Assessment of lung doses in patients undergoing total body irradiation for haematological malignancies with and without lung shielding
Details
Publication Year 2023-09,Volume 67,Issue #6,Page 684-690
Journal Title
Journal of Medical Imaging and Radiation Oncology
Publication Type
Research article
Abstract
INTRODUCTION: Total body irradiation (TBI) practices vary considerably amongst centres, and the risk of treatment related toxicities remains unclear. We report lung doses for 142 TBI patients who underwent either standing TBI with lung shield blocks or lying TBI without blocks. METHODS: Lung doses were calculated for 142 TBI patients treated between June 2016 and June 2021. Patients were planned using Eclipse (Varian Medical Systems) using AAA_15.6.06 for photon dose calculations and EMC_15.6.06 for electron chest wall boost fields. Mean and maximum lung doses were calculated. RESULTS: Thirty-seven patients (26.2%) were treated standing using lung shielding blocks with 104 (73.8%) treated lying down. Lowest relative mean lung doses were achieved using lung shielding blocks in standing TBI, reducing the mean lung doses to 75.2% of prescription (9.9 Gy), +/-4.1% (range 68.6-84.1%) for a prescribed dose of 13.2 Gy in 11 fractions, including contributions from electron chest wall boost fields, compared to 12 Gy in 6 fraction lying TBI receiving 101.6% mean lung dose (12.2 Gy) +/-2.4% (range 95.2-109.5%) (P << 0.05). Patients treated lying down with 2 Gy single fraction received the highest relative mean lung dose on average, with 108.4% (2.2 Gy) +/-2.6% of prescription (range 103.2-114.4%). CONCLUSION: Lung doses have been reported for 142 TBI patients using the lying and standing techniques described herein. Lung shielding blocks significantly reduced mean lung doses despite the addition of electron boost fields to the chest wall.
Publisher
Wiley
Keywords
Humans; *Whole-Body Irradiation/adverse effects/methods; Lung; *Hematologic Neoplasms/etiology/therapy; Radiotherapy Dosage; physics; quality assurance; radiation oncology
Department(s)
Radiation Oncology; Physical Sciences
PubMed ID
37343142
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