The first Russian experience of TomoTherapy for total body irradiation in children

Background. Combination of total body irradiation (TBI) with chemotherapy is widely used technique for conditioning before hematopoietic stem cell transplantation for patient with hematological malignancies worldwide. Best results of patient’s survival were showed in comparison with conditioning regimen included only chemotherapy.

Aim – development of TBI technique at children with the help of TomoTherapy equipment and including it to the conditioning protocol before allogenic bone marrow transplantation.

Materials and methods. During the period between July 2014 and February 2016 radiation therapy was made for 38 patients. Treatment was performed daily, 2 times per day with single basic dose on extended target (PTV) 2 Gr to total focal dose 12 Gr. Taking into account potential sensitivity of healthy organs and based on literature data, the following risk organs were chosen: lungs, kidneys and anterior eye chamber.

Results. All patients successfully passed the planned program of treatment. Follow-up period was from 0 to 21 months (average – 7.2 months). No one of the patients did not showed any toxic episodes from the critical organs (lungs, kidneys, eye lens).

Conclusions. TBI on TomoTherapy equipment allows to provide maximal control on irradiation dose distribution in PTV with the decreasing of radiation for critical organs. This allows achieving the decreasing of possibility of serious complications of radiation therapy and high effectiveness of treatment.

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