SU-E-T-813: Using Intensity Modulated Radiation Therapy for Total Body Irradiation - a Phantom Study

2011 ◽  
Vol 38 (6Part23) ◽  
pp. 3678-3678 ◽  
Author(s):  
D Vade BonCoeur ◽  
C Pelloski ◽  
N Gupta ◽  
M Weldon ◽  
J Woollard ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Total Body Irradiation ◽  
Intensity Modulated Radiation Therapy ◽  
Phantom Study ◽  
Intensity Modulated ◽  
Total Body

scholarly journals Adequate target volume in total-body irradiation by intensity-modulated radiation therapy using helical tomotherapy: a simulation study

2016 ◽  
Vol 58 (2) ◽  
pp. 210-216 ◽  
Author(s):  
Ryosuke Takenaka ◽  
Akihiro Haga ◽  
Hideomi Yamashita ◽  
Keiichi Nakagawa
Keyword(s):  
Radiation Therapy ◽  
Total Body Irradiation ◽  
Intensity Modulated Radiation Therapy ◽  
Target Volume ◽  
The Body ◽  
High Fluence ◽  
Intensity Modulated ◽  
Small Set ◽  
Total Body ◽  
Set Up

Abstract Recently, intensity-modulated radiation therapy (IMRT) has been used for total-body irradiation (TBI). Since the planning target volume (PTV) for TBI includes the surrounding air, a dose prescription to the PTV provides high fluence to the body surface. Thus with just a small set-up error, the body might be exposed to a high-fluence beam. This study aims to assess which target volume should be prescribed the dose, such as a clinical target volume (CTV) with a margin, or a CTV that excludes the surface area of the skin. Three treatment plans were created for each patient: the 5-mm clipped plan (Plan A), the 0-mm margin plan (Plan B) and the 5-mm margin plan (Plan C). The CTV was the whole body. PTVs were the CTV with the exception of 5 mm from the skin surface in Plan A, equal to the CTV in Plan B, and the CTV with a 5 mm margin in Plan C. The prescribed dose was 12 Gy in six fractions. To assess the influence of the set-up error, dose distributions were simulated on computed tomography (CT) images shifted 2 pixels (= 4.296 mm), 5 pixels (= 10.74 mm) and 10 pixels (= 21.48 mm) in the lateral direction from the original CT. With a set-up error of 10.74 mm, V110% was 8.8%, 11.1% and 23.3% in Plans A, B and C, respectively. The prescription to the PTV containing the surrounding air can be paradoxically vulnerable to a high-dose as a consequence of a small set-up error.

scholarly journals Safety of total body irradiation using intensity-modulated radiation therapy by helical tomotherapy in allogeneic hematopoietic stem cell transplantation: a prospective pilot study

2020 ◽  
Vol 61 (6) ◽  
pp. 969-976
Author(s):  
Tatsuya Konishi ◽  
Hiroaki Ogawa ◽  
Yuho Najima ◽  
Shinpei Hashimoto ◽  
Atsushi Wada ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Stem Cell ◽  
Pilot Study ◽  
Hematopoietic Stem Cell Transplantation ◽  
Total Body Irradiation ◽  
Helical Tomotherapy ◽  
Intensity Modulated Radiation Therapy ◽  
Hematopoietic Stem ◽  
Intensity Modulated ◽  
Total Body

Abstract Total body irradiation using intensity-modulated radiation therapy total body irradiation (IMRT-TBI) by helical tomotherapy in allogeneic hematopoietic stem cell transplantation (allo-HSCT) allows for precise evaluation and adjustment of radiation dosage. We conducted a single-center pilot study to evaluate the safety of IMRT-TBI for allo-HSCT recipients. Patients with hematological malignancies in remission who were scheduled for allo-HSCT with TBI-based myeloablative conditioning were eligible. The primary endpoint was the incidence of adverse events (AEs). Secondary endpoints were engraftment rate, overall survival, relapse rate, non-relapse mortality, and the incidence of acute and chronic graft-versus-host disease (aGVHD and cGVHD, respectively). Between July 2018 and November 2018, ten patients were recruited with a median observation duration of 571 days after allo-HSCT (range, 496–614). D80% for planning target volume (PTV) in all patients was 12.01 Gy. Average D80% values for lungs, kidneys and lenses (right/left) were 7.50, 9.03 and 4.41/4.03 Gy, respectively. Any early AEs (within 100 days of allo-HSCT) were reported in all patients. Eight patients experienced oral mucositis and gastrointestinal symptoms. One patient experienced Bearman criteria grade 3 regimen-related toxicity (kidney and liver). All cases achieved neutrophil engraftment. There was no grade III–IV aGVHD or late AE. One patient died of sinusoidal obstruction syndrome 67 days after allo-HSCT. The remaining nine patients were alive and disease-free at final follow-up. Thus, IMRT-TBI was well tolerated in terms of early AEs in adult patients who underwent allo-HSCT; this warrants further study with longer observation times to monitor late AEs and efficacy.

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