Volumetric modulated arc therapy based total body irradiation: Workflow and clinical experience with an indexed rotational immobilization system

Abstract An indexed rotational immobilization system was developed for supine total body irradiation (TBI). Treatment plans had multi-isocentric volumetric modulated arc therapy (VMAT) beams to the upper body and parallel-opposed fields to the lower body, with a 12 Gy prescription dose to >90% of the body and mean lung dose ∼8 Gy. In the end-to-end test, point dose measurements had