Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
J Med Imaging Radiat Oncol. 2023 Sep;67(6):684-690. doi: 10.1111/1754-9485.13550. Epub 2023 Jun 21.
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.
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.
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%).
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.
全身照射（TBI）的实践在各中心之间差异很大，治疗相关毒性的风险尚不清楚。我们报告了 142 例接受带肺屏蔽块站立 TBI 或不带块仰卧 TBI 的 TBI 患者的肺剂量。
对 2016 年 6 月至 2021 年 6 月期间接受 TBI 的 142 例患者进行了肺剂量计算。使用 Eclipse（Varian Medical Systems）进行计划，使用 AAA_15.6.06 进行光子剂量计算，使用 EMC_15.6.06 进行电子胸部壁增强场。计算平均和最大肺剂量。
37 例（26.2%）采用带肺屏蔽块的站立式治疗，104 例（73.8%）采用仰卧式治疗。在站立式 TBI 中使用肺屏蔽块可获得最低的相对平均肺剂量，将平均肺剂量降低至处方剂量的 75.2%（9.9Gy），±4.1%（范围 68.6-84.1%）对于 13.2Gy 的 11 个分次，包括电子胸部壁增强场的贡献，与 6 个分次的 12Gy 仰卧 TBI 相比，12Gy 仰卧 TBI 接受 101.6%的平均肺剂量（12.2Gy），±2.4%（范围 95.2-109.5%）（P≪0.05）。接受 2Gy 单次分次的仰卧位患者平均接受了最高的相对平均肺剂量，处方剂量的 108.4%（2.2Gy），±2.6%（范围 103.2-114.4%）。
本文报告了使用描述的仰卧和站立技术的 142 例 TBI 患者的肺剂量。尽管在胸部壁上增加了电子增强场，但带肺屏蔽块显著降低了平均肺剂量。
