eISSN: 1897-4309
ISSN: 1428-2526
Contemporary Oncology/Współczesna Onkologia
Current issue Archive Manuscripts accepted About the journal Supplements Addendum Special Issues Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
vol. 16
Original paper

Tomotherapy – a different way of dose delivery in radiotherapy

Tomasz Piotrowski, Małgorzata Skórska, Agata Jodda, Adam Ryczkowski, Joanna Kaźmierska, Krystyna Adamska, Aldona Karczewska-Dzionk, Małgorzata Żmijewska-Tomczak, Hanna Włodarczyk

Wspolczesna Onkol 2012; 16 (1): 16–25
Online publish date: 2012/02/29
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
Aim of the study : Helical tomotherapy is one of the methods of radiotherapy. This method enables treatment implementation for a wide spectrum of clinical cases. The vast array of therapeutic uses of helical tomotherapy results directly from the method of dose delivery, which is significantly different from the classic method developed for conventional linear accelerators. The paper discusses the method of dose delivery by a tomotherapy machine. Moreover, an analysis and presentation of treatment plans was performed in order to show the therapeutic possibilities of the applied technology. Dose distributions were obtained for anaplastic medulloblastoma, multifocal metastases to brain, vulva cancer, tongue cancer, metastases to bones, and advanced skin cancer. Tomotherapy treatment plans were compared with conventional linear accelerator plans.

Results : Following the comparative analysis of tomotherapy and conventional linear accelerator plans, in each case we obtained the increase in dose distribution conformity manifested in greater homogeneity of doses in the radiation target area for anaplastic medulloblastoma, multifocal metastases to brain, vulva cancer, metastases to bones, and advanced skin cancer, and the reduction of doses in organs at risk (OAR) for anaplastic medulloblastoma, vulva cancer, tongue cancer, and advanced skin cancer. The time of treatment delivery in the case of a tomotherapy machine is comparable to the implementation of the plan prepared in intensity-modulated radiotherapy (IMRT) technique for a conventional linear accelerator. In the case of tomotherapy the application of a fractional dose was carried out in each case during one working period of the machine. For a conventional linear accelerator the total value of the fractional dose in the case of anaplastic medulloblastoma and metastases to bones was delivered using several treatment plans, for which a change of set-up was necessary during a fraction.

Conclusion : The obtained results confirm that tomotherapy offers the possibility to obtain precise treatment plans together with the simplification of the therapeutic system.

helical tomotherapy, IMRT, treatment planning, evaluation of the dose distribution


Kukołowicz PF. Charakterystyka wiązek terapeutycznych fotonów i elektronów. RTA, Kielce 2001.  

Piotrowski T, Kazmierska J. Tomoterapia spiralna. W: Skuteczna ochrona radiologiczna w medycynie. Kubicka M, Barczyk J (ed.). Verlag Dashofer, Warszawa 2008.  

. Galvin JM, Smith AR, Moeller RD, et al. Evaluation of multileaf collimator design for a photon beam. Int J Radiat Oncol Biol Phys 1992; 23: 789-801.  

Brahme A. Optimal setting of multileaf collimators in stationary beam radiation therapy. Strahlenther Onkol 1988; 164: 343-50.  

Milecki P, Stryczyńska G, Nawrocki S, Iżycki D. Radioterapia konformalna 3-D - stan obecny i perspektywy. Wspolczesna Onkol 2000; 1: 30-2.  

. Kallman P, Lind B, Eklof A, Brahme A. Shaping of arbitrary dose distributions by dynamic multileaf collimation. Phys Med Biol 1988; 33: 1291-300.  

Grządziel A, Ślosarek K, Rutkowski R, Rembielak A. IMRT – new standards in treatment planning. Rep Pract Oncol Radiother 2001; 6: 29-30.  

Maciejewski B, Malicki J, Ślosarek K, Drzewiecka B, Radiobiological rationale for advantages and limitations of IMRT in clinical practice. Nowotwory 2001; 51: 355-64.  

Bindhu J, Supe S, Pawar Y. Intensity modulated radiotherapy (imrt) the white, black and grey: a clinical perspective. Rep Pract Oncol Radiother 2009; 14: 95-103.

Ziółkowska E, Reszke J, Morgaś T, Drzewiecka B, Makarewicz R. Rola IMRT w redukcji dawki promieniowania w odbytnicy w trakcie radykalnej radioterapii raka gruczołu krokowego. Wspolczesna Onkol 2005; 9: 296-9.

Idasiak A, Wolny E, Wydmański J, Hawrylewicz L, Miszczyk L. Za-stosowanie konformalnej radioterapii i modulacji intensywności wiązki w planowaniu pooperacyjnej radioterapii chorych na raka trzustki. Wspolczesna Onkol 2004; 8: 347-52.

Sas-Korczyńska B, Śładowska A, Rozwadowska-Bogusz B, Dyczek S, Lesiak J, Kokoszka A, Korzeniowski S. Comparison between intensity modulated radiotherapy (IMRT) and 3D tangential beams technique used in patients with early-stage breast cancer who received breast-conserving therapy. Rep Pract Oncol Radiother 2010; 15: 79-86.

Otto K. Volumetric modulated arc therapy: IMRT in a single gantry arc. Med Phys 2008; 35: 310-7.

Bedford JL. Treatment planning for volumetric modulated arc therapy. Med Phys 2009; 36: 5128-38.

Pesce GA, Clivio A, Cozzi L, Nicolini G, Richetti A, Salati E, Valli M, Vanetti E, Fogliata A. Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy. Radiat Oncol 2010; 5: 54.

Doornaert P, Verbakel WF, Bieker M, Slotman BJ, Senan S. RapidArc planning and delivery in patients with locally advanced head-and-neck cancer undergoing chemoradiotherapy. Int J Radiat Oncol Biol Phys 2011; 79: 429-35.

Popple RA, Fiveash JB, Brezovich IA, Bonner JA. RapidArc radiation therapy: first year experience at the University of Alabama at Birmingham. Int J Radiat Oncol Biol Phys 2010; 77: 932-41.

. Welsh JS, Patel RR, Ritter MA, Harari P, Mackie TR, Mehta MP. Helical tomotherapy: an innovative technology and approach to radiation therapy. Technol Canc Res Treat 2002; 1: 55-63.

Mackie TR. History of tomotherapy. Phys Med Biol 2006; 51: 427-453.

Dejean C, Kantor G, Henriques de Figueiredo B, et al. Helical tomotherapy: description and clinical applications. Bull Cancer 2010; 97: 783-9.

Reynders T, Tournel K, De Coninck P, et al. Dosimetric assessment of static and helical TomoTherapy in the clinical implementation of breast cancer treatments. Radiother Oncol 2009; 93: 71-9.

Sterzing F, Uhl M, Hauswald H, et al. Dynamic jaws and dynamic couch in helical tomotherapy. Int J Radiat Oncol Biol Phys 2010; 76: 1266-73.

. Sen A, West MK. Commissioning experience and quality assurance of helical tomotherapy machines. J Med Phys 2009; 34: 194-9.

Shah AP, Langen KM, Ruchala KJ, Cox A, Kupelian PA, Meeks SL. Patient dose from megavoltage computed tomography imaging. Int J Radiat Oncol Biol Phys 2008; 70: 1579-87.

Welsh JS, Lock M, Harari PM, et al. Clinical implementation of adaptive helical tomotherapy: a unique approach to image-guided intensity modulated radiotherapy. Technol Cancer Res Treat 2006; 5: 465-79.

Brahme A. Optimization of stationary and moving beam radiation therapy techniques. Radiother Oncol 1988; 12: 129-40.

Holmes TW, Mackie TR, Reckwerdt P. An iterative filtered backprojection inverse treatment planning algorithm for tomotherapy. Int J Radiat Oncol Biol Phys 1995; 32: 1215-25.

Kissick MW, Fenwick J, James JA, et al. The helical tomotherapy thread effect. Med Phys 2005; 32: 1414-23.

Tomita N, Kodaira T, Tachibana H, Nakamura T, Nakahara R, Inoku-chi H, Shibamoto Y. Helical tomotherapy for brain metastases: dosimetric evaluation of treatment plans and early clinical results. Technol Cancer Res Treat 2008; 7: 417-24.

. Sterzing F, Welzel T, Sroka-Perez G, Schubert K, Debus J, Herfarth KK. Reirradiation of multiple brain metastases with helical tomotherapy. A multifocal simultaneous integrated boost for eight or more lesions. Strahlenther Onkol 2009; 185: 89-93.

Chawla S, Abu-Aita R, Philip A, Lundquist T, Okunieff P, Milano MT. Stereotactic radiosurgery for spinal metastases: case report and review of treatment options. Bone 2009; 45: 817-21.

Kim JY, Kay CS, Kim YS, Jang JW, Bae SH, Choi JY, Yoon SK, Kim KJ. Helical tomotherapy for simultaneous multitarget radiotherapy for pulmonary metastasis. Int J Radiat Oncol Biol Phys 2009; 75: 703-10.

Pen~agarícano J, Moros E, Corry P, Saylors R, Ratanatharathorn V. Pediatric craniospinal axis irradiation with helical tomotherapy: patient outcome and lack of acute pulmonary toxicity. Int J Radiat Oncol Biol Phys 2009; 75: 1155-61.

. Zhuang AH, Liu A, Schultheiss TE, Wong JY. Dosimetric study and verification of total body irradiation using helical tomotherapy and its comparison to extended SSD technique. Med Dosim 2010; 35: 243-9.

. Malicki J. Accuracy of dose determination during total body irradiation. Strahlenter Onkol 1999; 175: 208-12.

Malicki J, Wachowiak J, Kosicka G, Stryczyńska G, Nowak A, Pracz J. Total body irradiation before bone marrow transplantation: aims and results. Adv Exp Med Biol 2001; 495: 277-82.

. Chen AM, Lee NY, Yang CC, Liu T, Narayan S, Vijayakumar S, Purdy JA. Comparison of intensity-modulated radiotherapy using helical tomotherapy and segmental multileaf collimator-based techniques for nasopharyngeal carcinoma: dosimetric analysis incorporating quality assurance guidelines from RTOG 0225. Technol Cancer Res Treat 2010; 9: 291-8.

. Zhang X, Penagaricano J, Moros EG, Corry PM, Yan Y, Ratanatharat-horn V. Dosimetric comparison of helical tomotherapy and linac-IMRT treatment plans for head and neck cancer patients. Med Dosim 2010; 35: 264-8.

Kim S, Lee IJ, Kim YB, Koom WS, Jeon BC, Lee CG, Kim GE, Keum KC. A comparison of treatment plans using linac-based intensity-modulated radiation therapy and helical tomotherapy for maxillary sinus carcinoma. Technol Cancer Res Treat 2009; 8: 257-63.

Tomita N, Kodaira T, Tachibana H, Nakamura T, Nakahara R, Inokuchi H, Mizoguchi N, Takada A. A comparison of radiation treatment plans using IMRT with helical tomotherapy and 3D conformal radiotherapy for nasal natural killer/T-cell lymphoma. Br J Radiol 2009; 82: 756-63.

Kim YB, Kim JH, Jeong KK, Seong J, Suh CO, Kim GE. Dosimetric comparisons of three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, and helical tomotherapy in whole abdominopelvic radiotherapy for gynecologic malignancy. Technol Cancer Res Treat 2009; 8: 369-77.

Kunos CA, Dobbins DC, Kulasekere R, Latimer B, Kinsella TJ. Comparison of helical tomotherapy versus conventional radiation to deliver craniospinal radiation. Technol Cancer Res Treat 2008; 7: 227-33.

Cattaneo GM, Dell’oca I, Broggi S, et al. Treatment planning comparison between conformal radiotherapy and helical tomotherapy in the case of locally advanced-stage NSCLC. Radiother Oncol 2008; 88: 310-8.

Alongi F, Fiorino C, Cozzarini C, Broggi S, Perna L, Cattaneo GM, Calandrino R, Di Muzio N. IMRT significantly reduces acute toxicity of whole-pelvis irradiation in patients treated with post-operative adjuvant or salvage radiotherapy after radical prostatectomy. Radiother Oncol 2009; 93: 207-12.

Slampa P, Zitterbart K, Dusek L, et al. Craniospinal irradiation of medulloblastoma in the supine position. Rep Pract Oncol Radiother 2006; 11: 25-272.
Quick links
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe