ESTRO ACROP and SIOPE recommendations for myeloablative Total Body Irradiation in children

Hoeben, Bianca A.W.; Pazos, Montserrat; Seravalli, Enrica; Bosman, Mirjam E.; Losert, Christoph; Albert, Michael H.; Boterberg, Tom; Ospovat, Inna; Milla, Soraya Mico; Abakay, Candan Demiröz; Engellau, Jacob; Johansson, Vilberg; Kos, Gregor; Supiot, S.; Llagostera, C.; Bierings, Marc; Scarzello, Giovanni; Seiersen, Klaus; Smith, Edward R.; Ocanto, Abrahams; Ferrer, C.; Bentzen, Søren M.; Kobyzeva, Daria; Loginova, Anna; Janssens, Geert O.

doi:10.1016/j.radonc.2022.05.027

Cited by 16 publications

(15 citation statements)

References 224 publications

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“… 1,2 High dose, myeloablative TBI treatments should also eradicate malignant tumour cells, particularly in sanctuary sites which chemotherapy may find more difficult to penetrate, such as the brain or the testes. Patients undergoing myeloablative TBI are at risk of significant toxicities, in particular to the lungs with the risk of developing interstitial pneumonitis.. 2,3 Patients who are unable to tolerate myeloablative TBI undergo lower dose single fractionation regimes (reduced conditioning or non-myeloablative TBI). 2 .…”

Section: Introductionmentioning

confidence: 99%

“…Patients undergoing myeloablative TBI are at risk of significant toxicities, in particular to the lungs with the risk of developing interstitial pneumonitis.. 2,3 Patients who are unable to tolerate myeloablative TBI undergo lower dose single fractionation regimes (reduced conditioning or non-myeloablative TBI). 2 .…”

Section: Introductionmentioning

confidence: 99%

“…5 Methods to optimise 3D dose distributions and minimise doses to OARs could confer benefits to these patients and in particular paediatric cases. 2 …”

Section: Introductionmentioning

confidence: 99%

“…The European SIOPE survey in 2021 16 concluded that modern TBI techniques with integrated shielding would allow for the reduction of OAR doses. Recent guidelines for paediatric TBI 2 have concluded that myeloablative TBI performance for children is currently heterogeneous and centre-specific.…”

Section: Introductionmentioning

confidence: 99%

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Optimised conformal total body irradiation: a heterogeneous practice, so where next?

Misson-Yates

Cunningham

Gonzalez

et al. 2023

BJR

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The use of volumetric arc therapy (VMAT) and inverse planning has been in routine use in radiotherapy for two decades. However, use in total body irradiation (TBI) has been more recent and few guidelines exist as to how to plan or verify. This has led to heterogeneous approaches. The goal of this review is to provide an overview of current advanced planning and dosimetry verification protocols used in optimised conformal TBI as a basis for investigating the need for greater standardisation in TBI.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…5 Methods to optimise 3D dose distributions and minimise doses to OARs could confer benefits to these patients and in particular paediatric cases. 2 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Optimised conformal total body irradiation: a heterogeneous practice, so where next?

Misson-Yates

Cunningham

Gonzalez

et al. 2023

BJR

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show abstract

“…There are reports on different strategies for gonadal shielding, including use of the testicular clamshell, a large lead (5 cm 2 × 8 cm thickness) rectangular block, beam shaping at the collimator, and even implementation of multi‐leaf collimators during volumetric modulated arc therapy‐based TBI. 1 , 11 , 12 , 13 , 14 , 15 We report and depict techniques not previously well described for placing gonadal shielding for patients treated by anterior–posterior/posterior–anterior (AP/PA) fields in an upright, sitting position and also for a patient treated in the lateral decubitus position.…”

Section: Introductionmentioning

confidence: 99%

Unique approaches for testicular shielding during total‐body irradiation for pediatric patients

Agarwal

Kelly

Papanikolaou

et al. 2022

J Applied Clin Med Phys

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Total‐body irradiation (TBI) has been used as a part of the conditioning regimen for patients undergoing hematopoietic stem cell transplantation for certain nonmalignant conditions such as sickle cell disease. Although effective, TBI can cause lasting side effects for pediatric patients. One of these potential side effects includes oligospermia or even permanent azoospermia. Although many investigators have studied ways to shield the testicles during the TBI for nonmalignant conditions, there is no set standard. We describe the technical aspects of effective techniques to shield the testicles of male pediatric patients undergoing TBI. We verified that our techniques reduced the testicular dose by approximately 80%–85% of the TBI prescription dose in four male pediatric patients, keeping the dose well below the documented doses that can cause permanent infertility and hypogonadism.

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Development of an external system for monitoring the couch speed in radiotherapy using continuous bed movement

Shimizu,

Nakamura,

Sasaki

et al. 2024

J Applied Clin Med Phys

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PurposeTotal body irradiation before bone marrow transplantation for hematological malignancies using Radixact, a high‐precision radiotherapy machine, can potentially reduce side effects and the risk of secondary malignancies. However, stable control of couch speed is critical, and direct assessment methods outlined in quality assurance guidelines are lacking. This study aims to develop a real‐time couch speed verification system for the Radixact.MethodsThe developed system used a linear encoder to measure couch speed directly. Accuracy was verified via a linear stage, comparing measurements with a laser distance sensor. After placing a phantom simulating the human body on the Radixact couch, the couch speed was verified using predefined speed plans.ResultsOperating the linear stage at 0.1, 0.5, and 1.0 mm/s revealed that the maximum position error of the developed verification system compared to the laser distance sensor was nearly equivalent to the distance resolution of the system (0.05 mm/pulse), with negligible average speed error. When the Radixact couch operated at 0.1, 0.5, and 1.0 mm/s, the values obtained by the verification system agreed with the theoretical values within the sampling period (0.01 s) and distance resolution (0.05 mm).ConclusionThe verification system developed provides real‐time monitoring of the speed of the Radixact table, ensuring treatment effectiveness and patient safety. It would guarantee the couch speed's soundness and contribute to the “visualization” of safety.

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ESTRO ACROP and SIOPE recommendations for myeloablative Total Body Irradiation in children

Cited by 16 publications

References 224 publications

Optimised conformal total body irradiation: a heterogeneous practice, so where next?

Optimised conformal total body irradiation: a heterogeneous practice, so where next?

Unique approaches for testicular shielding during total‐body irradiation for pediatric patients

Development of an external system for monitoring the couch speed in radiotherapy using continuous bed movement

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