Clinical implementation of radiosurgery using the Helical TomoTherapy unit

Area of Science:

• Radiation Oncology
• Medical Physics
• Neurosurgery

Background:

• The American Society of Radiation Oncology recommends radiosurgery for brain metastases.
• Widespread implementation requires accessibility in community radiation therapy facilities.

Purpose of the Study:

• To describe clinical experience implementing radiosurgery using a Helical TomoTherapy unit.
• To assess the feasibility and efficiency of Helical TomoTherapy for stereotactic radiosurgery (SRS).

Main Methods:

• Utilized a Helical TomoTherapy unit, a unique intensity-modulated radiation therapy (IMRT) system with tight machine tolerances suitable for radiosurgery.
• Employed a frameless immobilization system with a thermoplastic mask and a noninvasive stereotactic radiosurgery (SRS)-stereotactic radiotherapy (SRT) fixation device.
• Leveraged the TomoHD treatment planning system for IMRT and the integrated image-guidance system for patient localization.

Main Results:

• The radiosurgery procedure was successfully streamlined, comparable to IMRT workflows.
• Treatment times averaged approximately 10 minutes, similar to IMRT procedures.
• Standard patient-specific quality assurance protocols for IMRT were effectively applied to SRS.

Conclusions:

• Stereotactic radiosurgery (SRS) using Helical TomoTherapy is feasible and efficient for community settings.
• Helical TomoTherapy offers a streamlined approach to SRS, reducing treatment time and complexity.
• This technology enhances accessibility of SRS for managing brain metastases.