Total marrow irradi̇ati̇on wi̇th intensi̇ty modulated radi̇ati̇on therapy in treatment planni̇ng system usi̇ng the monte carlo algori̇thm

The purpose of this study is the assessment of the feasibility of Intensity modulated radiotherapy (IMRT) activity for total marrow irradiation (TMI) irradiation. Bone marrow cancer begins in the plasma cells, the most important part of the body's immune system. As a result of cancer, plasma cells produce a single type of antibody called paraprotein, which has no useful function. These abnormal cells multiply by themselves to copy. The number of abnormal cells on this count surpasses. These are also called myeloma cells (1). The treatment of bone marrow cancer in general is chemotherapy and bone marrow (stem cell) transportation. These procedures are usually combined with radiotherapy. Nowadays, in addition to these, they are used in intelligent molecules. These markers are smart molecules, and smart molecules are a form of treatment that only focuses on the target and reaches the cancer cell and destroys that cell (1). In our study, VMAT treatment plans of 10 patients diagnosed with Brain Tumor were established. The VMAT plans consist of 3 partial arc (head and neck, chest and pelvis) 3 arcs (dual arc for the head and neck planes) irradiation in the 3 treatment areas (head and neck, chest and pelvis) created with 6 MV photon energy to cover the whole body (until the mid and upper extremity bones). Treatment doses were defined as 2 Gy to 12 Gy per daily fraction. The treatment results obtained with the YART technique; the doses of the organs at risk and the feasibility of the treatment. At the end of the planning, 95% of the defined dose of PTV volume is provided. 3 PTV için de ölçülen D99, D1, Dmean, Dmax ve Dmin değerlerimiz belirlenmiştir. The averages of these values and the mean values of the values were found to be 11.4, 13.6, 12.9, 14.2 and 7.1, respectively. As a consequence of these data, we obtained a DVH close to the ideal in PTVs determined. When doses at risk were examined in Dmean, D1 and D99 values, doses at 12 Gy irradiation were 9.7 for brain, 8.7 for heart, 11 for kidney, 9.2 for kidney, 9.2 for lung, 8.9 for liver, 8.9 for intestine, 8.7 for lens, the doses of brain 13.1, heart 12.9, eyes 12.8, kidney 12.8, lung 13.1, liver 13.0, intestine 13.0, lens 10.2 and ileum 12.8 Gy at the time of examination of D99, brain 3.7, heart 4.1, eyes 7.4, kidney 5.6, 3.9, 4.5 in the liver, 4.2 in the intestines, 6.1 in the lenses and 4.4 Gy in the ileum. This proves that when the given dose of 12 Gy is given in 3 dimensional conformal radiotherapy, the dose of all the organs at risk as a result of the administration of two doses is superior to the dose of the YART technique. In our study, the calculated homogeneity index values were close to 1, a sign of how homogeneously the PTV was wrapped by the defined dose, and the closeness of the conformity indices were indicative of how well the isodose target volume of the treatment dose was. The results of our study show that the YART plans prepared using the treatment planning systems available in our clinic are applicable. Key words: Bone Marrow; Radiotherapy; IMRT; TMI