Accelerated large volume irradiation with dynamic Jaw/Dynamic Couch Helical Tomotherapy

Sonja Krause, Sebastian Beck, Kai Schubert, Steffen Lissner, Susanta Hui, Klaus Herfarth, Juergen Debus, Florian Sterzing

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: Helical Tomotherapy (HT) has unique capacities for the radiotherapy of large and complicated target volumes. Next generation Dynamic Jaw/Dynamic Couch HT delivery promises faster treatments and reduced exposure of organs at risk due to a reduced dose penumbra.Methods: Three challenging clinical situations were chosen for comparison between Regular HT delivery with a field width of 2.5 cm (Reg 2.5) and 5.0 cm (Reg 5.0) and DJDC delivery with a maximum field width of 5.0 cm (DJDC 5.0): Hemithoracic Irradiation, Whole Abdominal Irradiation (WAI) and Total Marrow Irradiation (TMI). For each setting, five CT data sets were chosen, and target coverage, conformity, integral dose, dose exposure of organs at risk (OAR) and treatment time were calculated.Results: Both Reg 5.0 and DJDC 5.0 achieved a substantial reduction in treatment time while maintaining similar dose coverage. Treatment time could be reduced from 10:57 min to 3:42 min / 5:10 min (Reg 5.0 / DJDC 5.0) for Hemithoracic Irradiation, from 18:03 min to 8:02 min / 8:03 min for WAI and to 18:25 min / 18:03 min for TMI. In Hemithoracic Irradiation, OAR exposure was identical in all modalities. For WAI, Reg 2.5 resulted in lower exposure of liver and bone. DJDC plans showed a small but significant increase of ∼ 1 Gy to the kidneys, the parotid glans and the thyroid gland. While Reg 5.0 and DJDC were identical in terms of OAR exposure, integral dose was substantially lower with DJDC, caused by a smaller dose penumbra.Conclusions: Although not clinically available yet, next generation DJDC HT technique is efficient in improving the treatment time while maintaining comparable plan quality.

Original languageEnglish (US)
Article number191
JournalRadiation Oncology
Issue number1
StatePublished - Nov 12 2012

Bibliographical note

Funding Information:
This work has been supported by the Faculty of Medicine, University of Heidelberg, Germany. The department of Radiation Oncology, University Hospital of Heidelberg has a research cooperation with Tomotherapy Inc.


  • Dynamic jaw/dynamic couch
  • Helical tomotherapy
  • Hemithoracic irradiation
  • Large volumes
  • Total marrow irradiation
  • Whole abdominal irradiation


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