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Dosimetric Evaluation of a Modulated Arc Technique for Total Body Irradiation

P Tsiamas

P Tsiamas*, M Czerminska , G Makrigiorgos , M Karen , P Zygmanski , Brigham & Women's Hospital/ Dana-Farber Institute/ Harvard Medical School, Boston, MA


TH-C-12A-4 Thursday 10:15AM - 12:15PM Room: 12A

A simplified Total Body Irradiation (TBI) was developed to work with minimal requirements in a compact linac room without custom motorized TBI couch. Results were compared to our existing fixed-gantry double 4 MV linac TBI system with prone patient and simultaneous AP/PA irradiation.

Modulated arc irradiates patient positioned in prone/supine positions along the craniocaudal axis. A simplified inverse planning method developed to optimize dose rate as a function of gantry angle for various patient sizes without the need of graphical 3D treatment planning system. This method can be easily adapted and used with minimal resources. Fixed maximum field size (40x40 cm2) is used to decrease radiation delivery time. Dose rate as a function of gantry angle is optimized to result in uniform dose inside rectangular phantoms of various sizes and a custom VMAT DICOM plans were generated using a DICOM editor tool. Monte Carlo simulations, film and ionization chamber dosimetry for various setups were used to derive and test an extended SSD beam model based on PDD/OAR profiles for Varian 6EX/ TX. Measurements were obtained using solid water phantoms. Dose rate modulation function was determined for various size patients (100cm - 200cm). Depending on the size of the patient arc range varied from 100° to 120°.

A PDD/OAR based beam model for modulated arc TBI therapy was developed. Lateral dose profiles produced were similar to profiles of our existing TBI facility. Calculated delivery time and full arc depended on the size of the patient (~8min/ 100° - 10min/ 120°, 100 cGy). Dose heterogeneity varied by about ±5% - ±10% depending on the patient size and distance to the surface (buildup region).

TBI using simplified modulated arc along craniocaudal axis of different size patients positioned on the floor can be achieved without graphical / inverse 3D planning.

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