This approach to conditioning prior to stem cell transplantation facilitated the successful engraftment of all 11 patients included in the study while avoiding radiation pneumonitis, a common side effect following radiation therapy to the chest wall that results in inflammation of the lung. Engraftment is an important milestone in the transplant recovery process
"An important challenge in successfully providing TBI is attaining consistency of dose in the area of the junction between the treatment segments. In our study, we were able to achieve a 10% heterogeneity in the junction area; with a conventional linear accelerator, this would be higher than 20%. We want this number to be as low as possible because this means that we're delivering the dose we want to the area receiving radiation," said Dr. Françoise Izar, radiation oncologist, department of radiotherapy, IUCT Oncopole. "Using TomoHelical mode we were able to provide precise and homogeneous tumor coverage and excellent sparing of organs at risk. We significantly reduced the median dose to selected critical organs and it was possible to escalate dose to the sites at high risk of residual disease, improving long-term outcomes."
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Simultaneous TBI and targeted radiation boost improves outcomes for high-risk or refractory/relapsed patients with leukemia
In a second study, clinicians at Guangzhou General Hospital of Guangzhou Military Command and Sir Run Shaw Hospital in China, published results of their TBI study titled, "Haploidentical hematopoietic SCT using helical tomotherapy for total-body irradiation and targeted dose boost in patients with high-risk/refractory acute lymphoblastic leukemia," in the January 2018 issue of Bone Marrow Transplantation. Highlights of the study include:
In a novel approach, the clinical team used TomoHelicalâ„¢ to simultaneously deliver TBI and a targeted radiation dose boost to total marrow, central nervous system, and disease sites outside of the bone, to improve outcomes for high-risk or refractory/relapsed patients with leukemia
TomoHelical mode provides a rotating beam source with a multileaf collimator moving in a spiral pattern relative to the patient, which allowed large areas to be delineated and treated, while neighboring areas were spared
All evaluable patients achieved sustained, full donor stem cell engraftment. One-year overall survival and disease free-survival rates following implantation were both reported as 70.7%
