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Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
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Accelerated tomotherapy delivery with TomoEdge technique.

Sonja Katayama1, Matthias F Haefner, Angela Mohr

  • 1Department of Radiation Oncology, University Hospital Heidelberg, Germany. sonja.katayama@med.uni-heidelberg.de.

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TomoEDGE, an advanced tomotherapy technique, significantly reduces treatment time by over 30% using a 5 cm field width without compromising plan quality for most patients. However, it may not be suitable for all complex cases, such as prostate lymph node treatments.

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Radiotherapy Technology

Background:

  • Tomotherapy is a radiation therapy technique that delivers precise, conformal radiation doses.
  • TomoEDGE represents an advancement in tomotherapy, incorporating a dynamic secondary collimator for potentially improved treatment delivery.
  • Assessing the clinical utility and impact of new radiotherapy technologies is crucial for optimizing patient care.

Purpose of the Study:

  • To compare the clinical applicability and treatment quality of the new TomoEDGE technique with a 5 cm field width against the standard tomotherapy mode.
  • To evaluate the effect of TomoEDGE on treatment speed, integral dose, dose conformity, and organ-at-risk sparing.
  • To determine the suitability of the 5 cm field width for various cancer sites and treatment scenarios.

Main Methods:

  • A plan comparison study involving the first 45 patients treated with TomoEDGE.
  • Creation of at least two treatment plans per patient: one standard mode (Reg 2.5) and one TomoEDGE 5 cm field width (Edge 5).
  • A third plan (Edge 2.5) was created if Edge 5 was deemed unsuitable, using TomoEDGE with a 2.5 cm field width.

Main Results:

  • 30 out of 45 patients were suitable for treatment with the Edge 5 cm field width, demonstrating over 30% reduction in beam on time without compromising plan quality.
  • The 5 cm field width was not clinically applicable for prostate pelvic lymph node treatments and extensive head and neck irradiations due to increased dose to critical organs.
  • Slight, non-statistically significant increases in dose to the bladder, small bowel, and brain were observed in specific complex cases when using the 5 cm field width.

Conclusions:

  • TomoEDGE with a 5 cm field width offers significant treatment speed advantages in the majority of clinical applications.
  • Careful patient selection is necessary to ensure optimal organ-at-risk sparing when utilizing the wider field width.
  • TomoEDGE is a valuable enhancement to tomotherapy, improving patient comfort and safety through faster treatment delivery.