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• W4244873513 abstract "The aim of this study was to examine current practice patterns in pediatric total body irradiation (TBI) among COG institutions. Between Nov 2019 and Feb 2020 a questionnaire containing 52 questions related to the technical aspects of TBI was sent to physicists at 152 COG institutions performing TBI. A total of 63 physicists representing 63 institutions responded. The questions were mainly targeted to extract technical information on the most commonly used technique which are AP/PA and lateral. Specific questions on patient position, beam arrangement, beam energy, lung block, beam spoiler, lung dose estimation, dose rate and planning technique were queried. Another set of questions related to the clinical management of TBI was also sent to COG physicians and 85 physicians responded which reflects positively on physician engagement. 63% use AP/PA technique with patients positioned decubitus (31%), standing with support (33%), lying supine and prone (46%) and 7% supine only. 30% used 6MV for treatment, 10% 10MV, 12% 15 MV and 5% 18MV. 13% did not use any lung blocks for the AP/PA treatment whereas 61% used lung blocks daily and 26% used lung blocks every other day or for several fractions of treatment. When lung blocks were used the thickness of the lung blocks varied to achieve 25- 85% transmission. 97% institutions customized the lung blocks. 69% specified lung dose to mid lung, 14 % as mean lung dose and the remaining as a percentage of transmission in the lung. Although 24% acquired a CT scan, only 14% did CT planning. 52% institutions performed lateral TBI and positioned patients supine (77%) and sitting up or partially sitting up (23%). A range of energies was used to treat lateral TBI 6MV; (43%), 10MV (10%) 15MV (20%) and 18MV (20%). 63% did not use lung blocks for lateral TBI whereas the remaining 37% used lung blocks for a certain number of fractions. All institutions customized their lung blocks however the thickness varied to provide 50 to 70% transmission. 67% specified mid lung dose whereas 37% did not specify lung dose for lateral TBI. Of the 67% who specified mid lung dose, only 33% used CT or 2D imaging to estimate the mid lung dose. No CT planning was done for lateral TBI. 100% of the physician responders answered “yes” to redefining current TBI techniques and > 75% supported the investigation of new TBI techniques in an effort to lower the lung doses. The practice of TBI amongst COG institutions is very heterogeneous. Dose accuracy is difficult to assess as few perform CT-based planning. These findings warrant caution to be exercised when interpreting radiation related efficacies and toxicities when multi-institutional clinical studies are carried out. COG is currently undertaking steps to standardize the practice of TBI." @default.
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• W4244873513 date "2020-11-01" @default.
• W4244873513 modified "2023-10-16" @default.
• W4244873513 title "Practice Patterns of Pediatric Total Body Irradiation (TBI) Techniques: A Children’s Oncology Group Survey" @default.
• W4244873513 doi "https://doi.org/10.1016/j.ijrobp.2020.07.1512" @default.
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