Unfortunately, parts of the 'Materials and Methods section' and a sentence in the 'Discussion section' had to be corrected. On page 3, left column, the complete first paragraph was corrected and now reads as follows: Auto-Planning is fully integrated into Pinnacle v.9.10 TPS to automate the inverse planning process [11-13]. On page 3, left column, the complete third paragraph was corrected and now reads as follows: Thus, Auto-planning is designed to automatically perform many of the manual operations in the IMRT planning process. On page 3, right column, second paragraph to page 4 left column, first paragraph, the complete section was corrected and now reads as follows: Table 2 shows the Auto-Planning optimization preset used for the patients in this study. In the Advanced Setting Tab (see also Ref. 20
Background and purpose: Total body irradiation (TBI) is a treatment used in the conditioning of patients prior to hematopoietic stem cell transplantation. We developed an extended-distance TBI technique using a conventional linac with multi-leaf collimator to deliver a homogeneous dose, and spare critical organs. Materials and methods: Patients were treated either in lateral recumbent or in supine position depending on the dose level. A conventional linac was used with the patient midline at 350 cm from the beam source. A series of beams was prepared manually using a 3D treatment planning system (TPS) aiming to improve dose homogeneity, spare the organs at risk and facilitate accurate patient positioning. An optimized dose calculation model for extended-distance treatments was developed using phantom measurements. During treatment, in-vivo dosimetry was performed using electronic dosimeters, and accurate positioning was verified using a mobile megavoltage imager. We analyzed dose volume histogram parameters for 19 patients, and in-vivo measurements for 46 delivered treatment fractions. Results: Optimization of the dose calculation model for TBI improved dose calculation by 2.1% at the beam axis, and 17% at the field edge. Treatment planning dose objectives and constraints were met for 16 of 19 patients. Results of in-vivo dosimetry were within the set limitations (±10%) with mean deviations of 3.7% posterior of the lungs and 0.6% for the abdomen. Conclusions: We developed a TBI treatment technique using a conventional linac and TPS that can reliably be used in the conditioning regimen of patients prior to stem cell transplantation.
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