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Rota%on # 11 Special Procedures: TBI, TSeT and
IORT Mentor: Tim Waldron
By Vibha Chaswal
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
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
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
1 Treatment Cycle per week over two days: Day 1 – AP/RPO/LPO Day 2 – PA/LAO/RAO
Thank You