Radiation Oncology/RT Techniques/Total Marrow Irradiation

• Total Marrow Irradiation (TMI) with Helical Tomotherapy:
  1. Radiotherapy treatment technique that targets bone marrow and sanctuary sites prior to stem cell or bone marrow transplantation (SCT/BMT)
  2. Complex procedure that involves several critical steps that all need to be carefully addressed for a successful implementation, such as dose homogeneity in field junctions, choice of target margins, integrity of treatment and back-up planning
• The average dose to key OARs was reduced by up to 40% compared to TBI
• Probability of dose coverage to target of 98% dose to 93% volume was 90% for all fractions
• Average treatment time was 1 h 56 min, reduced to 1 h 31 min with surface scanning
• Total body surface scanning can reduce total time down to 1 h