therapy.”
In addition to providing clinical treatments with the TomoTherapy Hi·Art System®, Ramsey, Scaperoth, and their colleagues are conducting a number of research projects with TomoTherapy, using data from current treatment plans to model the effects of the protocols under study.
One promising line of research involves adaptive therapy for lung cancer. “On lung treatments we’ve observed, we’ve seen the tumor volume shrink as much as 60% during a week’s course of TomoTherapy treatment” notes Ramsey. “We are investigating creating new treatment plans on a weekly basis, based on tumor shrinkage. This would allow us to further reduce the amount of healthy tissue irradiated.”
Reduction in tumor volume for lung patients treated with image-guidance radiotherapy at the Thompson Center.
Dr. Ramsey is also involved in research that adapts TomoTherapy treatment plans on a daily basis for patients with prostate cancer. Normally radiation treatment fractions are based on a single plan; however, in cases such as prostate, the position of the tumor and surrounding tissues can change significantly from day to day.
“With the Hi·Art System’s TomoImage guidance, we can generate 3 to 5 different plans ahead of time, and then choose which plan best fits the anatomy for any particular day,” explains Ramsey."We believe that IMRT is the future of radiation therapy, and that the TomoTherapy Hi·Art System provides the best solution for combining image guidance with precise IMRT.”
Ramsey points out that about 30% of the patients treated with TomoTherapy would not otherwise have been candidates for radiation treatments. “These were patients who had already been treated with conventional RT or IMRT and had been ‘maxed out’ in a conventional sense,” explains Ramsey.
“We’re very excited to be providing this level of services to the community, on the forefront of image-guided IMRT.”
15 May 2004
