Total-body irradiation on an isocentric linear accelerator: a radiation output compensation technique

A treatment technique for total-body irradiation (TBI) is proposed that combines arc therapy with dynamic output control to achieve high-grade dose uniformity. The patient lies on a low couch and receives exposure in the prone and supine positions from a modulated arcing beam. The technique has been validated using a personal computer to control the linear accelerator and we demonstrate that only minor alterations to current dynamic therapy systems would be required. We have examined the practical application of this treatment with emphasis on methods of conformal therapy where an optimized dose distribution is prepared from a matrix of caliper measurements taken from the patient. This technique provides a means for regular TBI treatment on a computer-controlled linear accelerator that is easy to set up, requires short exposure times and is comfortable for the patient.