Implementation of Total Marrow Irradiation With Helical Tomotherapy; Clinical Experiences and Report on Organ Sparing in Pediatric Patients

2018 ◽  
Vol 101 (4) ◽  
pp. 1006-1007 ◽  
Author(s):  
Jacob Engellau ◽  
André Haraldsson ◽  
Per Engström ◽  
Stig Lenhoff
Keyword(s):  
Pediatric Patients ◽  
Helical Tomotherapy ◽  
Clinical Experiences ◽  
Total Marrow Irradiation ◽  
Organ Sparing

scholarly journals Implementing safe and robust Total Marrow Irradiation using Helical Tomotherapy – A practical guide

2019 ◽  
Vol 60 ◽  
pp. 162-167 ◽  
Author(s):  
André Haraldsson ◽  
Jacob Engellau ◽  
Stig Lenhoff ◽  
Silke Engelholm ◽  
Sven Bäck ◽  
...  
Keyword(s):  
Helical Tomotherapy ◽  
Practical Guide ◽  
Total Marrow Irradiation

Protocol implementation of total marrow irradiation (TMI) plus total lymphoid irradiation (TLI) using helical tomotherapy (HT)

2016 ◽  
Vol 32 ◽  
pp. 40-41
Author(s):  
M. Marcantonini ◽  
V. Lancellotta ◽  
G. Montesi ◽  
L. Falcinelli ◽  
C. Aristei ◽  
...  
Keyword(s):  
Helical Tomotherapy ◽  
Protocol Implementation ◽  
Total Lymphoid Irradiation ◽  
Total Marrow Irradiation

scholarly journals Practical Aspects of the Application of Helical Tomotherapy for Craniospinal Irradiation

2020 ◽  
Author(s):  
Joongyo Lee ◽  
Euidam Kim ◽  
Nalee Kim ◽  
Hwa Kyung Byun ◽  
Chang-Ok Suh ◽  
...  
Keyword(s):  
Weight Loss ◽  
Risk Factor ◽  
Pediatric Patients ◽  
Helical Tomotherapy ◽  
Craniospinal Irradiation ◽  
Setup Errors ◽  
Ap Weight ◽  
Setup Verification ◽  
The Difference ◽  
Pre Treatment

Abstract We investigated the practical aspects of the application of craniospinal irradiation using helical tomotherapy (HT-CSI) by evaluating interfractional setup errors and intrafractional movement during each treatment in 83 patients undergoing HT-CSI between January 2014 and December 2018. Interfractional setup errors in each axis (mediolateral; ML, craniocaudal; CC, and anteroposterior; AP) were assessed as differences between pre-treatment megavoltage computed tomography (MVCT) images scanned (zygomatic arch to the C4 spine) and planning CT images. Intrafractional movements were evaluated as the difference between pre-treatment and post-treatment MVCT (T12–L4 spine) images at each fraction. Median interfractional setup error was acceptable in every axis (ML: 1.6 mm, CC: 1.9 mm, AP: 3.1 mm). Seven patients (8.4%) experienced significant intrafractional displacement from 1 to 10 fractions (0.35% for ML, 0.77% for CC, 1.26% for AP). Weight loss grade 1+ during treatment (p=0.016) was an independent risk factor for significant intrafractional displacement. The risk factor for significant intrafractional movement in pediatric patients was weight loss grade 1+ (p=0.020), while there was no factor in adults. HT-CSI could be a feasible treatment modality with acceptable setup verification. Inter- and intrafractional errors were acceptable; paying attention to weight loss during treatment is necessary, especially in pediatric patients.

Whole lung irradiation in pediatric patients using helical tomotherapy to minimize cardiac, breast, and thyroid dose

2012 ◽  
Vol 2 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Farzan Siddiqui ◽  
Thomas Mathews ◽  
Bin S. Teh ◽  
John A. Kalapurakal ◽  
E. Brian Butler ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Helical Tomotherapy ◽  
Thyroid Dose ◽  
Lung Irradiation ◽  
Whole Lung Irradiation

A Phase I Study of Hypofractionated Tailored Total Marrow or Total Lymphoid Irradiation with Helical Tomotherapy Plus Chemotherapy As a Conditioning Regimen for Autologous Stem Cell Transplantation

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4523-4523
Author(s):  
G. Pica ◽  
S. Vagge ◽  
G. Beltrami ◽  
S. Nati ◽  
G. Catania ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Acute Leukemia ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Helical Tomotherapy ◽  
Conditioning Regimen ◽  
Intensity Modulated Radiotherapy ◽  
Total Marrow Irradiation ◽  
Total Body

Abstract Abstract 4523 Purpose: We performed a phase I study on the combination of hypofractionated intensity modulated radiotherapy plus busulfan or melphalan as conditioning regimen for autologous stem cell transplantation in patients with acute leukemia and relapsed lymphoma. Materials and methods: Thirteen patients with a median age of 54 (range 36–67) years entered this trial. Eight patients had acute leukemia (7 AML and 1 ALL) and 5 patients relapsed lymphomas (3 HD and 2 NHL). All patients were treated with helical tomotherapy to obtain a precise conformation of the dose distribution with the highest spare as achievable normal tissue. The conditioning regimen for acute leukemia consisted of tandem total marrow irradiation and total body irradiation (12Gy in 3 days - single fraction per day); in particular, it was performed with 8Gy in 2 fractions for total marrow irradiation and 4Gy for total body irradiation, respectively. After 2 days rest, busulfan was given at the dose of 3,2 mg/kg body weight/day for 2 days.The conditioning regimen for lymphomas consisted of 12Gy in 3 days (single fraction per day) delivered to the entire major lymph node-bearing areas, from the levels of the neck to the inguinal region, including the thymus and spleen; after 2 days rest, melphalan was given at the dose of 140 mg/m2. The median number of CD34+ cells infused was 4,2 × 106/kg BW (range 2,0–10,0). Results: The median doses delivered to organ at risk with total lymphoid irradiation was 40% to 80% respect to the target volume dose, while the median dose reduction achieved with total marrow irradiation ranged from 30% to 65% with the largest reduction (−50%–65%) obtained for brain, larynx, liver, lungs and kidneys. All patients showed complete engraftment after a median time of 14 days (range 11–21). The transfusion support for each patient was 1–2 units of packed red blood cells and 2–3 units of platelets concentrates. Seven out of 13 (53%) patients experienced fever of undetermined origin which lasted for a mean period of 3 days (range 1–6) and solved after broad spectrum i.v. antibiotics/antimicotics; furthermore, 6 patients developed grade 3/4 mucositis and total parenteral nutrition was administered for a mean time of 6 days (range 4–8). None of the patients experienced other grade 3/4 non hematologic toxicity. Conclusions: Our preliminary results show that hypofractionated-intensity modulated radiotherapy with helical tomotherapy plus chemotherapy is a safe conditioning regimen for autologous stem cell transplantation in acute leukemia and lymphomas. Our report is the first that investigated the feasibility of an high dose hypofractionated radiotherapy regimen to achieve an higher cell kill rate. According to this preliminary experience, we are extending this approach to multiple myeloma and to low risk acute leukemia patients in first complete remission. Disclosures: No relevant conflicts of interest to declare.

scholarly journals EP-1614 Incidence of second malignancies among pediatric patients treated with helical Tomotherapy

2019 ◽  
Vol 133 ◽  
pp. S870
Author(s):  
E. Coassin ◽  
A. Drigo ◽  
L. Barresi ◽  
G. Fanetti ◽  
C. Elia ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Helical Tomotherapy ◽  
Second Malignancies
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