Vol 27, No 2 (2022)
Research paper
Published online: 2022-03-17

open access

Page views 4613
Article views/downloads 336
Get Citation

Connect on Social Media

Connect on Social Media

Total body irradiation for standard treatment rooms: a robust sweeping beam technique with respect to the body shape

Iva Bratova1, Petr Paluska1, Jakub Grepl12, Igor Sirak1, Jiri Petera1, Milan Vosmik1
Rep Pract Oncol Radiother 2022;27(2):268-274.


Background: The purpose of this work is to improve a sweeping beam technique for total body irradiation (TBI) on a low flat couch using a varying patient thickness model. We designed a flat couch for total body irradiation in supine and prone position. Three generic arcs with rectangular segments for a patient torso thickness of 16, 22 and 28 cm were generated with respect to varying patient thickness of four particular parts of the body: head, torso, thighs and calves.

Materials and methods: Longitudinal and transversal dose profiles were measured using an ionization chamber and the EBT3 gafchromic film in a solid water slab phantom. The robustness of the method was examined in phantoms of different thicknesses.

Results: Measured dose homogeneity stays within ±10% of prescribed dose for all of the three patient thickness models. The robustness of the method was evaluated as the increase in dose in the phantom center of 0.7% per 1 cm reduction in phantom thickness.

Conclusion: The method is applicable for the broad range of patient sizes, comfortable for patients, robust and suitable for standard treatment rooms with a standard linear accelerator. It requires minimal investments into equipment.


Article available in PDF format

View PDF Download PDF file


  1. Quast U. Whole body radiotherapy: A TBI-guideline. J Med Phys. 2006; 31(1): 5–12.
  2. Giebel S, Miszczyk L, Slosarek K, et al. Extreme heterogeneity of myeloablative total body irradiation techniques in clinical practice: a survey of the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation. Cancer. 2014; 120(17): 2760–2765.
  3. Kawa-Iwanicka A, Lobodziec W, Dybek M, et al. Dose distribution homogeneity in two TBI techniques-Analysis of 208 irradiated patients conducted in Stanislaw Leszczynski Memorial Hospital, Katowice. Rep Pract Oncol Radiother. 2012; 17(6): 367–375.
  4. Van Dyk J, Galvin JM, Glasgow GP, Podgorsak EB. AAPM report No. 17. The physical aspects of total and half body photon irradiation. 1986.
  5. Pierce G, Balogh A, Frederick R, et al. Extended SSD VMAT treatment for total body irradiation. J Appl Clin Med Phys. 2019; 20(1): 200–211.
  6. Mancosu P, Cozzi L, Muren LP. Total marrow irradiation for hematopoietic malignancies using volumetric modulated arc therapy: A review of treatment planning studies. Phys Imaging Radiat Oncol. 2019; 11: 47–53.
  7. Jahnke A, Jahnke L, Molina-Duran F, et al. Arc therapy for total body irradiation--a robust novel treatment technique for standard treatment rooms. Radiother Oncol. 2014; 110(3): 553–557.
  8. Kim DY, Kim IlH, Yoon SS, et al. Effect of dose rate on pulmonary toxicity in patients with hematolymphoid malignancies undergoing total body irradiation. Radiat Oncol. 2018; 13(1): 180.
  9. Girinsky T, Benhamou E, Bourhis JH, et al. Prospective randomized comparison of single-dose versus hyperfractionated total-body irradiation in patients with hematologic malignancies. J Clin Oncol. 2000; 18(5): 981–986.
  10. Lavallée MC, Gingras L, Chrétien M, et al. Commissioning and evaluation of an extended SSD photon model forPINNACLE3: An application to total body irradiation. Med Phys. 2009; 36(8): 3844–3855.
  11. Lamichhane N, Patel VN, Studenski MT. Going the distance: validation of Acuros and AAA at an extended SSD of 400 cm. J Appl Clin Med Phys. 2016; 17(2): 63–73.
  12. Symons K, Morrison C, Parry J, et al. Volumetric modulated arc therapy for total body irradiation: A feasibility study using Pinnacle treatment planning system and Elekta Agility™ linac. J Appl Clin Med Phys. 2018; 19(2): 103–110.

Reports of Practical Oncology and Radiotherapy