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Helical tomotherapy for total lymphoid irradiation

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Abstract

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.

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Authors and Affiliations

  1. Department of Radiation Oncology, Medical University of South Carolina, 169 Ashley Avenue, PO Box 250318, Charleston, SC, 29425, USA

    Kathryn W. McCutchen, John M. Watkins, Lacy E. Terwilliger, Michael S. Ashenafi & Joseph M. Jenrette III

  2. Department of Pathology, Medical University of South Carolina, Charleston, SC, USA

    Paul Eberts

Authors
  1. Kathryn W. McCutchen
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  2. John M. Watkins
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  3. Paul Eberts
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  4. Lacy E. Terwilliger
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  5. Michael S. Ashenafi
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  6. Joseph M. Jenrette III
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Corresponding author

Correspondence to Joseph M. Jenrette III.

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McCutchen, K.W., Watkins, J.M., Eberts, P. et al. Helical tomotherapy for total lymphoid irradiation. Radiat Med 26, 622–626 (2008). https://doi.org/10.1007/s11604-008-0281-4

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  • DOI: https://doi.org/10.1007/s11604-008-0281-4

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