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Published online: 2025-02-06

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Evaluation of dose distributions in the overlapping regions of the modulated volumetric arcs used in total body irradiation in pediatric patients

Eduardo Carrasco Solis1, Antonella A. Anticona Verástegui1, J. Fernando Márquez Pachas1, Alberto E. Gonzales-Ccoscco23, Cecilia Querebalu Garcia4, Yesenia Miranda Tunque5, Gustavo Sarria Bardales5, Carlos Herrera Castillo5, Edward Artemio Meca Castro6, José Santa Cruz Delgado1, Fernando Carrasco7, Ana Perini83, Lucio Neves83, Arthur S.B.Z. Alves3, Alessa Maschio3, Jhonny Antonio Benavente Castillo1, Galo Patino Camargo1, William S. Santos39

Abstract

Background: The application of total body irradiation (TBI), using intensity-modulated techniques with dynamic arcs, creates overlap at the treatment arc boundaries, which can lead to dosimetric variations. Therefore, this research aimed to evaluate the dose distributions in the overlap regions of the arcs used in total body irradiation in pediatric patients.

Material and methods: This dosimetric evaluation was conducted on a CIRS 715-TY0710 pediatric body simulator, where a treatment plan with three isocenters was designed, generating two 4 cm overlap regions along the line connecting the isocenters. The plan was verified using the gamma criteria of 3%/3mm and 5%/5mm with the Octavius 4D software.

Results/Conclusions: The planning results showed 98.2% dose coverage over 95% of the planning target volume (PTV) with adequate tolerance for risk organs. Regarding the gamma analysis, the acceptance rate was greater than 95% at the treatment isocenters with criteria of 3%/3 mm and 5%/5 mm. However, there is a decrease in the approved points in the overlap zone when evaluated with a 3%/3 mm criterion, while maintaining an approval percentage above 95% when evaluated with a 5%/5 mm criterion.

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