Total body irradiation (TBI): Preliminary experience on clinical implementation

Ravichandran, R; Binukumar, Johnson Pichy; Davis, Cheriyathmanjiyial Antony; Rahbi, Zakia Al; Rajan, Balakrishnan; Mandhari, Zahid Al

doi:10.4103/0971-6203.121200

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…Using the MPD of the different regions the required Perspex compensator thickness was calculated to compensate the irregular thickness of the patient separation in different regions such as skull, neck, knee, calf, and ankle. [ 11 25 ] Calculated compensator thickness was positioned at the appropriate places. Figure 3 shows the CB TBI treatment setup.…”

Section: Aterials and M Ethodsmentioning

confidence: 99%

A Phantom Study on Feasibility of Manual Field-in-Field Clinical Implementation for Total Body Irradiation and Comparison of Midplane Dose with Different Bilateral TBI Techniques

Khanna

Pandu

Mohandass

et al. 2023

Journal of Medical Physics

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Objective: The aim of this study is to implement a new treatment technique in total body irradiation (TBI) using the manual field-in-field-TBI (MFIF-TBI) technique and dosimetrically verifying its results with respect to compensator-based TBI (CB-TBI) and open field TBI technique. Materials and Methods: A rice flour phantom (RFP) was placed on TBI couch with knee bent position at 385 cm source to surface distance. Midplane depth (MPD) was calculated for skull, umbilicus, and calf regions by measuring separations. Three subfields were opened manually for different regions using the multi-leaf collimator and jaws. The treatment Monitor unit (MU) was calculated based on each subfield size. In the CB-TBI technique, Perspex was used as a compensator. Treatment MU was calculated using MPD of umbilicus region and the required compensator thickness was calculated. For open field TBI, treatment MU was calculated using MPD of umbilicus region, and the treatment was executed without placing compensator. The diodes were placed on the surface of RFP to measure the delivered dose and the results were compared. Results: The MFIF-TBI results showed that the deviation was within ± 3.0% for the different regions, except for the neck for which the deviation was 8.72%. In the CB-TBI delivery, the dose deviation was ± 3.0% for different regions in the RFP. The open field TBI results showed that the dose deviation was not within the limit ± 10.0%. Conclusion: The MFIF-TBI technique can be implemented for TBI treatment as no TPS is required, and laborious process of making a compensator can be avoided while ensuring that the dose uniformity in all the regions within the tolerance limit.

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Section: Aterials and M Ethodsmentioning

confidence: 99%

A Phantom Study on Feasibility of Manual Field-in-Field Clinical Implementation for Total Body Irradiation and Comparison of Midplane Dose with Different Bilateral TBI Techniques

Khanna

Pandu

Mohandass

et al. 2023

Journal of Medical Physics

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“…In total body irradiation, the dose rate is a factor that influences biological effects, and it is accepted practice to keep the dose rate between 0.05 and 0.10 Gy/min [27]. For a flattening filter-free beam, the dose rates of up to 24 Gy/min could be used [28].…”

Section: Biological Dose With Mkm For Interruptionmentioning

confidence: 99%

Dose compensation based on biological effectiveness due to interruption time for photon radiation therapy

Kawahara

Nakano

Saito

et al. 2020

The British Journal of Radiology

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Objective: To evaluate the biological effectiveness of dose associated with interruption time; and propose the dose compensation method based on biological effectiveness when an interruption occurs during photon radiation therapy. Methods: The lineal energy distribution for human salivary gland tumor was calculated by Monte Carlo simulation using a photon beam. The biological dose (Dbio) was estimated using the microdosimetric kinetic model. The dose compensating factor with the physical dose for the difference of the Dbio with and without interruption (Δ) was derived. The interruption time (τ) was varied to 0.1, 0.2, 0.3, 0.4, 0.5, 1, 2, 3, 4, 5, 10, 20, 30, 40, 50, 75, and 120 min. The dose per fraction and dose rate varied from 2 to 8 Gy and 0.1 to 24 Gy/min, respectively. Results: The maximum Δ with 1 Gy/min occurred when the interruption occurred at half the dose. The Δ with 1 Gy/min at half of the dose was over 3% for τ >= 20 min for 2 Gy, τ = 10 min for 5 Gy, and τ = 10 min for 8 Gy. The maximum difference of the Δ due to the dose rate was within 3% for 2 and 5 Gy, and achieving values of 4.0% for 8 Gy. The dose compensating factor was larger with a high dose per fraction and high-dose rate beams. Conclusion: A loss of biological effectiveness occurs due to interruption. Our proposal method could correct for the unexpected decrease of the biological effectiveness caused by interruption time. Advances in knowledge: For photon radiotherapy, the interruption causes the sublethal damage repair. The current study proposed the dose compensation method for the decrease of the biological effect by the interruption.

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“…Wholebody exposures to any form of radiation are known to alter its general physiology of the animal (Sharma, Parmar, Sharma, Verma, & Goyal, 2011). Total body irradiation (TBI) has been used in the clinical treatment of many malignancies to produce sufficient immunosuppression and prevent allograft rejections (Ravichandran et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Chemical composition and therapeutic potential of three Cycas species in brain damage and pancreatitis provoked by γ-radiation exposure in rats

Ismail

Hassan

Moawad

et al. 2020

Journal of Radiation Research and Applied Sciences

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Total body irradiation (TBI): Preliminary experience on clinical implementation

Cited by 3 publications

References 7 publications

A Phantom Study on Feasibility of Manual Field-in-Field Clinical Implementation for Total Body Irradiation and Comparison of Midplane Dose with Different Bilateral TBI Techniques

A Phantom Study on Feasibility of Manual Field-in-Field Clinical Implementation for Total Body Irradiation and Comparison of Midplane Dose with Different Bilateral TBI Techniques

Dose compensation based on biological effectiveness due to interruption time for photon radiation therapy

Chemical composition and therapeutic potential of three Cycas species in brain damage and pancreatitis provoked by γ-radiation exposure in rats

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