Technical recommendations for implementation of Volumetric Modulated Arc Therapy and Helical Tomotherapy Total Body Irradiation

Enrica Seravalli; Mirjam E Bosman; Chunhui Han; Christoph Losert; Montserrat Pazos; Per E Engström; Jacob Engellau; Christian P L Fulcheri; Claudio Zucchetti; Simonetta Saldi; Carlos Ferrer; Abrahams Ocanto; Susan M Hiniker; Catharine H Clark; Mohammad Hussein; Sarah Misson-Yates; Daria A Kobyzeva; Anna A Loginova; Bianca A W Hoeben

doi:10.1016/j.radonc.2024.110366

Technical recommendations for implementation of Volumetric Modulated Arc Therapy and Helical Tomotherapy Total Body Irradiation

Radiother Oncol. 2024 Aug:197:110366. doi: 10.1016/j.radonc.2024.110366. Epub 2024 Jun 1.

Authors

Enrica Seravalli¹, Mirjam E Bosman¹, Chunhui Han², Christoph Losert³, Montserrat Pazos³, Per E Engström⁴, Jacob Engellau⁵, Christian P L Fulcheri⁶, Claudio Zucchetti⁶, Simonetta Saldi⁷, Carlos Ferrer⁸, Abrahams Ocanto⁹, Susan M Hiniker¹⁰, Catharine H Clark¹¹, Mohammad Hussein¹², Sarah Misson-Yates¹³, Daria A Kobyzeva¹⁴, Anna A Loginova¹⁴, Bianca A W Hoeben¹⁵

Affiliations

¹ Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands.
² Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, USA.
³ Department of Radiation Oncology, University Hospital, LMU Munich, Germany.
⁴ Department of Haematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.
⁵ Department of Radiation Oncology, Skåne University Hospital, Lund, Sweden.
⁶ Section of Medical Physics, Perugia General Hospital, Perugia, Italy.
⁷ Section of Radiation Oncology, Perugia General Hospital, Perugia, Italy.
⁸ Department of Medical Physics and Radiation Protection, La Paz University Hospital, Madrid, Spain.
⁹ Department of Radiation Oncology, San Francisco de Asís University Hospital, GenesisCare, Madrid, Spain.
¹⁰ Department of Radiation Oncology, Stanford University, Stanford, CA, USA.
¹¹ Radiotherapy Physics, National Radiotherapy Trials Quality Assurance Group (RTTQA), Mount Vernon Cancer Centre, Northwood, UK; Metrology for Medical Physics Centre, National Physical Laboratory, Teddington, UK; Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK; Medical Physics and Bioengineering Department, University College London, London, UK.
¹² Metrology for Medical Physics Centre, National Physical Laboratory, Teddington, UK.
¹³ Medical Physics Department, Guy's and St Thomas' Hospital, London, UK; UK School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK; National Physical Laboratory, Metrology for Medical Physics Centre, London, UK.
¹⁴ Deptartment of Radiation Oncology, Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.
¹⁵ Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands. Electronic address: [email protected].

PMID: 38830537
DOI: 10.1016/j.radonc.2024.110366

Abstract

As a component of myeloablative conditioning before allogeneic hematopoietic stem cell transplantation (HSCT), Total Body Irradiation (TBI) is employed in radiotherapy centers all over the world. In recent and coming years, many centers are changing their technical setup from a conventional TBI technique to multi-isocenter conformal arc therapy techniques such as Volumetric Modulated Arc Therapy (VMAT) or Helical Tomotherapy (HT). These techniques allow better homogeneity and control of the target prescription dose, and provide more freedom for individualized organ-at-risk sparing. The technical design of multi-isocenter/multi-plan conformal TBI is complex and should be developed carefully. A group of early adopters with conformal TBI experience using different treatment machines and treatment planning systems came together to develop technical recommendations and share experiences, in order to assist departments wishing to implement conformal TBI, and to provide ideas for standardization of practices.

Keywords: Consensus recommendations; Helical Tomotherapy; Hematopoietic stem cell transplantation; Total Body Irradiation; VMAT.

Publication types

Review

MeSH terms

Hematopoietic Stem Cell Transplantation / methods
Humans
Organs at Risk / radiation effects
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted* / methods
Radiotherapy Planning, Computer-Assisted* / standards
Radiotherapy, Intensity-Modulated* / methods
Radiotherapy, Intensity-Modulated* / standards
Whole-Body Irradiation* / methods