13.02.2025

For people with leukaemia, a bone marrow or blood stem cell transplant is often their only chance of survival. A crucial preparatory step before transplantation is whole-body radiotherapy. To enhance patient comfort Hannover Medical School (MHH) now offers rotational whole-body irradiation using a rotating treatment table, minimizing the need for position changes during therapy.

Image: Four people are standing at a linear accelerator with a rotating table top; Copyright: Karin Kaiser/MHH

Patients lie on a horizontal treatment table capable of 360-degree rotation which enhance patient comfort.

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Before a stem cell transplant, patients undergo conditioning therapy, which eliminates cancer cells and suppresses their immune system to prepare for donor cell acceptance. “Complete elimination is a prerequisite for the donor cells to grow as well as possible,” explains Professor Hans Christiansen, Director of the Department of Radiotherapy and Special Oncology. “Those affected first receive high-dose chemotherapy. In many cases, this is then combined with whole-body radiotherapy,” adds Associate Professor Roland Merten. This therapy benefits both adults and children, as the radiotherapy team collaborates closely with haematology specialists for comprehensive patient care.

Whole-body irradiation without position changes

Traditional radiotherapy typically targets specific areas, making it challenging to irradiate the entire body. Previously, patients had to lie on a special mat on the floor, requiring frequent repositioning during the procedure. This process was physically demanding, particularly for severely ill people.

With the new system, patients lie on a horizontal treatment table capable of 360-degree rotation, ensuring precise alignment without repositioning. During the procedure, the linear accelerator rotates around the body, delivering radiation with optimal accuracy. “Thanks to the special table top, we realise rotational irradiation in sections for the entire body, from the top of the skull to the sole of the foot,” explains medical physics expert Jens Bock. In medical terms, this method is known as VMAT (Volumetric Intensity Modulated Arc Therapy).

Improved therapy planning and execution

Beyond enhancing patient comfort, the rotating table streamlines the workflow for medical professionals, including specialists in medicine, medical physics, and radiology. Treatment planning begins days before irradiation, involving planning computed tomography (CT). During CT imaging, patients lie in the same position they will maintain throughout radiotherapy, secured by an individually molded plastic shell and head mask to ensure precision.

Treatment duration and patient benefit

Whole-body radiotherapy is the final preparatory step before bone marrow or blood stem cell transplantation. Patients undergo four to six sessions, with the first session lasting around 90 minutes and subsequent ones taking between 30 and 40 minutes. “We are pleased that we can make treatment a little easier for this group of patients with the rotating table top,” says Dana Loberenz, Head Medical Technologist for Radiology (MTR) at the clinic.

MEDICA-tradefair.com; Source: Hannover Medical School

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