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Conditioning Regimens

Clinical feasibility of TBI with helical tomotherapy

Bone Marrow Transplantation volume 46, pages 929–935 (2011)Cite this article

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Abstract

Our purpose was to present the clinical feasibility of TBI with helical tomotherapy (HT) in four patients with AML. Treatment planning, delivery, dose verification and summation, toxicity and patient outcomes for each patient are presented. TBI prescription was set in such a manner that 80% of the clinical target volume received 12 Gy in six fractions, at two fractions per day. Dose reconstruction was carried out by recontouring the regions of interest in the daily pretreatment megavoltage computed tomography of each individual fraction and calculating its corresponding dose. A deformable registration model was used for dose summation of all individual fractions. Differences between planned and delivered doses were calculated. Average planned and delivered doses to the regions of interest differed by up to 2.7%. TBI toxicity was limited to radiotherapy oncology group grade 1 dermatitis in all patients and grade 1 headache in one patient. Two patients are alive with no evidence of disease and no GVHD. Two patients died of GVHD, but there was no evidence of disease at the time of death. We conclude that HT simplifies the process of TBI. Dose verification is possible with HT showing small differences between plan and delivered doses.

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Acknowledgements

The authors thank the medical dosimetry group at the University of Arkansas-Central Arkansas Radiation Therapy Institute for their support and skillful treatment planning.

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Authors and Affiliations

  1. Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    J A Peñagarícano, M Chao, E G Moros & V Ratanatharathorn

  2. Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    F Van Rhee & P M Corry

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  1. J A Peñagarícano
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  2. M Chao
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  4. E G Moros
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Correspondence to J A Peñagarícano.

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Peñagarícano, J., Chao, M., Van Rhee, F. et al. Clinical feasibility of TBI with helical tomotherapy. Bone Marrow Transplant 46, 929–935 (2011). https://doi.org/10.1038/bmt.2010.237

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