Tomotherapy with AI: A Boon to Cancer Treatment - Dr Abhishek Purkayastha

Cancer is a disease that everybody fears. The moment anybody is detected with cancer, the eminent death comes into the patient’s mind. Today, medical science has developed many newer treatment modalities that can take care of cancer.

There has been huge progress in the last decade in the management of cancer. Often, many patients require all modalities which include surgery, chemotherapy, and radiation therapy. There are situations when the disease spreads very near to critical organs, making it extremely difficult to treat. But the Tomotherapy radiation machine has come as a boon in all such situations.

Tomotherapy with synchrony play an important role in treating such complex tumours with normal tissue toxicity and give successful results.

Successful management of the patient of Arteriovenous Malformation (AVM) via Tomotherapy:

“A 61-year-old female patient presented with complaints of headache, nausea, vomiting and reduced vision both eyes associated with two episodes of seizure since last 4 months. MRI Brain showed soft tissue mass lesion measuring 3.3 x 3.5 left fronto temporal region, with radiological diagnosis of Arterio Venous Malformation (AVM) confirmed by Cerebral Angiography. Brain AVMs are extremely rare and occur at an incidence of 1.12-1.42 per 100,000 person-years,” said Dr. Abhishek Purkayastha, Radiation Oncologist.

Dr. Abhishek Purkayastha further highlighted, “If untreated they rupture and cause brain haemorrhage resulting in morbidity and sometimes mortality. The relatives were very anxious and patient was unwilling for surgery. The patient was counselled and was assured of a curative treatment.

She was treated with Stereotactic radiosurgery (SRS) to a dose of 18 Gy in single fraction. Patient reviewed after 2 weeks with significant improvement in her symptoms. Her relatives were also happy with her improvement. She was kept on close follow-up, and her MRI Brain 3 months after SRS showed 40% reduction in the size of the AVM.

Next, serial MRI also showed reduction in the size of AVM. Now over a year post SRS, the patient comes for regular reviews, and she is able to lead a normal life with improvement in her vision and other symptoms. SRS directs many highly targeted radiation beams at the AVM to damage the blood vessels and cause scarring.

SRS have shown excellent treatment outcomes for patients with small- to moderated sized AVM which can be achieved in 80-90 % complete obliteration rate with a 2–3 years latency period. SRS is widely accepted as an alternative to microsurgery.”

Why Tomotherapy is a Game-Changer for Patients?

1. It is one of the revolutionary radiotherapy delivery systems, which is the latest and newest way to deliver radiation in a helical fashion. It has several revolutionary technologies like “Artificial Intelligence” based “Auto contouring Adaptive Radiotherapy, Re-irradiation module, Precise imaging system along with ultrafast delivery which helps to deliver radiation at all sites including difficult ones like, TMI, very long targets, complex tumours in proximity to a critical structure multiple targets at time, second-time radiation, moving targets, changing targets, etc. which were very difficult to deliver on conventional LINACs.

2. Tomotherapy gives highly conformal radiotherapy and can treat high-risk tumours safely even when the target is near to critical structure with minimal side effects.

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