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    Practice Patterns of Pediatric Total Body Irradiation Techniques: A Children's Oncology Group Survey

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    Authors
    Rassiah, Prema
    Ulin, Kenneth
    Penagaricano, Jose
    Fitzgerald, Thomas J.
    UMass Chan Affiliations
    Department of Radiation Oncology
    Imaging and Radiation Oncology Core, Rhode Island QA Center
    Document Type
    Journal Article
    Publication Date
    2021-12-01
    Keywords
    Oncology
    Pediatrics
    Radiation Medicine
    
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    Link to Full Text
    https://doi.org/10.1016/j.ijrobp.2021.07.1715
    Abstract
    PURPOSE: The aim of this study was to examine current practice patterns in pediatric total body irradiation (TBI) techniques among COG member institutions. METHODS AND MATERIALS: Between November 2019 and February 2020, a questionnaire containing 52 questions related to the technical aspects of TBI was sent to medical physicists at 152 COG institutions. The questions were designed to obtain technical information on commonly used TBI treatment techniques. Another set of 9 questions related to the clinical management of patients undergoing TBI was sent to 152 COG member radiation oncologists at the same institutions. RESULTS: Twelve institutions were excluded because TBI was not performed in their institutions. A total of 88 physicists from 88 institutions (63% response rate) and 96 radiation oncologists from 96 institutions (69% response rate) responded. The anterior-posterior/posterior-anterior (AP/PA) technique was the most common technique reported (49 institutions [56%]); 44 institutions (50%) used the lateral technique, and 14 (16%) used volumetric modulated arc therapy or tomotherapy. Midplane dose rates of 6 to 15 cGy/min were most commonly used. The most common specification for lung dose was the midlung dose for both AP/PA techniques (71%) and lateral techniques (63%). Almost all physician responders agreed with the need to refine current TBI techniques, and 79% supported the investigation of new TBI techniques to further lower the lung dose. CONCLUSIONS: There was no consistency in the practice patterns, methods for dose measurement, and reporting of TBI doses among COG institutions. The lack of standardization precludes meaningful correlation between TBI doses and clinical outcomes including disease control and normal tissue toxicity. The COG radiation oncology discipline is currently undertaking several steps to standardize the practice and dose reporting of pediatric TBI using detailed questionnaires and phantom-based credentialing for all COG centers.
    Source

    Rassiah P, Esiashvili N, Olch AJ, Hua CH, Ulin K, Molineu A, Marcus K, Gopalakrishnan M, Pillai S, Kovalchuk N, Liu A, Niyazov G, Peñagarícano J, Cheung F, Olson AC, Wu CC, Malhotra HK, MacEwan IJ, Faught J, Breneman JC, Followill DS, FitzGerald TJ, Kalapurakal JA. Practice Patterns of Pediatric Total Body Irradiation Techniques: A Children's Oncology Group Survey. Int J Radiat Oncol Biol Phys. 2021 Dec 1;111(5):1155-1164. doi: 10.1016/j.ijrobp.2021.07.1715. Epub 2021 Aug 2. PMID: 34352289. Link to article on publisher's site

    DOI
    10.1016/j.ijrobp.2021.07.1715
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/29939
    PubMed ID
    34352289
    Notes

    Full author list omitted for brevity. For the full list of authors, see article.

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    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ijrobp.2021.07.1715
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