Helical tomotherapy

Manufactured by Accuray

Sourced in United States

Helical TomoTherapy is a radiation therapy system designed to deliver precise and targeted radiation treatment. It utilizes a unique helical delivery pattern to precisely shape the radiation beam and continuously adjust it to the patient's anatomy. The system is capable of delivering intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT) for the treatment of various types of cancers.

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Lab products found in correlation

Truebeam stx linear accelerator, by Agilent Technologies (1 mentions) Varian 600cd, by Agilent Technologies (1 mentions) Tomotherapy planning system, by Accuray (1 mentions)

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TomoTherapy (22 citations)

5 protocols using helical tomotherapy

Helical TomoTherapy for CSI Treatment

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CSI using helical TomoTherapy (Accuray Inc., Sunnyvale, CA, USA) has been utilized in Yonsei Cancer Center from 2014. Patients who received HT-CSI between January 2014 and December 2018 were screened (n = 99). Patients were excluded from the study if they met one of the following criteria: (1) they received HT-CSI combined with 3D-CRT (n = 3), (2) they could not complete RT (n = 10), and (3) they did not have any record for translational displacements obtained through MVCT (n = 3). Finally, 83 patients were included in our cohort. Among 83 patients, 21, 42, 19 and 1 patients received HT-CSI using Hi-Art, Tomo-HD, Tomo-HDA and Radixact, respectively.
This study was approved by the Severance Hospital institutional review board (No. 4–2020-0046), and the requirement for informed consent was waived because of the retrospective nature of this study. All methods were carried out in accordance with relevant guidelines and regulations.

Lee J., Kim E., Kim N., Byun H.K., Suh C.O., Chung Y, & Yoon H.I. (2021). Practical aspects of the application of helical tomotherapy for craniospinal irradiation. Scientific Reports, 11, 6120.

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Immobilization and IMRT for Spinal RT

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CT simulation was performed with custom immobilization using Aquaplast® (Aquaplast Corporation, Wyckoff, NJ, USA) head masks for cervical spine cases and Wingstep/Prostep® (Elekta, Stockholm, Sweden) devices for thoracolumbar cases. In addition to OARs (dose constraints for which were per QUANTEC recommendations), the clinical target volume (CTV) was delineated on the planning CT and encompassed the affected vertebral body [6 (link)]. The planning target volume (PTV) was an isotropic 1 cm expansion of the CTV and was to be covered by the 90% isodose line. The prescription dose for both cohorts was 30 Gy in 10 fractions.
The IMRT group received image-guided (mega- or kilo-voltage cone beam computed tomography) RT by means of step-and-shoot IMRT, VMAT (Elekta Versa HD accelerator), or helical TomoTherapy (Accuray Inc., Madison, WI). The 3DCRT cohort was most commonly delivered with two or three anteroposterior 6 MV individually-formed beams. Position verification was applied by weekly kilo-voltage CT and before each fraction by comparing orthogonal portal images with digitally reconstructed radiographs from the planning CT.

Sprave T., Verma V., Förster R., Schlampp I., Hees K., Bruckner T., Bostel T., El Shafie R.A., Welzel T., Nicolay N.H., Debus J, & Rief H. (2018). Bone density and pain response following intensity-modulated radiotherapy versus three-dimensional conformal radiotherapy for vertebral metastases - secondary results of a randomized trial. Radiation Oncology (London, England), 13, 212.

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Hypofractionated IGRT and IMRT Protocol

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Patients were treated using image-guided radiation therapy (IGRT) and intensity-modulated radiation therapy (IMRT) techniques, using either helical tomotherapy (Accuray Inc, Sunnyvale, CA) or RapidArc on the Varian Truebeam STX linear accelerator (Varian Medical Systems, Palo Alto, CA). All of the patients were treated over 5 fractions, with doses ranging between 50 and 60 Gy.

Sun V., Kim J.Y., Williams A.C., Raz D.J., Sampath S, & Ferrell B. (2014). Quality of life and symptoms following stereotactic body radiotherapy in early-stage lung cancer patients. The Journal of community and supportive oncology, 12(11), 407-414.

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Intensity Modulated Radiation Therapy for Cancer

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All patients were treated with the intensity modulated radiation therapy technique randomly using the Varian-600CD (Varian Medical Systems, Palo Alto, CA, USA) or Helical TomoTherapy (Accuray Inc., Sunnyvale, CA, USA) linac with a prescribed dose of 70 to 80 Gy in 33 to 36 fractions. The treatment plans were designed on Pinnacle³ 9.0 treatment planning systems (Philips, Fitchburg, WI, USA) or TomoTherapy Planning System (Accuray Inc., Madison, WI, USA) using computed tomography datasets with a 3-mm slice thickness. The beam energy for all plans was 6 megavolt, and the ultimate goal of optimization for an individual patient plan was that the dose to organs at risk (OARs) can be kept as low as possible while maintaining optimal target coverage and dose uniformity to the target. Twelve of 20 patients received RT concurrent with chemotherapy, depending on their grade of disease.

Ren W.T., Li Y.X., Wang K., Gao L., Yi J.L., Huang X.D., Luo J.W., Wu R.Y., Yang Y., Wang J.Y., Wang W.Q., Wang J.B., Ye F., Ouyang H, & Dai J.R. (2019). Cerebral functional abnormalities in patients with nasopharyngeal carcinoma after radiotherapy: an observational magnetic resonance resting-state study. Chinese Medical Journal, 132(13), 1563-1571.

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Adjuvant Radiotherapy for Brain Tumors

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RT was mainly used as an adjuvant treatment after operation. In the present study, 39 (96%) of 41 patients received RT for adjuvant purpose. One (2%) patient received RT for radical aim and one (2%) received it for salvage aim after recurrence. The median delivered total dose of RT was 5,400 cGy (range, 4,680 to 6,000 cGy). The fraction size of RT was mainly 180 cGy (n = 35; 85.4%) or 200 cGy (n = 5, 12.2%). Only one patient received hypo-fractionation with daily dose of 240 cGy. The duration of RT was median 42 days (range, 28 to 55 days). The three-dimensional conformal RT (3D-CRT) group consisted of 19 patients and the intensity-modulated radiotherapy (IMRT) group had 22 patients. IMRT was performed with Helical Tomotherapy (Accuray, Sunnyvale, CA, USA).
The target volume was defined as follows: gross tumor volume (GTV) was defined in patients with residual or recurrent gross disease in pre-radiotherapy brain MRI. Clinical target volume (CTV) was defined as postoperative cavity in all patients with addition of T2 high-signal intensity lesion in low-grade brain tumor patients. PTV was defined CTV plus 5-mm margin in 3D-CRT patients, and 3-mm margin in IMRT patients. IMRT was performed with daily mega-voltage CT image-guided radiotherapy (IGRT).

Choi Y.K., Jang H.S., Choi B.O., Lee S.W, & Song J.H. (2023). Impact of radiation on immune cells in patients with low-grade brain tumor: Identifying critical factors affecting lymphopenia and neutrophil-to-lymphocyte ratio. Radiation Oncology Journal, 41(2), 120-128.

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