Evidence map›Paper›PMID 34985180›Full record

ArticleJournal of applied clinical medical physics2022

Effect of total body irradiation lung block parameters on lung doses using three-dimensional dosimetry.

Samuel M H Luk, Kent Wallner, Mallory C Glenn, Ralph Ermoian, Mark H Phillips, Yolanda D Tseng, Minsun Kim

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of applied clinical medical physics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. 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 · 2026
    Review
  2. Validation of Acuros for total body irradiation at extended distance.Journal of applied clinical medical physics · 2024
    Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Samuel M H LukDepartment of Radiation Oncology, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0002-4957-086X
Kent WallnerDepartment of Radiation Oncology, University of Washington, Seattle, Washington, USA.
Mallory C GlennDepartment of Radiation Oncology, University of Washington, Seattle, Washington, USA.
Ralph ErmoianDepartment of Radiation Oncology, University of Washington, Seattle, Washington, USA.
Mark H PhillipsDepartment of Radiation Oncology, University of Washington, Seattle, Washington, USA.
Yolanda D TsengDepartment of Radiation Oncology, University of Washington, Seattle, Washington, USA.
Minsun KimDepartment of Radiation Oncology, University of Washington, Seattle, Washington, USA.
University of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTotal body irradiation (TBI) is an integral part of stem cell transplant. However, patients are at risk of treatment-related toxicities, including radiation pneumonitis. While lung dose is one of the most crucial aspects of TBI dosimetry, currently available data are based on point doses. As volumetric dose distribution could be substantially altered by lung block parameters, we used 3D dosimetry in our treatment planning system to estimate volumetric lung dose and measure the impact of various lung block designs. MATERIALS AND

methodsWe commissioned a TBI beam model in RayStation that matches the measured tissue-phantom ratio under our clinical TBI setup. Cerrobend blocks were automatically generated in RayStation on thoracic Computed Tomography (CT) scans from three anonymized patients using the lung, clavicle, spine, and diaphragmatic contours. The margin for block edge was varied to 0, 1, or 2 cm from the superior, lateral, and inferior thoracic borders, with a uniform margin 2.5 cm lateral to the vertebral bodies. The lung dose was calculated and compared with a prescription dose of 1200 cGy in six fractions (three with blocks and three without).

resultThe point dose at midplane under the block and the average lung dose are at the range of 73%-76% and 80%-88% of prescription dose respectively regardless of the block margins. In contrast, the percent lung volume receiving 10 Gy increased by nearly two-fold, from 31% to 60% over the margins from 0 to 2 cm.

conclusionsThe TPS-derived 3D lung dose is substantially different from the nominal dose assumed with HVL lung blocks. Point doses under the block are insufficient to accurately gauge the relationship between dose and pneumonitis, and TBI dosimetry could be highly variable between patients and institutions as more descriptive parameters are not included in protocols. Much progress remains to be made to optimize and standardize technical aspects of TBI, and better dosimetry could provide more precise dosimetric predictors for pneumonitis risk.

Indexed as

Radiotherapy Planning, Computer-AssistedWhole-Body IrradiationHumansLungRadiometryRadiotherapy Dosagelung doseradiation oncologytotal body radiation

Identifiers

PMID34985180
PMCPMC8992940
OpenAlexW4206726400

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.