Special Procedures: TBI, TSET and IORT

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Special Procedures: TBI, TSET and IORT

  1. 1. Rota%on  #  11   Special  Procedures:  TBI,  TSeT  and   IORT   Mentor:  Tim  Waldron   By     Vibha  Chaswal  
  2. 2. TBI   •  •  •  •  •  •  •  Hand  MU  calcula%ons     Measuring  profiles  with  and  without  filter   Simula%ons  and  Treatments   Lung  block  manufacture   Compensator  determina%on  and  placement   Commissioning  procedure  discussion  with  TJW   AAPM  report  17  
  3. 3. TBI   Goals  of  TBI:   •  Immunosuppression  -­‐  lymphocyte  elimina%on  to  allow  engraOment   of  donor  bonemarrow   •  Eradica%on  of  malignant  cells  -­‐  leukemia,  lymphoma,  rarely  solid   tumors   •  Eradica%on  of  cells  with  gene%c  disorders  -­‐  Fanconi's  anemia,   thalassemia  major,  WiskoT-­‐Aldritch  syndrome   Dosimetric  goals  of  TBI  (AAPM  report  17):   •   Dose  Homogeneity  within  10  %   •   Prescribed  dose  to  mid-­‐plane   •   Dose  rate  of  10-­‐15  cGy/min   •   Verifica%on  by  Port  films  within  reasonable  margin   •   Lung  Shielding  
  4. 4. TSET   Goals  of  TSET:   •  Cutaneous  T  cell  lymphoma:  Mycosis  fungoides   Dosimetric  goals  of  TSET  (AAPM  report  23):   •  Average  energy  at  treatment  plane  =  3-­‐7  MeV   •  Uniform  dose  to  the  en%re  skin  (ver%cal  uniformity  +/-­‐  8  %   horizontal  +/-­‐  4  %  in    the  central  treatment  plane   •  X-­‐ray  back  ground  <  1  %   •   Dose  prescribed  to  a  point   •   High  dose  rate  treatment   •   Verifica%on  by  TLDs   •   Eye  shields   •  Boost  fields  for  under-­‐dosed  areas  
  5. 5. 1 Treatment Cycle per week over two days: Day 1 – AP/RPO/LPO Day 2 – PA/LAO/RAO
  6. 6. Thank  You  

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