HEAD AND NECK 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) that will help you fight your 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 head and neck 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.

The FDA provided clearance for the TomoTherapy technology in 2002 and in 2016 for the Radixact System, the next-generation TomoTherapy platform, for the treatment of tumors anywhere in the body, including the full spectrum of head and neck cancers. The TomoTherapy technology included in the Radixact System is supported by published clinical follow-up with a large number of patients.

  • A single-institution study of 72 patients with various stages of nasopharyngeal carcinoma (NPC) treated with the TomoHelical delivery method found that the five-year local control rate was 97 percent, demonstrating excellent long-term disease control. The study also showed that TomoHelical treatments resulted in generally mild acute and late toxicity.1
  • The prospective, multi-institutional study evaluated the clinical benefits of IMRT delivered using TomoHelical mode compared to volumetric modulated arc therapy (VMAT) for 166 patients with head and neck cancer. The local control rate and cancer-specific survival rate were significantly better in the TomoTherapy patient group than in the VMAT patient group.  Treatment with TomoHelical also enabled delivery of significantly reduced doses of radiation outside the tumor, leading to better acute salivary function than with VMAT.2
  • Clinicians compared TomoTherapy System treatment plans for oropharyngeal cancer (a complex disease requiring the delivery of different doses to different targets in the head and neck region while sparing multiple organs-at-risk) to those generated for conventional IMRT plans. The study authors concluded the TomoTherapy System “gives the most homogeneous target coverage with more sparing of the spinal cord, brainstem, parotids and the lower part swallowing apparatus than most of the other systems”.3
  • A retrospective, single center study of patients with locally advanced nasopharyngeal cancer (NPC) found those treated with the TomoTherapy System experienced better quality of life, such as salivary sparing compared to patients treated using a conventional IMRT system.4

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

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Treatment with the Radixact System is an outpatient procedure that does not require incisions or general anesthesia. Most patients will not require hospitalization or long recovery period. This makes Radixact treatment an excellent option for medically inoperable head and neck cancer patients, those seeking an alternative to surgery, or those for whom radiation therapy is recommended as a complementary treatment to traditional surgery.

The helical design of the Radixact System — unique among radiation therapy systems — enables continuous 360-degree radiation dose delivery as the patient table moves. The Radixact System revolves around you while thousands of “beamlets” — more precise 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 several weeks, similar to conventional radiation therapy.

Put simply, helical delivery means that the source of the radiation beam(s) (the linear accelerator or LINAC), can move from 360° around the patient during treatment delivery while the patient table move continuously in the gantry. Whereas conventional radiotherapy systems can only deliver radiation from a limited number of points, the helical delivery of the Radixact System gives your treatment team to administer the accurate dose of radiation to the tumor from 360 degrees around the patient.

Radixact treatment eliminates the inconvenience and risk associated with radioactive seed implants.

Radiation therapy is a treatment that uses high-energy x-rays (photons) to kill, 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 minimizing the side effects on healthy tissue. As imaging technologies have improved over the last several decades, radiation therapy has integrated those improvements to enhance dose delivery and minimize side effects.

Radiation may be recommended as an alternative to surgery, as a complement to surgery and/or in addition to other therapies. Radiation therapy is constantly evolving with the introduction of new technologies to the market. The Radixact System can deliver a type of radiation therapy known as image-guided intensity-modulated radiation therapy (IG-IMRT).

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 more accurately and precisely target the tumor — and can help minimize dose to surrounding organs and tissues.

IG-IMRT is a type of targeted external beam radiation therapy that enhances IMRT by using images acquired before each treatment.

With daily imaging, clinicians gain the confidence necessary to accurately set-up patients on the table before treatment and reduce margins throughout the course of the treatment. And by modulating the intensity of the radiation beams/beamlets, IMRT enables clinicians to carefully shape the radiation dose to fit the contours of the tumor, while minimizing dose to surrounding organs and healthy tissues. Perhaps nowhere is this superior precision and accuracy more important than when delivering treatment near the many delicate and critical structures of the head and neck.

There are more options than ever for treating head and neck cancers, and the right option depends on your specific tumor location, cancer type and cancer aggressiveness — as well as your health, age and lifestyle. The Radixact System is routinely used to treat a variety of cancers — from routine to complex tumors, those located in hard-to-reach areas and recurrent tumors. 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. Possible side effects could include but are not limited to:

  • Dry mouth
  • Nausea
  • Skin irritation
  • Headache
  • Mouth and gum sores
  • Difficulty swallowing
  • Difficulty eating
  • Stiffness in the jaw
  • Tooth decay

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 several  weeks. Because the Radixact System can deliver radiation continuously, without requiring interruptions to reposition the patient, 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.

Radixact treatments are designed to reduce side effects and enable patients to return to their daily routines with minimal interruption to their normal activities during or following their treatment.

Precisely delivering the prescribed radiation dose to the target is essential for optimizing cancer control. Additionally, precise dose delivery reduces irradiation of healthy tissues surrounding the target.

This is of particular concern when treating head and neck cancers, which are inevitably in close proximity to other essential structures, including brain tissues, the spinal column and critical glands. Maximizing delivery precision helps to safeguard these critical structures, preserve related functions and protect patient quality of life.

Because the precise targeting of the Radixact System significantly reduces irradiation of surrounding healthy tissues, patients treated with the Radixact System could be candidates for re-irradiation, in the event of recurrence. Additionally, patients treated with the Radixact System may sometimes be candidates for surgical interventions, in the event of recurrence.

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

As of January 2020, IG-IMRT treatment for head and neck cancers is covered by Medicare in all 50 states and the District of Columbia. In addition, many private insurance payers cover IG-IMRT treatment for head and neck cancers. It is always best to check your insurance policy, and if applicable, be sure to review your employee contract to determine if your insurance coverage benefits are limited. If you live outside of the United States, typically the Radixact Center that you would choose for treatment can answer coverage questions.

Not every patient’s head and neck cancer is effectively treated with IG-IMRT. Talk to your physician about your best options and come to a joint decision.

References:

1 Leung et al. “Treatment of nasopharyngeal carcinoma by TomoTherapy: five-year experience.” Radiation Oncology. 2013;8:107.

2 Bibault JE et al. “Clinical Outcomes of Several IMRT Techniques for Patients With Head and Neck Cancer: A Propensity Score-Weighted Analysis.” Int J Radiat Oncol Biol Phys. 2017 Nov 15;99(4):929-937.

3 Van Gestel D., et al. “RapidArc, SmartArc and TomoHD compared with classical step and shoot and sliding window intensity modulated radiotherapy in an oropharyngeal cancer treatment plan comparison.” Radiation Oncology 2013;8:37.

4 Chen et al. “Intensity-modulated radiotherapy for nasopharyngeal carcinoma: improvement of the therapeutic ratio with helical tomotherapy vs. segmental multileaf collimator-based techniques.” The British Journal of Radiology 2012;85:e537-543.