Yonsei medical journal
Hypofractionated Total Marrow and Lymphoid Irradiation for Relapsed/Refractory Leukemia Using Helical Tomotherapy: Workflow and Dosimetric Analysis
By Ni W, Wang X, Yang H and 5 others.
Abstract
Purpose
To report the workflow optimization, dosimetric characteristics, and clinical outcomes of hypofractionated total marrow irradiation (TMI) and total marrow and lymphoid irradiation (TMLI) as part of conditioning regimens for patients with relapsed or refractory leukemia undergoing hematopoietic stem cell transplantation (HSCT).
Materials and methods
Ninety-two patients treated between December 2024 and October 2025 were retrospectively analyzed. Prescription doses ranged from 10.5 to 15.0 Gy, delivered in once-daily fractions of 3.0-4.0 Gy. Patients were grouped by prescription dose (10.5-12.0 Gy, n=72 vs. 14.0-15.0 Gy, n=20). Dosimetric parameters of planning target volumes and organs at risk (OARs) were extracted. Survival outcomes were analyzed using Kaplan-Meier analysis.