BRAIN TUMORS

Frequently Asked Questions

The Radixact System, the next-generation TomoTherapy® platform, has been designed to enable doctors to more effectively and efficiently deliver precise radiation treatments to more patients. The TomoTherapy platform represented a dramatic advance in the radiation oncology field, as the only system specifically designed for integrated 3D daily image-guidance with intensity modulated radiation therapy (IG-IMRT) that will help patients control their cancer. The TomoTherapy technology, used in the Radixact System, has more than two decades of clinical evidence and has been used to help thousands of cancer patients. Today, the Radixact System is routinely used to treat a variety of cancers – from routine to complex tumors, those located in hard-to-reach areas, recurrent tumors and cancers of the skin and blood.

The FDA provided clearance for the TomoTherapy technology for the treatment of tumors anywhere in the body, including brain tumors, in 2002. The next generation of the TomoTherapy platform, the Radixact System, was cleared in 2016.

For metastatic lesions:

  • A retrospective analysis evaluated the use of stereotactic radiosurgery (SRS) delivered with helical TomoTherapy as the exclusive treatment for patients with with one and three brain metastases. The study found the non-invasive treatment was very well-tolerated and provides encouraging clinical outcomes 1.
  • A single-institution study found that SRS delivered with helical TomoTherapy for the treatment of brain metastases provides good results with a low incidence of toxicities. The authors concluded that, “helical TomoTherapy is a viable alternative to deliver radiosurgery for treatment of brain metastases.” 2
  • A retrospective study of patients with large brain metastases that could not be surgically removed found that hypofractionated stereotactic radiotherapy (SRT) delivered using helical TomoTherapy “can be considered a safe treatment for brain metastases larger than 2 cm given the low rate of radionecrosis associated with this method.” 3
  • A prospective study assessed the use of SRT delivered with helical TomoTherapy in four sessions to treat single or multiple metastases. The study investigators found the treatment protocol resulted in excellent tumor control with minimal toxicity 4.


For primary tumors:

  • A study evaluated patients diagnosed with stage II-III meningioma in the brain who received IG-IMRT delivered with helical TomoTherapy. Treatment resulted in good local control of the disease with minimal toxicity 5.
  • A study investigated the use of helical TomoTherapy to deliver IG-IMRT and a simultaneous boost of radiation, in combination with chemotherapy, in the treatment of high-grade gliomas. The study authors concluded, “Helical TomoTherapy proved to be an effective and safe treatment modality, with an improvement of accuracy in delivery of high-dose radiotherapy despite the presence of nearby critical structures.” 6
  • Multiple studies evaluating the feasibility of using the helical TomoTherapy for craniospinal axis irradiation (medulloblastomas) have shown clinician interest in this technique and its benefits in treating this type of tumor7, 8, 9.
  • A study compared treatment plans developed for helical TomoTherapy and conventional radiation therapy systems to treat patients with glioblastoma multiforme (GM) whose tumors were located close to critical organs. The authors concluded that, “Tomotherapy plans were superior to linear accelerator plans from the aspect of organ-at-risk sparing.” 10
  • A treatment planning study assessing helical TomoTherapy, IMRT and 3D-CRT showed that, for patients with glioblastoma multiforme, helical TomoTherapy provided better target coverage than IMRT and improved sparing of OARs compared to IMRT and 3D-CRT 11.

Radixact treatment is available at many locations worldwide. TomoTherapy treatments are available at hundreds of locations worldwide.

Find a Treatment Center Near You

The helical design of the Radixact System – unique among radiation therapy systems – enables multiple 360-degree radiation dose delivery as the treatment table moves the patient at a deliberate pace through the center of the system. The Radixact System revolves around you while thousands of “beamlets” – smaller than the radiation beams of conventional systems – are delivered to the tumor. Each beamlet can deliver a different dose of radiation. Different doses go to different parts of each tumor, with less damage to surrounding healthy tissue.

Integrated imaging and advanced dose-delivery capabilities enable your treatment team to create a more personalized treatment plan and confidently deliver the most precise dose of radiation, directly to the tumor. Radixact helical delivery also enables treatment of a full range of diseases, including larger, more complex tumors, multiple tumors, and recurrent tumors.

Radixact treatments are completed in one to several weeks, similar to conventional radiation therapy.

Helical delivery means that the source of the radiation beam(s) (the linear accelerator or linac), can move in multiple 360 degree rotations around the patient during treatment delivery while the treatment table moves the patient at a deliberate pace through the center of the system. Whereas conventional radiation therapy systems can only deliver radiation from a limited number of points, the helical delivery of the Radixact System helps to allow your treatment team to administer the accurate dose of radiation to the tumor from 360 degrees around the patient.

Radiation therapy is a treatment that uses high-energy x-rays (photons) to destroy cancer cells and shrink or control the growth of tumors. Radiation therapy works by damaging cells, disabling them from growing and dividing. The goal of any radiation treatment is to destroy cancer cells while helping minimize dose to healthy tissue. As imaging technologies have advanced over the past several decades, radiation therapy has integrated those upgrades to help enhance dose delivery, improve outcomes and reduce the side effects of treatment.

Radiation therapy has been proven to provide effective treatment for many brain tumors, and may be combined with other treatments including surgery and chemotherapy. Radiation therapy is constantly evolving with the introduction of new technologies to the market. The Radixact System can deliver highly advanced types of radiation therapy known as image-guided, intensity-modulated radiation therapy (IG-IMRT), stereotactic radiosurgery (SRT) / stereotactic radiotherapy (SRT).

Intensity-modulated radiation therapy (IMRT) is a specialized form of external beam radiation therapy that varies the intensity of each radiation beam. IMRT can help clinicians shape the delivery of radiation to fit the contours of the tumor more accurately and precisely – and help minimize dose to surrounding organs and tissues.

Image-guided intensity-modulated radiation therapy (IG-IMRT) is a type of targeted external beam radiation therapy that enhances IMRT by using images acquired before each treatment to help ensure accurate patient and tumor/target positioning before delivery of the radiation treatment.

With daily imaging, clinicians gain the confidence necessary to accurately set-up the patient on the table before treatment and reduce margins throughout the course of the treatment. And by modulating the intensity of the radiation beams/beamlets, IG-IMRT enables clinicians to carefully shape the radiation dose to fit the contours of the target(s), while minimizing dose to surrounding healthy brain tissues and structures. This precision and accuracy is particularly valuable when it comes to minimizing dose to the extremely delicate and vital tissue and structures of the brain and central nervous system.

Stereotactic radiosurgery (SRS) is a non-invasive, ultra-precise form of radiation therapy designed to deliver higher doses of radiation to the tumor than conventional radiation therapy with minimal dose to surrounding healthy tissue. SRS is generally used to treat functional abnormalities and small tumors in the brain. The benefit of SRS is that treatments are administered over a much shorter course of treatment than conventional radiation therapy.

With the Radixact System, integrated imaging and advanced dose-delivery capabilities enable your treatment team to create a more personalized treatment plan and confidently deliver the most precise dose of radiation, directly to the tumor. The benefit of SRS is that treatments are administered over a much shorter course of treatment than conventional radiation therapy.

There are more options than ever for treating brain tumors, and the right option depends on your specific diagnosis. The Radixact System is typically used to treat a wide range of brain tumors, including even the most advanced and complex cases that will require craniospinal irradiation. The best way to determine if Radixact treatment is right for you is to find a Radixact treatment location and make an appointment to discuss your specific details.

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Most radiation side effects are minimal and last only a short time. Side effects can, however, be severe, depending on many factors including the tumor size and location. Possible short-term side effects could include:

  • Fatigue
  • Hair loss
  • Headaches
  • Nausea
  • Speech problems
  • Mild skin reactions
  • Mild neurological symptoms, such as memory problems

Long-term side effects can include memory loss and cognitive changes, such as difficulty understanding and performing complex tasks. Long-term side effects depend directly on how much radiation is received by healthy brain tissue during the course of treatment.

Ask your doctor for more details about the side effects of your specific radiation therapy.

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You can expect your Radixact treatment to require daily sessions over one to several weeks, depending on the type and number of tumors or lesions treated. Because the Radixact System can deliver radiation continuously, without requiring interruptions to reposition, the entire treatment process typically lasts 10-20 minutes — including patient set-up time.

Treatment sessions are non-invasive outpatient procedures, and no anesthesia is required.

No anesthesia is required for Radixact treatment and treatment sessions are completed on an outpatient basis.

The Radixact System is designed to minimize dose to healthy tissues and reduce the incidence of side effects, with the goal of improving  patient quality of life both during and especially after treatment. In some circumstances, side effects may occur.

Precisely delivering the prescribed radiation dose to the target is essential for optimizing long-term disease control, while minimizing the risk of side effects. This is of particular concern when treating brain tumors, which are in direct proximity to the delicate and vital tissues and structures of the brain. Precisely delivering the prescribed radiation dose to the target location is essential for long-term tumor control – and helping to minimize the risk of potential side effects that can impact short- and long-term quality of life.

Because the precise targeting of the Radixact System significantly reduces irradiation of surrounding healthy tissues, some patients previously treated with radiation therapy may be candidates for re-irradiation with the Radixact System, in the event of recurrence. Each patient should consult his physician regarding his or her own specific case.

Medicare and private insurance companies in the United States may reimburse image guided IMRT or SRS for brain tumors subject to medical necessity and your health insurance plan constraints. Patients should contact a Radixact treatment center to determine, if this procedure is a covered benefit under your health insurance plan and any out-of-pockets costs such as deductibles, co-insurances, and/or copayments.

Not every patient’s condition is effectively treated with the Radixact System. Talk to your physician about the best options and come to a joint decision.

1 Bruni A, Gaito S, Ciarmatori A, et al. Radiosurgery Using Tomotherapy for Patients with Brain Oligo-metastasis: A Retrospective Analysis on Feasibility and Tolerance. Anticancer Res. 2015 Dec;35(12):6805-12. PMID: 26637900.

2 Barra S, Agostinelli S, Vagge S, et al.Radiosurgery with Helical Tomotherapy: Outcomes for Patients with One or Multifocal Brain Metastasis. Technol Cancer Res Treat. 2015 Dec;14(6):693-9.

3 Koide Y, Tomita N, Adachi S, et al. Retrospective analysis of hypofractionated stereotactic radiotherapy for tumors larger than 2 cm. Nagoya J Med Sci. 2019 Aug;81(3):397-406.

4 Nagai A, Shibamoto Y, Yoshida M, et al. Treatment of single or multiple brain metastases by hypofractionated stereotactic radiotherapy using helical tomotherapy. Int J Mol Sci. 2014 Apr 22;15(4):6910-24.

5 Boulle G, Bracci S, Hitchcock K, et al. Treatment of grade II-III intracranial meningioma with helical tomotherapy. J Clin Neurosci. 2019 Jan;59:190-196.

6 Donato V, Caruso C, Bressi C, et al. Evaluation of helical tomotherapy in the treatment of high-grade gliomas near critical structures. Tumori. 2012 Sep-Oct;98(5):636-42.

7 Sun Y, Liu G, Chen W, et al. Dosimetric comparisons of craniospinal axis irradiation using helical tomotherapy, volume-modulated arc therapy and intensity-modulated radiotherapy for medulloblastoma. Transl. Cancer Res. 2019;8.

8 Sugie C, Shibamoto Y, Ayakawa S, et al. Craniospinal Irradiation Using Helical Tomotherapy: Evaluation of Acute Toxicity and Dose Distribution. Technol. Cancer Res. Treat. 2011;10:187–195.

9 Mesbah L, Matute R, Usychkin S, et al. Helical tomotherapy in the treatment of pediatric malignancies: a preliminary report of feasibility and acute toxicity. Radiat. Oncol. 2011;6:102.

10 Koca T, Basaran H, Sezen D, Karaca S, Ors Y, Arslan D, Aydin A. Comparison of linear accelerator and helical tomotherapy plans for glioblastoma multiforme patients. Asian Pac J Cancer Prev. 2014;15(18):7811-

11 Chan M, Schupak K, Burman C, Chui C, Clifton Ling C. Comparison of intensity-modulated radiotherapy with three-dimensional conformal radiation therapy planning for glioblastoma multiforme. Medical Dosimetry. 28(4);261-5