Helical Tomotherapy versus Conventional Radiation to Deliver Abdominopelvic Radiation

Abstract

While whole abdominopelvic radiation (APRT) provided satisfactory radiation dosimetry for the treatment of cancers with peritoneal dissemination, APRT was abandoned due to unsatisfactory tumor control from necessary radiation shielding of vital organs. Our goal was to develop a helical tomotherapy (TOMO) abdominopelvic radiation technique improving target tissue coverage while dose-limiting vital organs, especially hematopoietic bone marrow. This study reports our clinical development of a TOMO abdominopelvic radiation technique for treatment of patients with advanced stage ovarian cancer. Novel chemoradiosensitizing agent clinical trials incorporating our TOMO abdominopelvic radiation technique for treatment of patients with recurrent ovarian cancer are under development.

Long-term Benefit of Tumor Volume-Directed Involved Field Radiation Therapy in the Management of Recurrent Ovarian Cancer

“…23 The future may include sophisticated intensity modulated whole abdominal radiation with new chemosensitizers in patients with ROC with multiple peritoneal recurrences having failed salvage regimens. [24][25][26][27] In addition, particle therapy with carbon is being explored. 28 With modern fractionated stereotactic radiotherapy techniques, it may be possible to administer large focused doses of radiation to localized ROC quickly; this can theoretically take the place of debulking surgery with minimal functional disturbance in very selected situations like the retroperitoneum or in sites away from bowel.…”

Successful salvage treatment of myxoid liposarcoma with multiple peritoneal seeding using helical tomotherapy-based intraperitoneal radiotherapy: a case report

“…HT can improve radiation dose coverage of peritoneal surfaces, especially near the kidney and liver, due to the freedom of beam direction and delicate intensity modulation. HT can also deliver lower radiation doses to the liver, bilateral kidneys, and bone marrow [ 25 ]. The broad practical use of IPRT is limited by an extended radiation beam field lengths of >40 cm, multiple dose isocenters in the abdomen and pelvis, and treatment complexity.…”