TomoTherapy to discuss the uses of CT scanner-based device at the 10th Biennial ESTRO Conference

TomoTherapy Incorporated (NASDAQ: TOMO) announced today that there will be more than 40 presentations at the 10th Biennial ESTRO Conference on Physics and Radiation Technology for Clinical Radiotherapy that explore use of the TomoTherapy® treatment system. The TomoTherapy system -- a versatile, CT scanner-based device that integrates image guidance for increased treatment accuracy and helical radiation therapy delivery for enhanced tumor targeting -- is helping cancer centers advance patient care around the world. The papers cover a breadth of advantages related to the TomoTherapy system, including the importance of daily imaging for precise patient positioning and adaptive therapy purposes, fundamental advancements in treatment planning and improvements in treatment quality for the patient.

The ESTRO Conference will take place August 30 to September 3, 2009, in Maastricht, The Netherlands. At booth 140, TomoTherapy will highlight how its radiotherapy platform is reshaping radiation therapy, with exhibits and presentations on topics such as the evolution and future of the TomoTherapy platform, user case studies, use of TomoDirect™ technology to increase system versatility and throughput, and the new TQA™ quality assurance tool. The conference will feature more than 40 TomoTherapy-related papers, on a range of topics, including:

Clinically Applied Imaging

• Adaptive Radiotherapy to Treatment Response - UCL-Cliniques Universitaires Saint Luc, Brussels, Belgium. This study explores how recent advancements in imaging, computational and technological fields may enable clinicians to achieve high precision radiation dose delivery. Initial results show that use of the TomoTherapy system's adaptive planning capabilities allows for a significant reduction in the volume of tissue irradiated to high dose and may assist in responding to dosimetric variations caused by anatomical changes during treatment, providing the opportunity to employ dose escalation strategies.
  
• Evaluation of Megavolt CT (MVCT) Imaging Protocols in the Treatment of Head and Neck Cancer with Helical TomoTherapy - ZNA Middelheim-UZA, Antwerp, Belgium. This study was designed to evaluate several imaging protocols based on the results of an extended evaluation of TomoTherapy MVCT images, acquired on a daily basis, for head and neck cancer patients. Researchers concluded that the TomoTherapy system enables quick and easy daily imaging and reduces margins that account for set-up uncertainties, which therefore reduces the amount of healthy tissue that is irradiated during treatment.
  
• Validation of an Elastic Registration Method to Parotid Shrinkage as Assessed by MVCT Scans during TomoTherapy - Scientific Institute San Raffaele, Milan, Italy; IBFM-CNR and Scientific Institute San Raffaele, Milan, Italy; and IBNM-CNR and Politecnico, Milan, Italy. This paper evaluated the use of MVCT images during TomoTherapy(SM) treatments to address changes in the parotid gland as a way to reduce common side effects of radiotherapy during treatment of head and neck cancer. The study concludes that daily MVCT scans enabled clinicians to evaluate the three-dimensional behavior of tissues during the course of radiotherapy, with a detailed analysis of position, volume and shape, and calculate an accurate dose received by the parotids during the course of treatment.
  

Technology Comparisons

• BEUD/Secondary Malignancy Analysis: Comparison of HT, MLC-Based IMRT, and CRT in Prostate Treatment Planning - Cancer Therapy & Research Center at the University of Texas Health Science Center, San Antonio, Texas, and Karolinska Institutet and Stockholm University, Stockholm, Sweden. This study addresses development and assessment of treatment plans based on radiobiological parameters, compared to conventional treatment planning comparison techniques for prostate cancer. Early evidence in this study indicates that helical TomoTherapy treatments results in a lower probability of secondary malignancy than MLC-based IMRT and 3D conformal radiation.
  
• Comparison of IMRT Delivery Techniques and Helical TomoTherapy Using Pareto Front Evaluation - Lund University Hospital, Lund, Sweden; and Copenhagen University Hospital Herlev, Herlev, Denmark. This study was designed to compare different IMRT treatment planning and delivery systems using Pareto front evaluation. For the case examined in this study, the TomoTherapy treatment planning system was deemed to be superior to Nucletron's Oncentra Masterplan (OMP) and Varian's Eclipse systems regarding target coverage and sparing of the parotid gland.
  
• Assessment of the Treatment of Breast Carcinoma with TomoTherapy - UZ Brussel, Oncologish Centrum, Brussels, Belgium; and Centre Paul Strauss, Strasbourg, France. This study investigates use of helical TomoTherapy treatments and its discrete-angle alternative, TomoDirect(SM) treatments, compared to conventional radiotherapy for treatment of post-operative breast carcinoma. Results show that helical TomoTherapy and TomoDirect modalities can deliver dose distributions that the radiotherapist judges to be equal to or better than conventional treatment according to the organ to be protected.
  

Improved Treatment Quality

• A Collaborative Dosimetric Comparison for Helical TomoTherapy and Single-Arc Intensity Modulated Arc Therapy (IMAT) Between Two Institutions - University of Wisconsin School of Medicine and Public Health, Madison, Wisc.; University of Wisconsin Cancer Center, Wisconsin Rapids, Wisc.; and University of Maryland, Baltimore, Md. This study was designed as a dosimetric comparison of helical TomoTherapy treatments and Single-Arc IMAT treatments. Results indicated that helical TomoTherapy provided better dose uniformity by a factor of two, and slightly better dose sparing to 80 percent of the normal tissues studied, such as the lens, eyes, spinal cord, parotid, rectum and bladder.
  
• Safe Ultra-High Dose Escalation on Dominant Intraprostatic Lesions (DIL) by TomoTherapy - Scientific Institute San Raffaele, Milan, Italy; and Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy. This abstract examines dose escalation possibility for prostate tumors that are considered to be resistant to radiation and need higher doses for control. Researchers determined that the high-quality imaging and superior dosimetry of the TomoTherapy system may permit clinicians to safely escalate the dose to at least 100 Gy in the DIL volume and control exposure of critical structures.
  

Quality Assurance

• TomoTherapy Quality Assurance (TQA™): A Fast and Comprehensive Software Tool - UCL-Cliniques Universitaires Saint Luc, Brussels, Belgium. This paper compares the TQA software tool with classical quality assurance methodology. The researchers concluded that the TQA tool is not only a fast and comprehensive quality assurance tool, it also provides accurate and reliable information.
  
• A New Method for Output Factors Measurements/MC Computations for Stereotactic and Dynamic Jaws TomoTherapy - UCL-Cliniques Universitaires Saint Luc, Brussels, Belgium; University of Wisconsin-Madison, Madison, Wisc.; and TomoTherapy Inc. This paper -- which earned the ESTRO Varian award for research in the field of radiobiology, radiation physics, clinical radiotherapy or radiation technology -- discusses a method of calculating output factors for small field sizes with the TomoTherapy system, which was successfully verified by Monte Carlo simulations.
  

Also, this year ESTRO has recognized the 1993 paper "TomoTherapy: A New Concept for Delivery of Dynamic Conformal Radiotherapy" as "A Classic Medical Physics Paper." Lead author is Thomas "Rock" Mackie, PhD, TomoTherapy's co-founder and chairman.

"It is rewarding to see how TomoTherapy users across the globe are advancing cancer care by using our unique platform," said Mackie. "From the wealth of data offered in the papers at ESTRO, it is clear that the TomoTherapy system offers users the flexibility to cancers throughout the body -- from the simple to the most complex -- with precise treatment plans that result in more effective delivery of radiation and the potential of fewer side effects for patients."