Breast 3D-CRT with TomoDirect™
Efficiency and precision—when fewer beam angles are needed
The TomoDirect™ modality offers a highly efficient treatment option for routine indications, available for the Radixact® and TomoTherapy® Systems.
Expands patient-first treatment like no other system in the world
Image guided, intensity modulated radiation therapy (IG-IMRT), featuring best-in-class clinical workflows and highly conformal and homogenous treatments enabled by a unique ultra-fast multi-leaf collimator (MLC). The Radixact® System shapes radiation to the tumor while sparing normal, healthy tissue.
Conformal, homogenous coverage
TomoDirect provides non-rotational delivery of beamlets from fixed gantry angles, enabling highly efficient and precise 3D conformal radiation therapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) capabilities. Continuous couch motion enhances treatment delivery over the longest treatment fields in the industry. The advantages of TomoDirect for breast treatments over competitive modalities have been shown in published planning comparisons.1-3
Combined with TomoEDGE™ dynamic jaws, TomoDirect provides efficient treatments and highly conformal dose distribution in both whole breast and whole breast with supraclavicular regional lymph nodes4.
Streamlined workflows
- Highly customized treatment planning: Create treatment plans that include 2 to 12 target-specific gantry angles and user-defined levels of modulation
- Interactive 3D-CRT: Treatment planning with daily 3D-CT image guidance to support margin reduction and positioning accuracy
- Longest treatment fields in the industry: Eliminates multiple isocenters and field junctions that are time-consuming to plan and deliver and can lead to hot and cold spots.
Outstanding precision & dose fall-off
- Beam expansion: Open additional leaves beyond the target to compensate for target motion (up to five leaves per angle)
- TomoEDGE™ Dynamic Jaws: Dynamically conform to the target in the craniocaudal direction, producing sharp dose fall-off for precise sparing of normal tissue and increased throughput
- Fastest leaf speed in the industry: Produces more modulation compare to other IMRT delivery techniques.
An ideal clinical solution for routine and complex breast cancer treatments
The Radixact and TomoTherapy systems offer TomoDirect delivery, providing efficient
treatments for a spectrum of cancer cases from a single platform.
Tailoring Radiotherapy to Breast Cancer:
The Role of the TomoTherapy® System
Professor Roberto Orecchia
Scientific Director of the European
Institute of Oncology, Milan, Italy
TomoEDGE™ Dynamic Jaws
Total scheduled procedure time averages 10-15 minutes* with TomoEDGE™ dynamic jaws
*Includes set-up, full 3D imaging and average beam-on time of 4.5 minutes. Total procedure times are approximate and based on internal Accuray test data. Times may vary with various clinical situations.
“For postoperative breast irradiation with static TomoTherapy, the dynamic jaw mode was effective in reducing the treatment time and the doses of OARs in both of the plans of the whole breast with supraclavicular regional lymph nodes and those of the whole breast.”
Efficacy of the Dynamic Jaw Mode in Helical Tomotherapy With Static Ports for Breast Cancer. TCRT. 2014; 14: 459-465. Sugie C. et al.
http://journals.sagepub.com/doi/10.1177/1533034614558746
Clinical Examples
Whole Breast
- Treatment mode: TomoDirect 3D-CRT
- Rx: 50.40Gy/28Fx
- Delivery time: 1:46 min:sec
Breast & Lumpectomy Cavity
- Treatment mode: TomoDirect IMRT
- Rx: 40Gy/15Fx + 48Gy simultaneous integrated boost (SIB) to lumpectomy cavity
- Delivery time: 6:59 min:sec
References:
1. Han E.Y. et al. “Estimation of the risk of secondary malignancy arising from whole-breast irradiation: comparison of five radiotherapy modalities, including TomoHDA” Oncotarget. 2016; 7(16): 22960-9 – https://doi.org/10.18632/oncotarget.8392
2. Nagai A. et al. “Intensity-modulated radiotherapy using two static ports of TomoTherapy for breast cancer after conservative surgery: dosimetric comparison with other treatment methods and 3-year clinical results. Journal of Radiation Research. 2017; Feb 23: 1-8 – https://doi.org/10.1093/jrr/rrw132
3. Michalski A. et al. “A dosimetric comparison of 3D-CRT, IMRT, and static TomoTherapy with an SIB for large and small breast volumes.” Medical Dosimetry. 2014; 39: 163-168
4. Sugie C. et al. “Efficacy of the Dynamic Jaw Mode in Helical Tomotherapy With Static Ports for Breast Cancer.“TCRT. 2014; 14: 459-465 – https://doi.org/10.1177/1533034614558746
Radixact & TomoTherapy for Breast
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