Application of volume-modulated rotational radiotherapy for total body irradiation
ORIGINAL PAPERS
Abstract
Introduction. Total body irradiation before hematopoietic stem cell transplantation includes procedures of anatomical and topometric preparation, dosimetric planning of dose delivery to the biological target taking into account the limitations of irradiation of critical structures, dosimetric control and therapeutic irradiation. Each of the listed stages is carried out using high-tech equipment with the participation of highly qualified radiotherapists and medical physicists. The aim of the study is to summarize and present the experience of the N.N. Petrov National Medical Research Center of Oncology in total therapeutic irradiation using volume-modulated rotational radiotherapy using Rapid Arc VMAT technology. Materials and methods. Anatomical and topometric preparation is performed on a Siemens Somatom Definition tomograph, dosimetric modeling of radiation is performed in the Eclipse 17 Varian planning system, therapeutic irradiation is delivered by volume-modulated rotational radiotherapy on a True Beam Varian accelerator. Results and discussion. To date, 51 patients aged 3 to 18 years have undergone total therapeutic irradiation at the N.N. Petrov National Medical Research Center of Oncology. The implemented technique ensures homogeneous coverage of the biological target while maintaining doses in organs at risk within their tolerance limits. Conclusions. The use of the latest radiotherapeutic technologies increases the requirements for quality assurance programs for radiotherapeutic treatment, and an integral part of such a program for total body irradiation using a medical linac is monitoring the accuracy of patient positioning using an on-board kilovoltage imaging system.
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