Paired dosimetric comparison of VMAT-based total body and total marrow irradiation in adult leukemia patients: enhanced organ sparing with consistent plan complexity - Summary - MDSpire
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Paired dosimetric comparison of VMAT-based total body and total marrow irradiation in adult leukemia patients: enhanced organ sparing with consistent plan complexity
To evaluate whether total marrow irradiation (TMI) can provide clinically meaningful organ sparing while maintaining acceptable treatment complexity compared to total body irradiation (TBI).
Key Findings:
TMI plans showed a statistically significant reduction in dose to all evaluated organs at risk compared to TBI (p < 0.001).
Mean doses to the heart, kidneys, and liver were reduced by approximately 5–6 Gy, and the lung dose was also significantly decreased.
TMI provided improved dose homogeneity and showed significantly lower monitor units, segment number, and modulation factor compared to TBI.
Interpretation:
Limitations:
Treatment uncertainties related to patient positioning, respiratory motion, and field-junction dose matching should be carefully managed during clinical implementation.
