Total-body irradiation using linac-based volumetric modulated arc therapy: Its clinical accuracy, feasibility and reliability.
Radiother Oncol
; 129(3): 527-533, 2018 12.
Article
en En
| MEDLINE
| ID: mdl-30172456
ABSTRACT
PURPOSE:
To report the feasibility, accuracy, and reliability of volumetric modulated arc therapy (VMAT)-based total-body irradiation (TBI) treatment in patients with acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL). MATERIALS ANDMETHODS:
From 2015 to 2018, 30 patients with AML or ALL were planned and treated with VMAT-based TBI, which consisted of three isocenters and three overlapping arcs. TBI dose was prescribed to 90% of the planning treatment volume (PTV) receiving 12â¯Gy in six fractions, at two fractions per day. Mean lung and kidney doses were restricted less than 10â¯Gy, and maximum lens dose less than 6â¯Gy. Quality assurance (QA) comprised the verification of the irradiation plans via dose-volume histogram (DVH) based 3D patient QA system.RESULTS:
Average mean lung dose was 9.7⯱â¯0.2â¯Gy, mean kidney dose 9.6⯱â¯0.2â¯Gy, maximum lens dose 4.5⯱â¯0.4â¯Gy, mean PTV dose 12.7⯱â¯0.1â¯Gy, and heterogeneity index of PTV was 1.16⯱â¯0.02 in all patients. Grade 3 or more acute radiation toxicity was not observed. When comparing plan and DVH-based 3D patient QA results, average differences of 3.3%⯱â¯1.3 in mean kidney doses, 1.1%⯱â¯0.7 in mean lung doses, and 0.9%⯱â¯0.4 in mean target doses were observed.CONCLUSION:
Linac-based VMAT increased the dose homogeneity of TBI treatment more than extended SSD techniques. Partial cone-beam CT and optical surface-guided system assure patient positioning. DVH-based 3D patient dose verification QA was possible with linac-based VMAT showing small differences between planned and delivered doses. It is feasible, accurate, and reliable.Palabras clave
Texto completo:
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Base de datos:
MEDLINE
Asunto principal:
Leucemia Mieloide Aguda
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Irradiación Corporal Total
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Radioterapia de Intensidad Modulada
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Leucemia-Linfoma Linfoblástico de Células Precursoras
Límite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Radiother Oncol
Año:
2018
Tipo del documento:
Article