{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:20:01Z","timestamp":1791566401834,"version":"4.3.4"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100006775","name":"GE Healthcare","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006775","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Technol Cancer Res Treat"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Halcyon\u2122 O-ring linear accelerators (linacs) provide a robust and efficient radiotherapy option for clinics. Interest in volumetric arc therapy (VMAT) based total body irradiation (TBI) has grown, with most current VMAT TBI protocols employing C-arm linacs; however, the feasibility of Halcyon-based VMAT TBI has been recently hypothesized. This study investigates the planning feasibility and dosimetric quality of VMAT-based, lung-sparing TBI delivered by Halcyon linac to pediatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>10 pediatric patients (94 \u2013 134 cm in height) previously treated to 12 Gy TBI through traditional 3D planning techniques were retrospectively replanned on a Halcyon linac. 2-3 VMAT plans containing 4-6 isocenters each with 2-2.5 arcs were created to treat the head, abdomen, and legs, with 1-2 static-gantry treatment matching areas being used between VMAT planning regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Lung doses were significantly reduced below the clinically significant level of 8 Gy, achieving mean doses of 6.66 \u00b1 0.52 Gy (55.5% \u00b1 4.3%). Target coverage was achieved with D90% of 77.5% \u00b1 12.5% and homogeneity indexes of 0.92 \u00b1 0.1. Planning time took 5-6 hours per patient: 1.5 hours for contouring and field placement and 3.5-4.5 hours for plan optimization and dose calculations. Using a dose rate of 800 MU\/min field delivery time took an average of 20.8 \u00b1 7 minutes with average portal dosimetry quality assurance passing rates of 99.6% and 99.9% for 2%\/2mm and 3%\/3mm gamma analysis metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>VMAT lung sparing TBI via Halcyon linacs is feasible and dosimetrically acceptable, with greatest applicability to smaller patients (&lt;100 cm). Planning and setup complexity increases dramatically for larger patients (&gt;100 cm) due to the smaller maximum field sizes (28 x 28 cm2) achievable. Future developments in software-based automations for target delineation, multiple field matching, and plan optimization could allow for more practicable treatment of larger patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15330338261443068","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T10:55:26Z","timestamp":1776077726000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Dosimetric Performance Analysis of Pediatric Based Halcyon\u2122 Volumetric Arc Therapy-Based Lung-Sparing Total Body Irradiation"],"prefix":"10.1177","volume":"25","author":[{"given":"Allison","family":"Haertter","sequence":"first","affiliation":[{"name":"New York Proton Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3070-9463","authenticated-orcid":false,"given":"Keshav","family":"Goel","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Niculcea","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taoran","family":"Li","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine E.","family":"Hill-Kayser","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Plastaras","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"LaRiviere","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele M.","family":"Kim","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2018.04.071"},{"key":"e_1_3_6_3_2","volume-title":"Clinical Radiation Oncology","author":"GlaT J","year":"2015","unstructured":"GlaT J. 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