Radiation therapies


Attacking the tumor, protecting the patient

Scary-looking machines are used at the facilities of the ETMC Cancer Institute, but there’s really nothing to fear – unless you’re a tumor.

These highly advanced machines are linear accelerators, called the Elekta Precise and Synergy and the Varian TrueBeam. They’re designed to detect, diagnose and fight cancers while they protect the patients from unintended effects of the radiation, limit the overall time of exposure and minimize patient discomfort during treatment.

At ETMC hospitals, radiation oncologists (physicians who specialize in these treatments) and medical physicists operate the accelerators and supervise the therapy program. This combination of state-of-the-art technology and healthcare professionalism helps us maintain focus on our core mission to improve the quality of life for East Texans.

Standard radiation therapy

Radiation therapy is crucial to modern cancer treatment. More than 12,000 patients have been treated at the ETMC Cancer Institute’s radiation oncology center since its opening in 1982, and today roughly two-thirds of cancer patients receive radiation treatment.

At the ETMC Cancer Institute, standard radiation therapy and 3-D radiation therapy are delivered with linear accelerators. We use this therapy to treat multiple tumor sites including brain, lung, breast, bone and spine. The physician can specify the type of linear accelerator needed, depending on the characteristics of the patient and the cancer.

Intensity modulated radiation therapy (IMRT) is used to deliver a dose of radiation conformed to the volume of the tumor, while sparing the healthy tissues and organs in the vicinity as much as possible. It is often used for tumors in the head and neck.

Volumetric modulated arc therapy (VMAT) is delivered using the more advanced TrueBeam linear accelerator. The gantry rotates constantly around the patient, delivering precisely calculated units of energy to give a conformal dose of radiation according to the tumor volume. VMAT is also known as RapidArc or SmartARC.

TrueBeam technology is a game changer

The TrueBeam generates high-quality 3-D images to locate the targeted tumor, then uses high-dose radiation to deliver therapeutic radiation. The TrueBeam represents a game-changing level of flexibility by enabling physicians to tailor a radiotherapy treatment to the patient’s individual needs. TrueBeam:

  • compensates for patient breathing and movement
  • tracks the tumor in real time for precise imaging and therapy
  • forms the radiation beam to match the size and shape of nearly any tumor
  • destroys cancer cells while protecting surrounding healthy tissue
  • minimizes patient discomfort and maximizes convenience by taking only minutes per treatment

For more information on radiation therapies at the ETMC Cancer Institute, call 903-595-5550.

content-cancer-blas-headshot“With the TrueBeam, we can do in two minutes what used to take 10 minutes.”

– Blas Caroprese, PhD, chief medical physicist

TrueBeam facts

The TrueBeam™ system is an advanced medical linear accelerator—or radiotherapy and radiosurgery treatment system—capable of fast and precise image-guided radiotherapy.

This technology from Varian Medical Systems was engineered from the ground up to deliver high doses with accuracy in the fractions of millimeters, narrowly targeting tumors and better able to avoid the surrounding healthy tissues and organs.


TrueBeam delivers many forms of advanced treatments, including image-guided radiotherapy (IGRT), intensity-modulated radiotherapy (IMRT), RapidArc® radiotherapy technology and Gated RapidArc. The ability to choose between these different treatment modalities represents a game-changing level of flexibility for tailoring a patient’s radiotherapy treatments. With TrueBeam, doctors can tailor treatments for each patient’s specific case.

This technology makes it possible to deliver fast, accurate image-guided treatments within just a few minutes per day.

The precision of Varian’s TrueBeam system is measured in increments of less than a millimeter. This accuracy is made possible by the system’s sophisticated architecture, which synchronizes imaging, patient positioning, motion management, beam shaping and dose delivery. The system performs accuracy checks every ten milliseconds throughout the entire treatment.

Before and at any point during a treatment, the TrueBeam system can generate high-quality 3-D images of the tumor and surrounding anatomy, and this can be done 60 percent faster than was possible with previous generations of Varian imaging technology. Images can be generated using 25 percent less X-ray dose. These images are used to fine-tune a patient’s position prior to and during the treatment process.

TrueBeam offers many other innovations, including:

  • Imaging tools that can verify not only the patient’s position, but also the magnitude of tumor motion during a treatment, enabling accurate tumor targeting.
  • Fast, automated treatment delivery management software that significantly shortens the duration of sophisticated treatments involving different beam angles.
  • RapidArc radiotherapy technology, which delivers a precise image-guided intensity-modulated treatment in as little as two minutes a day.

RapidArc new Gated RapidArc capability makes it possible to use this treatment approach for tumors of the kidney, liver, lung and breast, when tumor motion is an issue.

In addition to faster treatments, TrueBeam’s enhanced communication technology enables a constant interaction between the patient and therapist operating the equipment, creating a virtual presence of the therapist in the treatment room. Three closed-circuit television systems enable comprehensive monitoring of the patient and the system from outside the treatment room. Additional enhanced features allow music to be played during treatment, helping to create a more soothing treatment environment.

Why does speed matter?

Faster radiotherapy treatments can be easier on the patient, who does not need to hold still for long periods of time. By reducing the time it takes to deliver IMRT and other highly precise forms of radiotherapy, TrueBeam has the potential to improve patient comfort.

The technology

Varian’s TrueBeam is an innovative medical technology that integrates and synchronizes performance of imaging and treatment technology. The system’s imager is used to guide patient placement and treatment delivery. The machine rotates around the patient to deliver the radiation treatments from nearly any angle.

The radiation beam is sculpted and shaped to match the three-dimensional shape of the tumor. This is accomplished using an important accessory called a multi-leaf collimator (MLC), a device with 120 computer-controlled mechanical “leaves” or “fingers” that can move to create apertures of different shapes and sizes. The MLC aperture changes during the course of treatment, to carefully target the tumor and protect surrounding tissues to the greatest extent possible.

The benefits of treatment on a Varian TrueBeam machine

  • TrueBeam unlocks treatment options for patients who otherwise may not have been candidates for traditional radiotherapy.
  • It gives medical professionals the tools to treat more complex cancer cases.
  • TrueBeam is fast and precise. Its speed means shorter treatment times, which leads to less interruption of patients’ daily lives.

For more information about TrueBeam contact the ETMC Cancer Institute at 903-595-5550.