ESTRO meets Asia 2024 - Abstract Book

S154

Interdisciplinary – Haematology

ESTRO meets Asia 2024

Keywords: radiotherapy, lymphoma

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Total body irradiation – VMAT implementation: experience of the MedEuropa Center Bucharest, Romania

Cecilia Gabriela Negrei 1 , Gabriel T Ricu 1 , Cristian I Barbu 1 , Violeta Ciocaltei 2 , Raducu Popa 2

1 Radiotherapy, MedEuropa, Bucharest, Romania. 2 Physics, MedEuropa, Bucharest, Romania

Purpose/Objective:

The paper aims to present the experience of the MedEuropa Bucharest Radiotherapy Center in the implementation of the program dedicated to total body radiotherapy (TBI) as part of the conditioning for bone marrow allo-transplantation.

Material/Methods:

Currently we are the only center in Romania providing total body irradiation, VMAT techniques and program has been initiated at our Center in February 2023. The work includes brief general theoretical aspects, the description of how the activity is specifically organized within the Clinic for TBI treatment, the preliminary results in the case of the 12 patients who benefited from TBI between February and December 2023, brief focus on cranial-spine irradiation followed by total body irradiation (1 case at the time of abstract presentation, other 2 in preparation in 2024). All patients have been treated using volumetric modulated arc therapy (VMAT) technique, 6 to 7 isocenters, patients age 6 to 52 years of old, TBI schedules 4 to 12 Gy, depending on patient’s age, co-morbidities, conditioning regimen preferred by transplantation team.

Results:

The data presented are preliminary, they include still a very small number of patients, being a database under construction and the information included in the evaluation are: the type of acute leukemia, how many relapses, in complete/partial/refractory remission, survival D30, D100, radiotherapy complications – pneumological/hepatic/renal/mucositis, grafting day. Other data which will be included is represented by: CT simulation particularities, mean beam on time depending on treatment schedule/number of isocenters, radiation rate flow, contouring particularities for 12 Gy regimen, mean lung, kidney, liver doses for 12 Gy regimen as well for CSI-TBI combination.

Conclusion:

As conclusion, based on limited number of cases we have offered treatment we can say VMAT technique assures reduced toxicities and complications (no pneumonitis, no venous occlusive disease and no kidney failure related to radiotherapy), maintaining the benefit of timely engraftment, few cases of GVHD (grade 1-2, cutaneous mainly).

Keywords: Implementation, VMAT, TBI

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