{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:33:51Z","timestamp":1760243631228,"version":"build-2065373602"},"reference-count":19,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,12]],"date-time":"2022-11-12T00:00:00Z","timestamp":1668211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Total body irradiation (TBI) 2 \u00d7 2 Gy for 3 consecutive days followed by chemotherapy for conditioning pediatric patients with acute lymphoid leukemia (ALL) before bone marrow transplantation is superior to chemo-conditioning alone. The globally used anterior-posterior\/posterior-anterior (AP\/PA) technique is the most referable method, but volumetric modulated arc therapy (VMAT) with modern linear accelerators is more precise in terms of ensuring better dose distribution, especially for skin, and higher protection of organs at risk, resulting in less side effects. Method: For TBI, a modern VMAT technique was used. Whole-body immobilization in the supine position was performed using a vacuum mattress with a full body coverage, with a water-equivalent bolus of 1 cm thickness. The design goal was to achieve dose inhomogeneity of less than \u00b110%. Results: From 2020 to 2022, we performed TBI for five pediatric patients with ALL, with full body bolus and VMAT, who later received hematopoietic stem cell transplantation. No acute complications related to TBI were observed during the treatment period with a median follow-up of 1.27 (0.43\u20132.11) years. Conclusion: Using full body water-equivalent bolus with VMAT for TBI provides a safe method for children with a better organ sparing in the short term follow-up.<\/jats:p>","DOI":"10.3390\/children9111740","type":"journal-article","created":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T02:33:10Z","timestamp":1668393190000},"page":"1740","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Full Body Surface Coverage with Water-Equivalent Bolus as Novel Technique for Total Body Irradiation before Hematopoietic Stem Cell Transplantation in Pediatric Acute Lymphoid Leukemia"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8273-3667","authenticated-orcid":false,"given":"Andrea","family":"Furka","sequence":"first","affiliation":[{"name":"Department of Oncology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Department of Clinical Radiology, Faculty of Health Care, Institute of Practical Methodology and Diagnostics, University of Miskolc, 3526 Miskolc, Hungary"},{"name":"Centre of Clinical Oncology and Radiotherapy, Borsod-Aba\u00faj-Zempl\u00e9n County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsofia","family":"Nagy","sequence":"additional","affiliation":[{"name":"Centre of Clinical Oncology and Radiotherapy, Borsod-Aba\u00faj-Zempl\u00e9n County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imre","family":"Szab\u00f3","sequence":"additional","affiliation":[{"name":"Centre of Clinical Oncology and Radiotherapy, Borsod-Aba\u00faj-Zempl\u00e9n County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e1bor","family":"Fekete","sequence":"additional","affiliation":[{"name":"Centre of Clinical Oncology and Radiotherapy, Borsod-Aba\u00faj-Zempl\u00e9n County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1gnes","family":"Kelemen","sequence":"additional","affiliation":[{"name":"Velkey L\u00e1szl\u00f3 Child\u2019s Health Center, Borsod-Aba\u00faj-Zempl\u00e9n County Central Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e1bor","family":"Bolob\u00e1s","sequence":"additional","affiliation":[{"name":"Centre of Clinical Oncology and Radiotherapy, Borsod-Aba\u00faj-Zempl\u00e9n County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e1briel","family":"Seb\u0151k","sequence":"additional","affiliation":[{"name":"Centre of Clinical Oncology and Radiotherapy, Borsod-Aba\u00faj-Zempl\u00e9n County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T\u00fcnde","family":"Moln\u00e1r","sequence":"additional","affiliation":[{"name":"Centre of Clinical Oncology and Radiotherapy, Borsod-Aba\u00faj-Zempl\u00e9n County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e1nos","family":"\u00c1rvai","sequence":"additional","affiliation":[{"name":"Centre of Clinical Oncology and Radiotherapy, Borsod-Aba\u00faj-Zempl\u00e9n County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2165-4196","authenticated-orcid":false,"given":"Ilona","family":"Tornyi","sequence":"additional","affiliation":[{"name":"Department of Human Genetics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"Kosty\u00e1l","sequence":"additional","affiliation":[{"name":"Department of Clinical Radiology, Faculty of Health Care, Institute of Practical Methodology and Diagnostics, University of Miskolc, 3526 Miskolc, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e1nos","family":"R\u00e9v\u00e9sz","sequence":"additional","affiliation":[{"name":"Department of Clinical Radiology, Faculty of Health Care, Institute of Practical Methodology and Diagnostics, University of Miskolc, 3526 Miskolc, Hungary"},{"name":"Centre of Clinical Oncology and Radiotherapy, Borsod-Aba\u00faj-Zempl\u00e9n County Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8307-8975","authenticated-orcid":false,"given":"Peter","family":"Hauser","sequence":"additional","affiliation":[{"name":"Velkey L\u00e1szl\u00f3 Child\u2019s Health Center, Borsod-Aba\u00faj-Zempl\u00e9n County Central Hospital and University Teaching Hospital, 3526 Miskolc, Hungary"},{"name":"Faculty of Health Sciences, University of Miskolc, 3526 Miskolc, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2938","DOI":"10.1200\/JCO.2014.59.1636","article-title":"Childhood acute lymphoblastic leukemia: Progress through collaboration","volume":"33","author":"Pui","year":"2015","journal-title":"J. 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Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1016\/j.ijrobp.2021.07.1715","article-title":"Practice patterns of pediatric total body irradiation techniques: A children\u2019s oncology group survey","volume":"111","author":"Rassiah","year":"2021","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"774348","DOI":"10.3389\/fped.2021.774348","article-title":"Total Body Irradiation in Haematopoietic Stem Cell Transplantation for Paediatric Acute Lymphoblastic Leukaemia: Review of the Literature and Future Directions","volume":"9","author":"Hoeben","year":"2021","journal-title":"Front. 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