Total body irradiation

Overview

Total body irradiation is a form of radiation therapy that delivers low doses of radiation to the entire body. Unlike other radiation treatments, which target specific areas with higher doses, this approach affects the whole body. It is typically used in preparation for a bone marrow or stem cell transplant.

This therapy plays a critical role in eliminating cancer cells that may reside in hard-to-reach areas, such as the bone marrow or nervous system. By targeting these regions, total body irradiation increases the chances of eradicating the disease more effectively before the transplant.

In addition, total body irradiation helps reduce bone marrow to create space for the new cells. It also suppresses the immune system, which is necessary to prevent rejection of the transplanted bone marrow, making the procedure more likely to succeed.

Reasons for undergoing the procedure

Radiation therapy to the entire body aids in bone marrow or stem cell transplant preparation. Your doctor might suggest the treatment to:

• Eliminate cancer cells from your neurological system, bone marrow, and other hard-to-reach places.
• In order to create room for the transplant, decrease your bone marrow.
• To increase the likelihood of a successful bone marrow transplant, safely suppress your immune system.

In addition to chemotherapy or targeted therapy, total body irradiation may be used to treat the following conditions:

• Multiple myeloma.
• Myelodysplastic syndrome.
• Leukemia.
• Lymphoma.

Risks

The side effects of this medication are common. The following variables affect how different total body radiation side effects are experienced:

• The quantity of treatments you receive.
• The exposure to radiation.
• Your general state of health.

Short-term side effects

People typically experience brief side effects that appear a few days or weeks after starting treatment, such as:

• Hair loss.
• Headaches.
• Diarrhea.
• Fatigue.
• Nausea or vomiting.
• Skin responses, such as change in color or itching.

Your blood cell count will also decrease as a result of total body radiation. You run a greater chance of:

• Infection.
• Iron-deficiency anemia.
• Bleeding, such as bleeding gums and nosebleeds (epistaxis)

Long-term side effects

Occasionally, whole body radiation causes side effects that take longer to manifest and can include:

• Infertility.
• Cataracts.
• Hypothyroidism, or underactive thyroid.
• Pulmonary fibrosis, or scarring of the lung tissue.

You run a higher chance of developing a second cancer after receiving a bone marrow transplant. It’s crucial to keep in mind, though, that the danger of developing a different kind of cancer following treatment is less than the danger to one’s health associated with forgoing the transplant.

Before the procedure

Before undergoing total body irradiation, you’ll have a preliminary appointment known as a simulation to plan your treatment. This session acts as a trial run to ensure you receive the correct dose of radiation. During this appointment, a computed tomography (CT) scan will be performed to outline the treatment area, and your radiation therapist will take measurements. Once the optimal body position for treatment is determined, small skin markings may be made, and photos will be taken to assist with positioning during the actual treatment. These markings are typically tiny and may be permanent.

During the procedure

You might have to spend a few days in the hospital while undergoing full body radiation treatment. While receiving treatment:

• The radiation therapist will position you in the same manner as during your planning appointment (simulation).
• They might use boards or devices to shield specific areas of your body, like your lungs, to minimize radiation exposure to those regions. Additionally, a large screen may be placed in front of you to ensure the radiation is evenly distributed.
• The therapist will then leave the room, but you can still communicate with them through an intercom while they monitor you from outside.
• A machine called a linear accelerator will move around you to deliver the radiation.
• Total body irradiation treatments can last up to 60 minutes. The first session might be longer as the therapist takes extra X-rays to confirm your positioning. You may be allowed to listen to music to help the time pass more quickly.

For a maximum of three to five days, most people undergo total body irradiation twice or three times per day. The number of radiation sessions required prior to your treatment will be discussed with your doctor.

Outcome

Controlling adverse effects, such as the following, can facilitate complete body irradiation:

• Sign up for a help group.
• Request antiemetic medicine if necessary. Try to get eight hours of slumber every night.
• If at all feasible, take time off work to relax following hospital discharge.
• Use moisturizer on a regular basis and according to skin care guidelines.
• Talk to others, such as a therapist or a loved one you can trust, about how you feel about the treatment.