Helical tomotherapy for total lymphoid irradiation

Total lymphoid irradiation is employed in the preparative regimens for allogeneic bone marrow and solid organ transplantation, solid organ transplant rejection, and chronic graft-versus-host disease. Linear accelerator-based radiotherapy, typically involving opposed anteroposterior and posteroanteri...

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Bibliographic Details
Published in:Japanese journal of radiology 2008-12, Vol.26 (10), p.622-626, Article 622
Main Authors: McCutchen, Kathryn W., Watkins, John M., Eberts, Paul, Terwilliger, Lacy E., Ashenafi, Michael S., Jenrette, Joseph M.
Format: Article
Language:English
Subjects:
Adult
Graft Rejection - radiotherapy
Heart Transplantation - adverse effects
Humans
Imaging
Lymphatic Irradiation - methods
Male
Medicine
Medicine & Public Health
Nuclear Medicine
Radiation Dosage
Radiology
Radiotherapy
Radiotherapy, Intensity-Modulated - methods
Technical Note
Tomography, Spiral Computed - methods
Transplantation Conditioning - methods
Whole-Body Irradiation - methods
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Summary:Total lymphoid irradiation is employed in the preparative regimens for allogeneic bone marrow and solid organ transplantation, solid organ transplant rejection, and chronic graft-versus-host disease. Linear accelerator-based radiotherapy, typically involving opposed anteroposterior and posteroanterior beams, has been commonly used; however, extended source-to-skin patient setup and/or field matching are required, and all organs within the beam coverage receive the entire prescribed dose. Megavoltage helical tomotherapy represents a technological advance in terms of both treatment delivery and patient positioning. The continuously rotating multileaf collimated fan beam allows highly conformal coverage of complex target geometries, in turn allowing avoidance of radiosensitive adjacent organs. In addition, the megavoltage computed tomographic scans allow potentially more accurate, targetbased setup verification. The present case report describes tomotherapy-based total lymphoid irradiation in an adult patient with late-onset cardiac transplant rejection. Treatment planning allowed dose minimization to the spinal cord, kidneys, intestinal compartment, and lungs. The patient tolerated treatment well without acute adverse effects, and he is now in early follow-up.
ISSN:0288-2043
1867-1071
1862-5274
1867-108X
DOI:10.1007/s11604-008-0281-4