ABSTRACT Introduction Total body irradiation (TBI) practice varies globally. The optimal technique for TBI has not yet been determined, although guidelines and recommendations are available. Five years after the initial Australia and New Zealand (ANZ) practice survey in 2019, we report updated 2024 TBI practice patterns from 19 ANZ centres who are members of the ANZ Transplant and Cellular Therapies (ANZTCT) TBI Special Interest Group (TBISIG). Method The 2024 survey was distributed in November 2024. Survey questions covered patient cohorts and caseloads, TBI regimens and dose‐fractionations, TBI techniques, planning considerations, quality assurance, and treatment delivery. For all centres, one staff member from each discipline (Radiation Oncology, Medical Physics, and Radiation Therapy) was invited to respond. Results Responses were received from all 19 centres. Seven centres use modulated techniques in 2024, whereas only one centre delivered modulated TBI in 2019. Twelve centres use large open fields in 2024, six of which are considering changing to volumetric modulated arc therapy (VMAT) TBI. Compared to large open fields, modulated techniques (1) require dedicated patient immobilisation equipment and treatment planning software, (2) reduce dose to organs at risk (such as lungs and kidneys) below the prescription dose, (3) have higher dose rates, and (4) require more time for planning and treatment delivery. Conclusion The 2024 survey showed diverse TBI practice patterns in ANZ. Compared to 2019, more centres are using or actively considering the implementation of modulated techniques, such as VMAT TBI, which adds to the complexity of treatment planning and delivery.
Li et al. (2026) studied this question.