Cancer incidence in India have been rising steadily. More than 14 lakh new cases are registered every year, and studies suggest that one in nine Indians may face cancer at some point in their life. With numbers like these, the demand for radiation treatments that are sharp, safe and tailored to each patient has only grown. Over the past decade, radiation therapy has shifted from broad fields to techniques that can shape the dose around the tumour with remarkable accuracy. Among these advances, tomotherapy has stood out as a technology that genuinely changes how we treat cancer.
New level of image-guided accuracy
One of the most important features of tomotherapy is that it takes a megavoltage CT scan before every treatment session. This daily scan helps us see the tumour and nearby organs exactly as they are on that day. Tumours can move, shrink or change shape during the course of treatment. Weight loss, swelling or even normal breathing can shift things inside the body. Traditional machines depend on the initial planning CT, which cannot track these changes. Tomotherapy fills this gap by giving us real-time images, so we can correct the patient’s position by a few millimetres if needed and make sure the radiation hits the exact target every time. This greatly reduces the chance of missing the tumour, especially in areas like the head and neck or spine where even small shifts matter.
Helical delivery that wraps the dose around the tumour
What makes tomotherapy different from a regular linear accelerator is its helical delivery. Instead of treating from a few fixed angles, the machine rotates fully around the patient while the couch moves through the gantry. The radiation is delivered in a spiral pattern. This allows us to shape the dose very closely around the tumour, even if the tumour has an irregular form. It also lets us protect nearby organs more effectively. The dose is smoother and more even, which helps in complex areas where planning is usually difficult.
Safe option for re-irradiation
Re-irradiation is one of the toughest decisions in cancer care. Once an area has been treated before, the surrounding tissues reach their tolerance limits. Treating the same region again without damaging healthy tissue becomes extremely difficult. Tomotherapy helps us navigate this situation with better control. Its ability to sculpt the dose so precisely allows us to treat recurrent disease near sensitive structures while keeping the risk of toxicity low. This has opened doors for many patients with head and neck recurrences, spine relapses or pelvic failures who previously had very limited options.
Ideal for treating long or complex areas
Some cancers require treatment across long stretches of the body. Craniospinal irradiation, long para-spinal tumours, wide lymph node regions or total marrow irradiation are examples. Most machines cannot cover such lengths in one go. They need multiple fields, which creates the challenge of matching those fields accurately. Poor matching can lead to higher or lower doses at the junctions. Tomotherapy solves this by treating the entire length in a single continuous run. There are no field junctions and no risk of uneven dose at the borders. This is especially helpful in paediatric CNS tumours and many complex adult cancers.
Fewer side effects and better quality of life with adaptive treatment
Better precision translates directly into fewer side effects. For head and neck cancers, tomotherapy helps protect the salivary glands, so patients are less troubled by dryness of mouth. In pelvic cancers, it reduces the dose to the bowel and bladder, which means fewer gastrointestinal problems. For thoracic tumours, it keeps lung dose low and reduces the risk of radiation pneumonitis. For abdominal tumours, it protects the liver, kidneys and stomach more effectively. These improvements help patients stay more comfortable during treatment and maintain their daily routines.
Since tomotherapy takes images every day, it fits very well into adaptive radiation therapy. As the tumour shrinks or the body changes during the course of treatment, we can adjust the plan at the right time. This keeps the dose accurate from start to finish. Weight loss, reduction in swelling or movement of organs are all changes we can adapt to. This kind of real-time correction is becoming increasingly important as treatments become more personalised.
Strong match for India’s patient needs
In India, cancers often present late and with large tumour volumes. Patients may have nutritional variations or complex recurrences that make treatment planning more challenging. Tomotherapy’s ability to handle irregular shapes and long disease segments makes it very useful in these situations. It works particularly well for head and neck cancers, which are common in India. It is also valuable for prostate and gynaecological cancers, paediatric tumours, CNS cancers and thoracic malignancies. The technology helps balance strong tumour control with safe organ protection.
Radiation therapy is rapidly moving towards AI-assisted planning, automation and data-driven decision-making. Tomotherapy already has the kind of architecture that supports this shift. With daily imaging, detailed dose data and strong computational systems, it can integrate well with upcoming AI tools such as automated contouring or AI-based adaptive planning. Tomotherapy has brought a major shift in how precision radiation therapy is delivered. With daily imaging, helical dose delivery and strong adaptive potential, it gives clinicians the ability to treat cancers more accurately while protecting normal tissues more effectively. In a country like India, where cancer cases are diverse and often complex, Tomotherapy can become a reliable and forward-looking option. It not only addresses current clinical challenges but also sets the stage for the next phase of personalised cancer care.