Holden Comprehensive Cancer Center
John Buatti, MD, professor and head of the Department of Radiation Therapy at University of Iowa Hospitals and Clinics, talks about an exciting new advance in cancer treatment:
What that is image-guided radiation therapy using cone beam CT ?
Image-guided radiation therapy or, IGRT, uses daily CT scanning to position the patient in the treatment room. This, in short, enables you to more accurately get the radiation beam to the tumor and avoid more of the normal tissues. This leads to fewer side-effects and better tumor control.
How does this new technology work?
The technology is really unique in being able to use a small panel on the treatment delivery device to collect radiation beams from a treatment-type beam to reconstruct a CT scan in the actual position of treatment. By doing that, you can more accurately and on a daily basis know exactly where the internal organs are located.
Which patients might benefit the most from IGRT therapy?
We're finding that this technology is very useful for almost all cancers, so we're using it extensively in head and neck tumors, lung tumors, abdominal tumors, and prostate cancers. Clearly the ability to know exactly where the tumor is on a daily basis is going to be helpful for the vast majority of cancers that we treat.
What advantages does this approach provide to patients?
The big advantage is that you can see the bones as well as internal organs, and sometimes the tumor, in space at the time of treatment. What we find is that, even though in the past we had gotten single images with X-rays on a weekly basis, the amount of movement you get is more than you had originally anticipated. We find that the organs, such as the prostate gland, abdominal organs, move a significant amount on a daily basis.
Is this still a developing technique, or is it already widely available?
I think it's becoming more widespread, but it's not currently available on a standard basis. The imaging is certainly improving, so the images we get today are even better than the first images we got with the technology a month or two ago because there are ways to optimize the reconstruction and the amount of radiation used to acquire the images that helps. All of that radiation is also applied to the treatment plan, so that it's actually coordinated as part of the treatment.
How can people find out if this might be a treatment option for them?
I believe the best way would be consultation and discussion with their physician about the potential applicability of daily localizing CT imaging during their treatment. I think if they discuss that potential, their physician will let them know what the potential role for their cancer is. From where I sit, again, I think that this will become a future standard for delivery of radiation and the more quickly applied, I think it will lead to significant improvement. |
