I was wondering if anyone had any information and/or research reports concerning the efficiency of RapidArc Linear
Rad vs Tomotherapy. All I've seen is marketing stuff. I don't care about the short rad time, but am interested in the preservaton of areas outside the cancer area. (salivary glands, etc.) The company says that there is less dosage of rad to other areas.
I am doing induction therapy now, but will do radiation in about 6 weeks. I'm currently scheduled to do tomotherapy, but have a hospital not too far that has the RapidArc.

Just wondering if there is a difference?????

From my experience with the two radiations it will depend on if you saliva glands are in the field of radiation or not. My first RO said that he was going to try to spare my saliva glands and I had little to no mucous or dry mouth issues with that treatment. This second time the treatment area was the base of my tongue and my saliva glands are fried and I also experienced all of the wonders of mucous.

JMHO

Patty

Patty: My cancer is BOT on the left. My Rad doctor said he could probably save the salivary glands on the right. I'm still going to do more research. The RapidArc machine is so new that I'm not sure much has been published. I'm going to try to call the company tomorrow.

Thanks for your reply.
Sandy

I'm very curous about the amount of scatter from both machines to to nearby healthy tissue. From what I gather some reoccurance of cancer is caused by the radiaton of healthy cells that in the vicinity of the cancer. They cells are changed (can't think of proper term) by the radiaton, but not actually kills. Hope this makes sense.

Sandy

Reoccurrence of this cancer are primarily because of incomplete primary treatment, (most commonly single discipline treatments in a non multidisciplinary environment) or a particularly aggressive version of SCC that responds incompletely to existing treatments.... and not scatter radiation. Micro mets to surrounding tissues locally and to the cervical nodes that are too small to be seen by any kind of scanning technology that we currently have, miss these until about 18-24 months post treatment, when they are big enough to finally show up on scans.

Scatter radiation is too low an amount to cause a cancer of its own, and the types that radiation causes (in higher doses) are not SCC. Radiation induced cancers, usually happen as mandibular osteosarcomas in about 3-5% of those treated with more than 70gys of radiation, and they occur about year ten after treatment. I personally fall into this risk group... thankfully 5% is a pretty low incidence rate.

Your previous posts though are areas where the greatest progress is being made, and that is in sparing collateral healthy tissues from damage such as the salivary glands, the carotids, spinal column etc. In both the technologies that you are considering, these are major benefits over older techniques.

Jim will have his last cyberknife treatment Friday, March 6. The total taken will be 5 and it was done every other day. His mouth is all swelled up and he is miserable. His chin has a growth on it and everything from his neck up, looks so so sore. I don't know if the cyberknife made it worse (for now) or if that is the cancer. I'll ask the dr. tomorrow. After his surgery last March 2008, I thought he was on his way to be healed. Never gave recurrence a thought, never gave mets to lungs a thought either. Poor guy, since his recurrence he can't even sip water---absolutely nothing by mouth, of course he never did eat after surgery. It's been a year. Prattle Prattle Prattle--I can go on forever. Good night all ! Claudia

Both Tomo and Varian(trilogy w/rapidarc) are very highly rated.

My cancer treatment center considered Tomo the Gold Standard for head and neck where numerous areas needed irradiate and avoidance of critical structures was paramount as was necessary in my case.

I am not sure if Varian has a newer model out now or not, but
The multi-leaf collimator leaves on the Tomo were thicker and I believe faster so there should be less scatter radiation.

A nice thing about the Varian is that the daily CT scan only uses about half the X-ray dose of the Tomo, and of course how fast it is.

I understand the next generation of Tomo will be much faster and adds another dimension of beam control which my RO contents will actually increase its current advantage over volumetric arc therapy systems like Rapidarc for complex cases .

I remember reading an article that arc therapy really can't effective use all its 360 degrees where Tomo apparently can.

My ENT contents his OC patients that get Tomo seem to recover quicker and perhaps more fully from dry mouth. The cancer center has several metro locations and only one Tomo unit so most of OC patients get treated on a Varian system and two of them in my support group seem to have considerably worse dry mouth than I do (mine is negligible).

When there is a choice, I would consider Tomo for OC, and leave the RapidArc for less complex targeting, but it is good that you have such fine contenders to choose between.

My RO briefly and I mean briefly explained that in both the Tomo and the Rapid their advantage is more preciseness (sparing more healthy tissues) and now more speed but he cautioned to say that a disadvantage is that with their sharp more precise beams you have a greater risk of missing the target (hence the advantage of daily imaging)so obviously it will depend upon the whole patient presentation. Same old problem...risk vs benefits.

One thing that we do not discuss is the qualifications and experience of the RO and other technicians involved in setting up these machines. They are just as important as the machine itself so getting Txed by the best person should also be high on your thinking.

Sandy

I will say that it is possible for them to save the saliva glands because they did save mine the first time around. The second time I was happy to have dry mouth if it means that I will not have another recurrence and was ok with being hit with everything that they had.

I wish you luck in your treatment and your research. I am glad that you found this site to help you with both.

Patty

I want to thank everyone for their reply. You have answered my query very thoroughly. As with everyone, I'm always checking the news for new information on drugs, treatment protocals, and equipment to get the best treatment available.

I can now comfortable say that I feel that I have the best option available to me. I'll start Tomotherapy in April. (The new RapidArc Varian machine I'll look into further if need by in the future.) In the meantime, my Oncologist and RO are looking into ways to save more of my salivary glands.

Thanks so much for your answers.

Sandy