Clinical Outcomes of Definitive Radiotherapy Delivered by Helical Tomotherapy.

Objective: To assess the disease response and patient survival outcomes for cancer patients treated with helical tomotherapy.

Study Design: Descriptive study. Place and Duration of the Study: The Tomotherapy Unit of Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from October 2020 to August 2023.

Methodology: A retrospective analysis was conducted on the data of patients who underwent definitive radiation at Tomotherapy Centre. The evaluation of disease response utilised CT scans performed three months after completing radiotherapy, following RECIST criteria. Survival and disease-free status were determined through telephonic interviews with the patients.

Results: A total of 654 patients received treatment on Tomotherapy, of which, 143 underwent definitive Radiotherapy. The average age was 51 ± 16.8 years, with 85 (59.4%) males. The predominant area subjected to definitive radiation was the head and neck, accounting for 65 cases (45.5%), trailed by the gastrointestinal tract and pelvis with 52 (36.4%) and 26 (18.2%) cases, respectively. Response assessment revealed a complete response in 73 (52.14%) patients, partial response in 47 (33.5%), stable disease in 11 (7.85%), and progressive disease in 9 (6.4%). Currently, 108 (77%) patients are alive. Twenty-eight (20%) patients experienced local or distant disease development. Among them, 6 (4.3%) patients had local recurrence, and 22 (15.7%) developed metastatic disease.

Conclusion: Helical tomotherapy offers promising disease control and survival outcomes, making it a viable treatment modality for cancer patients in a lower middle-income country. These findings highlight the importance of careful patient selection and optimising resource utilisation for curative treatments to enhance cancer care in Pakistan.

Key Words: Radiotherapy, Tomotherapy, Radiotherapy technique, Multidisciplinary treatment, Peer-review practice.