ESOPHAGEAL CANCER

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) to 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.

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

  • A single-institution study found that overall survival significantly improved with IMRT treatment 1. That study compared 1) IMRT and chemotherapy with 3D conformal radiation therapy and 2) chemotherapy in patients with locally advanced esophageal cancer.
  • A retrospective study evaluating a small number of patients with locally advanced esophageal cancer found IG-IMRT may provide curative doses of radiation with acceptable levels of toxicity, even in people with pre-existing conditions 2.
  • A study evaluating IMRT-based concurrent chemoradiotherapy (CCRT) and 3D conformal radiation therapy-based CCRT in patients with advanced (stage IIIA-IIIC) thoracic esophageal squamous cell carcinoma found that IMRT-based CCRT resulted in higher survival rates 3.

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 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 360 degrees 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 deliver the accurate dose of radiation to the tumor from multiple 360 degree rotations around your body.

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 improved over the past several decades, radiation therapy has integrated those advances to help enhance dose delivery, improve outcomes and reduce the side effects of treatment.

Radiation is a proven cornerstone of effective treatment for many esophageal cancers, 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 a highly advanced type of radiation therapy known as image-guided, intensity-modulated radiation therapy (IG-IMRT).

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 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 organs and other healthy tissues. This precision and accuracy is particularly valuable when it comes to minimizing the dose to the lungs, salivary glands and other surrounding tissues and organs.

There are more options than ever for treating esophageal cancers, and the right option depends on your specific diagnosis. Radixact is an ideal treatment option for a wide range of esophageal cancers, including the most advanced and complex cases. 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.

Most radiation side effects are minimal and last only a short time. Side effects can, however, be severe. Possible short-term side effects could include:

  • Redness, blistering or peeling in the areas getting radiation
  • Nausea and vomiting
  • Diarrhea
  • Fatigue
  • Painful sores in the mouth and throat
  • Dry mouth or thick saliva (spit)
  • Pain with swallowing

Long-term side effects could include:
  • Esophageal stricture (narrowing), which may require more treatment
  • Lung damage (trouble breathing and shortness of breath)

Ask your doctor for more details about the side effects of your specific radiation therapy. Learn More About Potential Side Effects

You can expect your Radixact treatment to require daily sessions over several weeks. 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. Most patients resume normal activity immediately after treatment sessions.

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 tissue and reduce the incidence of side effects, with the goal of improving patient quality of life both during and after treatment. In some circumstances, side effects may occur.

The Radixact System can deliver a highly advanced type of radiation therapy known as image-guided, intensity-modulated radiation therapy (IG-IMRT), enabling the delivery of extremely precise and accurate radiation doses to improve treatment outcomes and help reduce the risk of side effects that may impact patients’ quality of life. This precision may also enable patients to return to their daily routines sooner than if they had received a 3D conformal radiation therapy treatment.

Excessive radiation dose to the lungs or heart, organs near the esophagus, may result in pneumonitis, cardiac arrhythmia or heart failure, making it critically important for treatments to be extremely accurate and precise. Additionally, precise dose delivery is essential for optimizing long-term disease control.

Because the precise targeting of the Radixact System significantly reduces irradiation of surrounding healthy tissues, some patients previously treated with conventional radiation therapy systems may be candidates for re-irradiation with the Radixact System, in the event of recurrence. Patients should consult a physician regarding their own specific case. 

Medicare and private insurance companies in the United States may reimburse  IG-IMRT for esophageal cancers 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 their 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 IG-IMRT. Talk to your physician about the best options and come to a joint decision.

1 Bai XH, Dang J, Chen ZQ, He Z, Li G. Comparison between Intensity-Modulated Radiotherapy and Three-Dimensional Conformal Radiotherapy for Their Effectiveness in Esophageal Cancer Treatment: A Retrospective Single Institution Study. J Oncol. 2020 Mar 20;2020:6582341.

2 Nguyen NP, Jang S, Vock J, Vinh-Hung V, Chi A, Vos P, Pugh J, Vo RA, Ceizyk M, Desai A, Smith-Raymond L; International Geriatric Radiotherapy Group. Feasibility of intensity-modulated and image-guided radiotherapy for locally advanced esophageal cancer. BMC Cancer. 2014 Apr 17;14:265.

3 Lin WC, Chang CL, Hsu HL, Yuan KS, Wu ATH, Wu SY. Three-Dimensional Conformal Radiotherapy-Based or Intensity-Modulated Radiotherapy-Based Concurrent Chemoradiotherapy in Patients with Thoracic Esophageal Squamous Cell Carcinoma. Cancers (Basel). 2019 Oct 10;11(10):1529.