Linear Accelerator-Based Intensity-Modulated Total Marrow Irradiation Technique for Treatment of Hematologic Malignancies: A Dosimetric Feasibility Study
Purpose To investigate the dosimetric feasibility of linear accelerator-based intensity-modulated total marrow irradiation (IM-TMI) in patients with hematologic malignancies. Methods and Materials Linear accelerator-based IM-TMI treatment planning was performed for 9 patients using the Eclipse treat...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2011-03, Vol.79 (4), p.1256-1265 |
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| creator | Yeginer, Mete, Ph.D Roeske, John C., Ph.D Radosevich, James A., Ph.D Aydogan, Bulent, Ph.D |
| description | Purpose To investigate the dosimetric feasibility of linear accelerator-based intensity-modulated total marrow irradiation (IM-TMI) in patients with hematologic malignancies. Methods and Materials Linear accelerator-based IM-TMI treatment planning was performed for 9 patients using the Eclipse treatment planning system. The planning target volume (PTV) consisted of all the bones in the body from the head to the mid-femur, except for the forearms and hands. Organs at risk (OAR) to be spared included the lungs, heart, liver, kidneys, brain, eyes, oral cavity, and bowel and were contoured by a physician on the axial computed tomography images. The three-isocenter technique previously developed by our group was used for treatment planning. We developed and used a common dose–volume objective method to reduce the planning time and planner subjectivity in the treatment planning process. Results A 95% PTV coverage with the 99% of the prescribed dose of 12 Gy was achieved for all nine patients. The average dose reduction in OAR ranged from 19% for the lungs to 68% for the lenses. The common dose–volume objective method decreased the planning time by an average of 35% and reduced the inter- and intra- planner subjectivity. Conclusion The results from the present study suggest that the linear accelerator-based IM-TMI technique is clinically feasible. We have demonstrated that linear accelerator-based IM-TMI plans with good PTV coverage and improved OAR sparing can be obtained within a clinically reasonable time using the common dose–volume objective method proposed in the present study. |
| doi_str_mv | 10.1016/j.ijrobp.2010.06.029 |
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Methods and Materials Linear accelerator-based IM-TMI treatment planning was performed for 9 patients using the Eclipse treatment planning system. The planning target volume (PTV) consisted of all the bones in the body from the head to the mid-femur, except for the forearms and hands. Organs at risk (OAR) to be spared included the lungs, heart, liver, kidneys, brain, eyes, oral cavity, and bowel and were contoured by a physician on the axial computed tomography images. The three-isocenter technique previously developed by our group was used for treatment planning. We developed and used a common dose–volume objective method to reduce the planning time and planner subjectivity in the treatment planning process. Results A 95% PTV coverage with the 99% of the prescribed dose of 12 Gy was achieved for all nine patients. The average dose reduction in OAR ranged from 19% for the lungs to 68% for the lenses. The common dose–volume objective method decreased the planning time by an average of 35% and reduced the inter- and intra- planner subjectivity. Conclusion The results from the present study suggest that the linear accelerator-based IM-TMI technique is clinically feasible. We have demonstrated that linear accelerator-based IM-TMI plans with good PTV coverage and improved OAR sparing can be obtained within a clinically reasonable time using the common dose–volume objective method proposed in the present study.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2010.06.029</identifier><identifier>PMID: 21035960</identifier><identifier>CODEN: IOBPD3</identifier><language>eng</language><publisher>New York, NY: Elsevier</publisher><subject>ACCELERATORS ; Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; ANIMAL TISSUES ; Applied radiobiology (equipment, dosimetry...) ; Biological and medical sciences ; Biological effects of radiation ; BODY ; BONE MARROW ; Bone Marrow Transplantation ; Bone marrow, stem cells transplantation. Graft versus host reaction ; BRAIN ; CARDIOVASCULAR SYSTEM ; CENTRAL NERVOUS SYSTEM ; Child ; COMPUTERIZED TOMOGRAPHY ; DIAGNOSTIC TECHNIQUES ; DIGESTIVE SYSTEM ; DISEASES ; DOSES ; EYES ; FACE ; FEASIBILITY STUDIES ; FEMUR ; Fundamental and applied biological sciences. Psychology ; GLANDS ; HEAD ; HEART ; Hematologic Neoplasms - diagnostic imaging ; Hematologic Neoplasms - radiotherapy ; Hematology, Oncology and Palliative Medicine ; HEMATOPOIETIC SYSTEM ; Humans ; Infant ; KIDNEYS ; LINEAR ACCELERATORS ; LIVER ; LUNGS ; Medical sciences ; MEDICINE ; Multiple Myeloma - radiotherapy ; NEOPLASMS ; NERVOUS SYSTEM ; NUCLEAR MEDICINE ; ORAL CAVITY ; ORGANS ; Organs at Risk - radiation effects ; Particle Accelerators ; PLANNING ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - radiotherapy ; RADIATION DOSES ; Radiation Injuries - prevention & control ; RADIOLOGY ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted - instrumentation ; Radiotherapy Planning, Computer-Assisted - methods ; Radiotherapy, Intensity-Modulated - instrumentation ; Radiotherapy, Intensity-Modulated - methods ; Regression Analysis ; RESPIRATORY SYSTEM ; SENSE ORGANS ; SKELETON ; THERAPY ; Tissues, organs and organisms biophysics ; TOMOGRAPHY ; Tomography, X-Ray Computed ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation Conditioning - methods ; Whole-Body Irradiation - methods</subject><ispartof>International journal of radiation oncology, biology, physics, 2011-03, Vol.79 (4), p.1256-1265</ispartof><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-838ba72168b83d09368988719c8c2b7caf6b30cfeb7773355f74d3bb0a8bf53d3</citedby><cites>FETCH-LOGICAL-c419t-838ba72168b83d09368988719c8c2b7caf6b30cfeb7773355f74d3bb0a8bf53d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23985225$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21035960$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/21491670$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Yeginer, Mete, Ph.D</creatorcontrib><creatorcontrib>Roeske, John C., Ph.D</creatorcontrib><creatorcontrib>Radosevich, James A., Ph.D</creatorcontrib><creatorcontrib>Aydogan, Bulent, Ph.D</creatorcontrib><title>Linear Accelerator-Based Intensity-Modulated Total Marrow Irradiation Technique for Treatment of Hematologic Malignancies: A Dosimetric Feasibility Study</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose To investigate the dosimetric feasibility of linear accelerator-based intensity-modulated total marrow irradiation (IM-TMI) in patients with hematologic malignancies. Methods and Materials Linear accelerator-based IM-TMI treatment planning was performed for 9 patients using the Eclipse treatment planning system. The planning target volume (PTV) consisted of all the bones in the body from the head to the mid-femur, except for the forearms and hands. Organs at risk (OAR) to be spared included the lungs, heart, liver, kidneys, brain, eyes, oral cavity, and bowel and were contoured by a physician on the axial computed tomography images. The three-isocenter technique previously developed by our group was used for treatment planning. We developed and used a common dose–volume objective method to reduce the planning time and planner subjectivity in the treatment planning process. Results A 95% PTV coverage with the 99% of the prescribed dose of 12 Gy was achieved for all nine patients. The average dose reduction in OAR ranged from 19% for the lungs to 68% for the lenses. The common dose–volume objective method decreased the planning time by an average of 35% and reduced the inter- and intra- planner subjectivity. Conclusion The results from the present study suggest that the linear accelerator-based IM-TMI technique is clinically feasible. We have demonstrated that linear accelerator-based IM-TMI plans with good PTV coverage and improved OAR sparing can be obtained within a clinically reasonable time using the common dose–volume objective method proposed in the present study.</description><subject>ACCELERATORS</subject><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>ANIMAL TISSUES</subject><subject>Applied radiobiology (equipment, dosimetry...)</subject><subject>Biological and medical sciences</subject><subject>Biological effects of radiation</subject><subject>BODY</subject><subject>BONE MARROW</subject><subject>Bone Marrow Transplantation</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>BRAIN</subject><subject>CARDIOVASCULAR SYSTEM</subject><subject>CENTRAL NERVOUS SYSTEM</subject><subject>Child</subject><subject>COMPUTERIZED TOMOGRAPHY</subject><subject>DIAGNOSTIC TECHNIQUES</subject><subject>DIGESTIVE SYSTEM</subject><subject>DISEASES</subject><subject>DOSES</subject><subject>EYES</subject><subject>FACE</subject><subject>FEASIBILITY STUDIES</subject><subject>FEMUR</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>GLANDS</subject><subject>HEAD</subject><subject>HEART</subject><subject>Hematologic Neoplasms - diagnostic imaging</subject><subject>Hematologic Neoplasms - radiotherapy</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>HEMATOPOIETIC SYSTEM</subject><subject>Humans</subject><subject>Infant</subject><subject>KIDNEYS</subject><subject>LINEAR ACCELERATORS</subject><subject>LIVER</subject><subject>LUNGS</subject><subject>Medical sciences</subject><subject>MEDICINE</subject><subject>Multiple Myeloma - radiotherapy</subject><subject>NEOPLASMS</subject><subject>NERVOUS SYSTEM</subject><subject>NUCLEAR MEDICINE</subject><subject>ORAL CAVITY</subject><subject>ORGANS</subject><subject>Organs at Risk - radiation effects</subject><subject>Particle Accelerators</subject><subject>PLANNING</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - radiotherapy</subject><subject>RADIATION DOSES</subject><subject>Radiation Injuries - prevention & control</subject><subject>RADIOLOGY</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy Planning, Computer-Assisted - instrumentation</subject><subject>Radiotherapy Planning, Computer-Assisted - methods</subject><subject>Radiotherapy, Intensity-Modulated - instrumentation</subject><subject>Radiotherapy, Intensity-Modulated - methods</subject><subject>Regression Analysis</subject><subject>RESPIRATORY SYSTEM</subject><subject>SENSE ORGANS</subject><subject>SKELETON</subject><subject>THERAPY</subject><subject>Tissues, organs and organisms biophysics</subject><subject>TOMOGRAPHY</subject><subject>Tomography, X-Ray Computed</subject><subject>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><subject>Transplantation Conditioning - methods</subject><subject>Whole-Body Irradiation - methods</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFktGK1DAUhoso7rj6BiIBEa86Jk3bJF4I4-q6A7N4sSN4F5L0dM3YJmOSKvMovq0pHfUqcPL953D-_xTFc4LXBJP2zWFtD8Hr47rCuYTbNa7Eg2JFOBMlbZqvD4sVpi0uaYYviicxHjDGhLD6cXFREUwb0eJV8XtnHaiANsbAAEElH8r3KkKHti6BizadylvfTYNKubb3SQ3oVoXgf6FtCKqzKlnv0B7MN2d_TIB6H9A-gEojuIR8j25gzF0Hf29NVg723ilnLMS3aIM--GhHSCF_XYOKVtshD0R3aepOT4tHvRoiPDu_l8WX64_7q5ty9_nT9mqzK01NRCo55VqxirRcc9phQVsuOGdEGG4qzYzqW02x6UEzxmg2pmd1R7XGiuu-oR29LF4ufX1MVkZjU97FeOfAJFmRWpCW4Uy9Xqhj8HnNmORoY7ZsUA78FCVvasqYEDNZL6QJPsYAvTwGO6pwkgTLOTl5kEtyck5O4lbm5LLsxXnApEfo_on-RpWBV2dARaOGPsw2xv8cFbypqiZz7xYOsmk_LQRpButslnyHE8SDn4LLfkoiYyWxvJuPZL4Rks-DM07pH8bQumg</recordid><startdate>20110315</startdate><enddate>20110315</enddate><creator>Yeginer, Mete, Ph.D</creator><creator>Roeske, John C., Ph.D</creator><creator>Radosevich, James A., Ph.D</creator><creator>Aydogan, Bulent, Ph.D</creator><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20110315</creationdate><title>Linear Accelerator-Based Intensity-Modulated Total Marrow Irradiation Technique for Treatment of Hematologic Malignancies: A Dosimetric Feasibility Study</title><author>Yeginer, Mete, Ph.D ; Roeske, John C., Ph.D ; Radosevich, James A., Ph.D ; Aydogan, Bulent, Ph.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-838ba72168b83d09368988719c8c2b7caf6b30cfeb7773355f74d3bb0a8bf53d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>ACCELERATORS</topic><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>ANIMAL TISSUES</topic><topic>Applied radiobiology (equipment, dosimetry...)</topic><topic>Biological and medical sciences</topic><topic>Biological effects of radiation</topic><topic>BODY</topic><topic>BONE MARROW</topic><topic>Bone Marrow Transplantation</topic><topic>Bone marrow, stem cells transplantation. Graft versus host reaction</topic><topic>BRAIN</topic><topic>CARDIOVASCULAR SYSTEM</topic><topic>CENTRAL NERVOUS SYSTEM</topic><topic>Child</topic><topic>COMPUTERIZED TOMOGRAPHY</topic><topic>DIAGNOSTIC TECHNIQUES</topic><topic>DIGESTIVE SYSTEM</topic><topic>DISEASES</topic><topic>DOSES</topic><topic>EYES</topic><topic>FACE</topic><topic>FEASIBILITY STUDIES</topic><topic>FEMUR</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>GLANDS</topic><topic>HEAD</topic><topic>HEART</topic><topic>Hematologic Neoplasms - diagnostic imaging</topic><topic>Hematologic Neoplasms - radiotherapy</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>HEMATOPOIETIC SYSTEM</topic><topic>Humans</topic><topic>Infant</topic><topic>KIDNEYS</topic><topic>LINEAR ACCELERATORS</topic><topic>LIVER</topic><topic>LUNGS</topic><topic>Medical sciences</topic><topic>MEDICINE</topic><topic>Multiple Myeloma - radiotherapy</topic><topic>NEOPLASMS</topic><topic>NERVOUS SYSTEM</topic><topic>NUCLEAR MEDICINE</topic><topic>ORAL CAVITY</topic><topic>ORGANS</topic><topic>Organs at Risk - radiation effects</topic><topic>Particle Accelerators</topic><topic>PLANNING</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - radiotherapy</topic><topic>RADIATION DOSES</topic><topic>Radiation Injuries - prevention & control</topic><topic>RADIOLOGY</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy Planning, Computer-Assisted - instrumentation</topic><topic>Radiotherapy Planning, Computer-Assisted - methods</topic><topic>Radiotherapy, Intensity-Modulated - instrumentation</topic><topic>Radiotherapy, Intensity-Modulated - methods</topic><topic>Regression Analysis</topic><topic>RESPIRATORY SYSTEM</topic><topic>SENSE ORGANS</topic><topic>SKELETON</topic><topic>THERAPY</topic><topic>Tissues, organs and organisms biophysics</topic><topic>TOMOGRAPHY</topic><topic>Tomography, X-Ray Computed</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><topic>Transplantation Conditioning - methods</topic><topic>Whole-Body Irradiation - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yeginer, Mete, Ph.D</creatorcontrib><creatorcontrib>Roeske, John C., Ph.D</creatorcontrib><creatorcontrib>Radosevich, James A., Ph.D</creatorcontrib><creatorcontrib>Aydogan, Bulent, Ph.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yeginer, Mete, Ph.D</au><au>Roeske, John C., Ph.D</au><au>Radosevich, James A., Ph.D</au><au>Aydogan, Bulent, Ph.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Linear Accelerator-Based Intensity-Modulated Total Marrow Irradiation Technique for Treatment of Hematologic Malignancies: A Dosimetric Feasibility Study</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2011-03-15</date><risdate>2011</risdate><volume>79</volume><issue>4</issue><spage>1256</spage><epage>1265</epage><pages>1256-1265</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><coden>IOBPD3</coden><abstract>Purpose To investigate the dosimetric feasibility of linear accelerator-based intensity-modulated total marrow irradiation (IM-TMI) in patients with hematologic malignancies. Methods and Materials Linear accelerator-based IM-TMI treatment planning was performed for 9 patients using the Eclipse treatment planning system. The planning target volume (PTV) consisted of all the bones in the body from the head to the mid-femur, except for the forearms and hands. Organs at risk (OAR) to be spared included the lungs, heart, liver, kidneys, brain, eyes, oral cavity, and bowel and were contoured by a physician on the axial computed tomography images. The three-isocenter technique previously developed by our group was used for treatment planning. We developed and used a common dose–volume objective method to reduce the planning time and planner subjectivity in the treatment planning process. Results A 95% PTV coverage with the 99% of the prescribed dose of 12 Gy was achieved for all nine patients. The average dose reduction in OAR ranged from 19% for the lungs to 68% for the lenses. The common dose–volume objective method decreased the planning time by an average of 35% and reduced the inter- and intra- planner subjectivity. Conclusion The results from the present study suggest that the linear accelerator-based IM-TMI technique is clinically feasible. We have demonstrated that linear accelerator-based IM-TMI plans with good PTV coverage and improved OAR sparing can be obtained within a clinically reasonable time using the common dose–volume objective method proposed in the present study.</abstract><cop>New York, NY</cop><pub>Elsevier</pub><pmid>21035960</pmid><doi>10.1016/j.ijrobp.2010.06.029</doi><tpages>10</tpages></addata></record> |
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| subjects | ACCELERATORS Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ANIMAL TISSUES Applied radiobiology (equipment, dosimetry...) Biological and medical sciences Biological effects of radiation BODY BONE MARROW Bone Marrow Transplantation Bone marrow, stem cells transplantation. Graft versus host reaction BRAIN CARDIOVASCULAR SYSTEM CENTRAL NERVOUS SYSTEM Child COMPUTERIZED TOMOGRAPHY DIAGNOSTIC TECHNIQUES DIGESTIVE SYSTEM DISEASES DOSES EYES FACE FEASIBILITY STUDIES FEMUR Fundamental and applied biological sciences. Psychology GLANDS HEAD HEART Hematologic Neoplasms - diagnostic imaging Hematologic Neoplasms - radiotherapy Hematology, Oncology and Palliative Medicine HEMATOPOIETIC SYSTEM Humans Infant KIDNEYS LINEAR ACCELERATORS LIVER LUNGS Medical sciences MEDICINE Multiple Myeloma - radiotherapy NEOPLASMS NERVOUS SYSTEM NUCLEAR MEDICINE ORAL CAVITY ORGANS Organs at Risk - radiation effects Particle Accelerators PLANNING Precursor Cell Lymphoblastic Leukemia-Lymphoma - radiotherapy RADIATION DOSES Radiation Injuries - prevention & control RADIOLOGY RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted - instrumentation Radiotherapy Planning, Computer-Assisted - methods Radiotherapy, Intensity-Modulated - instrumentation Radiotherapy, Intensity-Modulated - methods Regression Analysis RESPIRATORY SYSTEM SENSE ORGANS SKELETON THERAPY Tissues, organs and organisms biophysics TOMOGRAPHY Tomography, X-Ray Computed Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation Conditioning - methods Whole-Body Irradiation - methods |
| title | Linear Accelerator-Based Intensity-Modulated Total Marrow Irradiation Technique for Treatment of Hematologic Malignancies: A Dosimetric Feasibility Study |
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