20 Years of Experience in Static Intensity-Modulated Total-Body Irradiation and Lung Toxicity

Abstract

Compensator-generated static intensity-modulated TBI with a total dose of 12 Gy and a lung dose of 11 Gy is a modern and comfortable treatment with moderate lung toxicity, small dose inhomogeneities and little setup failure before transplantation. Especially patients <16 years of age benefit from lung dose reduction.

In Vivo Dosimetry with Semiconducting Diodes for Dose Verification in Total-Body Irradiation

“…The speed of the couch was controlled by an analog signal which is derived from the linear accelerator and which is proportional to the dose output during a given reference speed (± 0.5%), thus compensating variations of dose output during treatment time [14]. As lung reactions are a frequent side effect of exposing the lung [5,21], customized lung blocks were used to reduce the lung dose to 10.0 Gy (79.4% of total dose). The risk of overdosage due to the minor diameter was reduced, applying a tissue-equivalent bolus to the neck region.…”

Retrospective, Monocentric Analysis of Late Effects after Total Body Irradiation (TBI) in Adults

“…Heinzelmann et al [4] recently reported results from the German Registry for Stem Cell Transplantation (DSRT) with a comprehensive overview about role and indications for TBI. Beside its efficacy in the different treatment schedules, patients surviving TBI are known to be at risk to develop a broad variety of late side effects [1,3,5,10,12,14]. Although patient survival is still the major concern in patients undergoing TBI [4], the knowledge of late effects of this treatment approach is important for patient information and comparison of different treatment strategies.…”

Experimental Determination of Peripheral Doses for Different IMRT Techniques Delivered by a Siemens Linear Accelerator

“…There is a vast number of IMRT delivery techniques [3], ranging from compensators [17,19] to multileaf collimator-(MLC-)based techniques (segmental and dynamic MLC delivery) and from serial to spiral tomotherapy [1,4]. On the other hand, segmental MLC delivery itself can vary significantly due to mechanical constraints in the MLC design, due to the optimization and segmentation approach that results in different-sized segments, both in area and monitor unit weight, and the shielding of the treatment head itself can have an influence.…”