ArticleRadiation oncology (London, England)2016
Total body irradiation with volumetric modulated arc therapy: Dosimetric data and first clinical experience.
Article in Radiation oncology (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers.
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Who cites it
57 citing papers in PubMed, 107 citations in OpenAlex.
- Trial
- Feasibility study of total marrow lymphoid irradiation with volumetric modulated arc therapy: clinical implementation in a tertiary care center.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2023Trial
- Preclinical feasibility of EPID-based transit dosimetry for total body irradiation.Journal of applied clinical medical physics · 2026Article
- VMAT-based total body irradiation on a conventional LINAC: workflow, procedure and preliminary results.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Incorporating Intensity Modulated Total Body Irradiation (IMRT-TBI) Into Future Cooperative Group Clinical Trials: An NRG Hematologic Malignancies Working Group-Led Report From the National Clinical Trials Network.International journal of radiation oncology, biology, physics · 2026Article
- In vivo dosimetry using an electronic portal imaging device for pediatric myeloablative Total body irradiation with volumetric modulated arc therapy.Physics and imaging in radiation oncology · 2026Article
- Impact of reduced interval from simulation CT to treatment delivery on dosimetric and positioning accuracy for total marrow lymph-node irradiation.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Large-field irradiation techniques in Germany: A DGMP Working Group survey on the current clinical implementation of total body irradiation, total skin irradiation and craniospinal irradiation.Zeitschrift fur medizinische Physik · 2026Article
- The Spinning Manny Indexed Overlay System for VMAT total body irradiation.Journal of applied clinical medical physics · 2026Article
- On the spectral changes of magna-field photon beams used in total body irradiation and impact on dosimetry.Journal of applied clinical medical physics · 2025Article
- Predicting late renal toxicity using a two-component repair model among pediatric patients receiving total body irradiation for stem cell transplant.Clinical and translational radiation oncology · 2025Article
- A multi-institutional survey on technical variations in total body irradiation in Japan.Radiological physics and technology · 2025Article
- Technique considerations for implementing volumetric-modulated arc therapy for total body irradiation within an Australian tertiary institution.Journal of medical radiation sciences · 2025Article
- Automated contouring, treatment planning, and quality assurance for total marrow lymphoid irradiation.Frontiers in oncology · 2025Article
- Evaluation of dose distributions in the overlapping regions of the modulated volumetric arcs used in total body irradiation in pediatric patients.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2025Article
- The implementation of low instantaneous dose rate total body irradiation with linear accelerator in small-size treatment rooms.Journal of applied clinical medical physics · 2024Article
- A novel AP/PA total body irradiation technique using abutting IMRT fields at extended SSD.Journal of applied clinical medical physics · 2024Article
- Non-contact scintillator imaging dosimetry for total body irradiation in radiotherapy.Physics in medicine and biology · 2024Article
- Volumetric modulated arc therapy total body irradiation improves toxicity outcomes compared to 2D total body irradiation.Frontiers in oncology · 2024Article
- Treatment robustness of total body irradiation with volumetric modulated arc therapy.Physics and imaging in radiation oncology · 2024Article
Corrections and comments
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Authors and funding
16 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo implement total body irradiation (TBI) using volumetric modulated arc therapy (VMAT). We applied the Varian RapidArc™ software to calculate and optimize the dose distribution. Emphasis was placed on applying a homogenous dose to the PTV and on reducing the dose to the lungs.
methodsFrom July 2013 to July 2014 seven patients with leukaemia were planned and treated with a VMAT-based TBI-technique with photon energy of 6 MV. The overall planning target volume (PTV), comprising the whole body, had to be split into 8 segments with a subsequent multi-isocentric planning. In a first step a dose optimization of each single segment was performed. In a second step all these elements were calculated in one overall dose-plan, considering particular constraints and weighting factors, to achieve the final total body dose distribution. The quality assurance comprised the verification of the irradiation plans via ArcCheck™ (Sun Nuclear), followed by in vivo dosimetry via dosimeters (MOSFETs) on the patient.
resultsThe time requirements for treatment planning were high: contouring took 5-6 h, optimization and dose calculation 25-30 h and quality assurance 6-8 h. The couch-time per fraction was 2 h on day one, decreasing to around 1.5 h for the following fractions, including patient information, time for arc positioning, patient positioning verification, mounting of the MOSFETs and irradiation. The mean lung dose was decreased to at least 80 % of the planned total body dose and in the central parts to 50 %. In two cases we additionally pursued a dose reduction of 30 to 50 % in a pre-irradiated brain and in renal insufficiency. All high dose areas were outside the lungs and other OARs. The planned dose was in line with the measured dose via MOSFETs: in the axilla the mean difference between calculated and measured dose was 3.6 % (range 1.1-6.8 %), and for the wrist/hip-inguinal region it was 4.3 % (range 1.1-8.1 %).
conclusionTBI with VMAT provides the benefit of satisfactory dose distribution within the PTV, while selectively reducing the dose to the lungs and, if necessary, in other organs. Planning time, however, is extensive.
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