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Talking to Your Doctor

Ask your doctor if Radixact® is right for you

Thanks to rapid advances in treatment technologies, you have more options than ever for effectively treating brain tumors. The first step in understanding your options is to talk to your doctor. To help you get that conversation started, we’ve put together a few questions to ask.

Questions to ask your doctor

  • What are my treatment options?
  • Which treatment option would best preserve my quality of life?
  • What is my recommended treatment option — and why?
  • Am I a candidate for Radixact treatment?
  • What is the treatment process for the treatment option you recommend and how long will it take?
  • What results should I expect?
  • What are the side effects and risks of the procedure; and which side effects are short-term, and which ones may be long-term?
  • How are these side effects managed and can they be prevented?

Additional information & resources

Extensive clinical research supports the use of the TomoTherapy technology used in the Radixact System for the treatment of a wide range of brain tumors. Listed below are key studies to support your discussion of Radixact with your doctor.

For metastatic lesions:

  • A retrospective analysis evaluated the use of stereotactic radiosurgery (SRS) delivered with helical TomoTherapy as the exclusive treatment for patients with between one and three brain metastases. The study found the non-invasive treatment was very well-tolerated and provides encouraging clinical outcomes 1.
  • Preliminary results from 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 tumor 7, 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.

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References:

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.

 

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Important Safety Statement: Most side effects of radiotherapy, including radiotherapy delivered with Accuray systems, are mild and temporary, often involving fatigue, nausea, and skin irritation. Side effects can be severe, however, leading to pain, alterations in normal body functions (for example, urinary or salivary function), deterioration of quality of life, permanent injury and even death. Side effects can occur during or shortly after radiation treatment or in the months and years following radiation. The nature and severity of side effects depend on many factors, including the size and location of the treated tumor, the treatment technique (for example, the radiation dose), the patient’s general medical condition, to name a few. For more details about the side effects of your radiation therapy, and if treatment with an Accuray product is right for you, ask your doctor.