Total body irradiation in Australia and New Zealand: results of a practice survey
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SCIENTIFIC PAPER
Total body irradiation in Australia and New Zealand: results of a practice survey Lotte S. Fog1 · Andrew Wirth2 · Michael MacManus2 · Simon Downes3 · Michael Grace4 · Alicia Moggré5 · Koki Mugabe6 · Gabor Neveri7 · Lisa Nourbehesht8 · Vanessa Panettieri1 · Dane Pope9 · Lucy Sim10 · Cameron Stanton11 · Blair Steer12 · Allan Stewart13 · Elena Ungureanu2 · Tomas Kron2 Received: 23 January 2020 / Accepted: 4 May 2020 © Australasian College of Physical Scientists and Engineers in Medicine 2020
Abstract Total body irradiation (TBI) is an important treatment modality for the preparation of patients for bone marrow transplants. It is technically challenging and the actual delivery may vary from clinic to clinic. Knowledge of the pattern of practice may be helpful for clinics to determine future practice. We carried out an email survey from April to September 2019 sending 48 TBI related questions to all radiotherapy clinics in Australia and New Zealand via the Australasian College of Physi‑ cal Scientists in Medicine email distribution list. Centres not performing TBI were not expected to complete the survey and centres that had participated in a previous survey, or that were known to perform the treatment, were followed up if no response was received. Of a total of approximately 70 centres, 14 clinics responded to the survey. The vast majority of clinics use conventional lateral and/or anterior–posterior beams at extended SSD for TBI treatment delivery. However, treatment planning, ancillary equipment (used for immobilisation/modulation), beam energy and prescribed lung doses vary considerably—with some clinics delivering the prescription dose to the lungs and some aiming to deliver a lung dose which is lower than the prescription dose. Only one clinic reported using an advanced delivery technique with modulated arcs at extended SSD. Centres either said they had no access to outcome data or did not answer this question. Compared with an earlier survey from 2005, 3 clinics have lowered their linac dose rate and 7 are the same or similar. The TBI practice in Australia and New Zealand remains varied, with considerable differences in treatment planning, beam energy, accepted lung doses and delivered dose rates. Keywords Total body irradiation · Bone marrow transplant · Treatment planning · Lung dose · Australia · New zealand
* Lotte S. Fog [email protected] 1
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Crown Princess Mary Cancer Centre Westmead, Cnr Hawkesbury Road and Darcy Rd, Westmead, NSW 2145, Australia
Chris O’Brien Lifehouse, 119‑143 Missenden Rd, Camperdown, NSW 2050, Australia
Alfred Health Radiation Oncology, The Alfred Hospital, 55 Commercial Rd, Melbourne, VIC 3004, Australia
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The Peter MacCallum Cancer Centre, Grattan St, Melbourne 3000, Australia
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Prince of Wales Hospital, 320‑346 Barker St, Randwick, NSW 2031, Australia
Radiation Oncology Princess, Alexandra Raymond Terrace ‑ 31 Raymond Terrace, South Brisbane, QLD 4101, Australia
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Genesis Care, Level A, St. Vincents Hospital, 438 Victoria S
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