Calculation and Measurements of Absorbed Dose in Total Body Irradiation

Svahn-Tapper, Gudrun; Nilsson, Per; Jönsson, Christel; Alvegård, Thor

doi:10.3109/02841869009090064

Cited by 6 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients receiving TBI were treated immobilised in a side position at 4.5 m distance from the radiation source 16 with lead blocks to shield the lungs. The absorbed dose rate at the dose maximum depth of 1.5 cm was approximately 30 cGy/min.…”

Section: Methodsmentioning

confidence: 99%

Organ sparing total marrow irradiation compared to total body irradiation prior to allogeneic stem cell transplantation

Haraldsson

Wichert

Engström

et al. 2021

European J of Haematology

View full text Add to dashboard Cite

Objectives Total body irradiation (TBI) is commonly used prior to hematopoietic stem cell transplantation (HSCT) in myeloablative conditioning regimens. However, TBI may be replaced by total marrow irradiation (TMI) at centres with access to Helical TomoTherapy, a modality that has the advantage of delivering intensity‐modulated radiotherapy to long targets such as the entire bone marrow compartment. Toxicity after organ sparing TMI prior to HSCT has not previously been reported compared to TBI or with regard to engraftment data. Methods We conducted a prospective observational study on 37 patients that received organ sparing TMI prior to HSCT and compared this cohort to retrospective data on 33 patients that received TBI prior to HSCT. Results The 1‐year graft‐versus‐host disease‐free, relapse‐free survival (GRFS) was 67.5% for all patients treated with TMI and 80.5% for patients with matched unrelated donor and treated with TMI, which was a significant difference from historical data on TBI patients with a hazard ratio of 0.45 (P = .03) and 0.24 (P < .01). Engraftment with a platelet count over 20 [K/µL] and 50 [K/µL] was significantly shorter for the TMI group, and neutrophil recovery was satisfactory in both treatment cohorts. There was generally a low occurrence of other treatment‐related toxicities. Conclusions Despite small cohorts, some significant differences were found; TMI as part of the myeloablative conditioning yields a high 1‐year GRFS, fast and robust engraftment, and low occurrence of acute toxicity.

show abstract

Section: Methodsmentioning

confidence: 99%

Organ sparing total marrow irradiation compared to total body irradiation prior to allogeneic stem cell transplantation

Haraldsson

Wichert

Engström

et al. 2021

European J of Haematology

View full text Add to dashboard Cite

show abstract

“…To validate the choice of CTV-PTV margins and to verify that all patients received the prescribed dose, we applied the concept of Dose Coverage Histogram (DCH) [21]. Basically, the Dose Coverage Histogram tells the probability that the dose to the CTV is covered to a certain level based on the variation in DVHs calculated from a number of treatments.…”

Section: Treatment Planningmentioning

confidence: 99%

“…Being a single Tomotherapy unit centre, to prevent treatment course interruption in case of machine breakdown, a conventional TBI treatment plan was prepared for each patient as described by Svahn-Tapper et al [21]. In vivo TLD or diode measurements performed at the first fractions were used for dose verification and if necessary also a dose correction.…”

Section: Backup Treatment Preparationmentioning

confidence: 99%

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

et al. 2019

View full text Add to dashboard Cite

Total Marrow Irradiation (TMI) with Helical Tomotherapy is a radiotherapy treatment technique that targets bone marrow and sanctuary sites prior to stem cell or bone marrow transplantation (SCT/BMT). TMI is a complex procedure that involves several critical steps that all need to be carefully addressed for a successful implementation, such as dose homogeneity in field junctions, choice of target margins, integrity of treatment and backup planning. In this work we present our solution for a robust and reproducible workflow throughout the treatment chain and data for twenty-three patients treated to date. Material & Methods: Patients were immobilized in a whole body vacuum cushion and thermoplastic mask. CTscanning and treatment were performed in two parts with field matching at the upper thigh. Target consisted of marrow containing bone and sanctuary sites. Lungs, kidneys, bowel, heart and liver were defined as organs at risk (OAR). A fast surface scanning system was used to position parts of the body not covered by the imaging system (MVCT) as well as to reduce treatment time. Results: All patients completed their treatment and could proceed with SCT/BMT. Doses to OARs were significantly reduced and target dose homogeneity was improved compared to TBI. Robustness tests performed on field matching and patient positioning support that the field junction technique is adequate. Replacing MVCT with optical surface scanning reduced the treatment time by 25 min per fraction. Conclusion: The methodology presented here has shown to provide a safe, robust and reproducible treatment for Total Marrow Irradiation using Tomotherapy.

show abstract

Comparison of different TBI techniques in terms of dose homogeneity – review study

Zarghani

Geraily

Hadisinia

2021

Cancer/Radiothérapie

View full text Add to dashboard Cite

Calculation and Measurements of Absorbed Dose in Total Body Irradiation

Cited by 6 publications

References 19 publications

Organ sparing total marrow irradiation compared to total body irradiation prior to allogeneic stem cell transplantation

Organ sparing total marrow irradiation compared to total body irradiation prior to allogeneic stem cell transplantation

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

Comparison of different TBI techniques in terms of dose homogeneity – review study

Contact Info

Product

Resources

About