Hi friends,

I have a dilemma I could use some help with. I read somewhere that by using a TOMO machine there is a better chance of saving the parotid (salivary) glands. With this as my objective, here is some background information:

I am needing radiation on both sides of the neck as I had two positive lymph nodes. The RO I am thinking about going with (unless your input suggests that I consider something else) at OHSU (a nationally recognized cancer center) emailed me:

"Planning will be done with the goal being all 35 treatments on Tomotherapy. We�ll also have a more traditional IMRT plan for back-up in case the Tomotherapy unit goes down any day. I don�t expect the Tomotherapy machine to go down, but all machines can have technical issues and we don�t have a Tomotherapy unit as back up. We do not want a break in therapy due to any TOMO malfunction."

Coincidentally the RO specializes in head and neck rads. However, since OHSU installed their first TOMO machine only about a month or so ago, my concern is what would happen if the machine fails. Since there is no TOMO backup unit the RO is also wanting to do a more traditional IMRT plan. I am also unsure how experienced the techs are at operating the machine. I know for sure that OHSU is aggressively marketing the TOMO machine in the local area.

My other option is to go to another nearby site (Meridian Park Radiation Oncology), where they've had multiple TOMOs for a long time. I have not yet met the RO at Meridian, but am willing to do this, depending on your input.

On the other hand, a couple of ROs have suggested that TOMO is a marketing buzz-word, and all I really need is traditional IMRT, and really I should not worry about whether or not rads are delivered using a "TOMO" machine, etc. etc.

I do want to increase the odds of saving (as much as possible) my parotid glands, and would appreciate any perspective(s).

Thanks in advance!

Best Regards,
Chetan