Cancers arising in the upper abdomen or gastrointestinal tract, such as esophageal, stomach, gall bladder, biliary and pancreatic cancers, are very serious since they may be fairly advanced at the time of detection, making curative surgery difficult or impossible. Larger tumors or cancers in the biliary region frequently require 5 or 6 weeks of radiation (with or without chemotherapy depending upon other factors), usually given after an attempt at surgery. The presence of radiation sensitive organs such as the liver, kidneys, spinal cord, and small intestines in this region can make it difficult to deliver an optimal radiation therapy program. Tomotherapy can allow treatment of most areas at risk for tumor recurrence to a high dose, while keeping the exposure of sensitive organs within their tolerance limits.
Most of these cancers also have a tendency to spread to the liver and occasionally to the lung. Since both the liver and lung are very sensitive to radiation, in the past it has been difficult to treat liver or lung metastases with radiation without damaging these organs. Tomotherapy now allows us to accurately target liver or lung tumors to receive fairly high doses of radiation, while safely sparing the rest of the organ.