Total body irradiation

Jump to navigation Jump to search

WikiDoc Resources for Total body irradiation

Articles

Most recent articles on Total body irradiation

Most cited articles on Total body irradiation

Review articles on Total body irradiation

Articles on Total body irradiation in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Total body irradiation

Images of Total body irradiation

Photos of Total body irradiation

Podcasts & MP3s on Total body irradiation

Videos on Total body irradiation

Evidence Based Medicine

Cochrane Collaboration on Total body irradiation

Bandolier on Total body irradiation

TRIP on Total body irradiation

Clinical Trials

Ongoing Trials on Total body irradiation at Clinical Trials.gov

Trial results on Total body irradiation

Clinical Trials on Total body irradiation at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Total body irradiation

NICE Guidance on Total body irradiation

NHS PRODIGY Guidance

FDA on Total body irradiation

CDC on Total body irradiation

Books

Books on Total body irradiation

News

Total body irradiation in the news

Be alerted to news on Total body irradiation

News trends on Total body irradiation

Commentary

Blogs on Total body irradiation

Definitions

Definitions of Total body irradiation

Patient Resources / Community

Patient resources on Total body irradiation

Discussion groups on Total body irradiation

Patient Handouts on Total body irradiation

Directions to Hospitals Treating Total body irradiation

Risk calculators and risk factors for Total body irradiation

Healthcare Provider Resources

Symptoms of Total body irradiation

Causes & Risk Factors for Total body irradiation

Diagnostic studies for Total body irradiation

Treatment of Total body irradiation

Continuing Medical Education (CME)

CME Programs on Total body irradiation

International

Total body irradiation en Espanol

Total body irradiation en Francais

Business

Total body irradiation in the Marketplace

Patents on Total body irradiation

Experimental / Informatics

List of terms related to Total body irradiation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Total body irradiation (TBI) is a form of radiotherapy used primarily as part of the preparative regimen for hematopoietic stem cell (or bone marrow) transplantation. As the name implies, TBI involves irradiation of the entire body, though in modern practice the lungs are often partially shielded to lower the risk of radiation-induced lung injury.[1][2] Total body irradiation in the setting of bone marrow transplantation serves to destroy or suppress the recipient's immune system, preventing immunologic rejection of transplanted donor bone marrow or blood stem cells. Additionally, high doses of total body irradiation can eradicate residual cancer cells in the transplant recipient, increasing the likelihood that the transplant will be successful.

Doses of total body irradiation used in bone marrow transplantation typically range from 10 to >12 Gy. For reference, a dose of 4.5 Gy is fatal in 50% of exposed individuals without aggressive medical care.[3] At these doses, total body irradiation both destroys the host's bone marrow (allowing donor marrow to engraft) and kills residual cancer cells. Non-myeloablative bone marrow transplantation uses lower doses of total body irradiation, typically about 2 Gy, which do not destroy the host bone marrow but do suppress the host immune system sufficiently to promote donor engraftment.

In modern practice, total body irradiation is typically fractionated. That is, the radiation is delivered in multiple small doses rather than one large dose. Early research in bone marrow transplantation by E. Donnall Thomas and colleagues demonstrated that this process of splitting TBI into multiple smaller doses resulted in lower toxicity and better outcomes than delivering a single, large dose.[4][5]

In addition to its use in bone marrow transplantation, total body irradiation has been explored as a treatment modality for high-risk Ewing sarcoma.[6] However, subsequent findings suggest that TBI in this setting causes toxicity without improving disease control,[7] and TBI is not currently used in the treatment of Ewing sarcoma outside of clinical trials.

References

  1. Gore EM, Lawton CA, Ash RC, Lipchik RJ (1996). "Pulmonary function changes in long-term survivors of bone marrow transplantation". Int. J. Radiat. Oncol. Biol. Phys. 36 (1): 67–75. PMID 8823260. Unknown parameter |month= ignored (help)
  2. Soule BP, Simone NL, Savani BN; et al. (2007). "Pulmonary function following total body irradiation (with or without lung shielding) and allogeneic peripheral blood stem cell transplant". Bone Marrow Transplant. 40 (6): 573–8. doi:10.1038/sj.bmt.1705771. PMID 17637691. Unknown parameter |month= ignored (help)
  3. Department of Homeland Security Working Group on Radiological Dispersal Device (RDD) Preparedness, from the United States Department of Homeland Security. Accessed May 29 2008.
  4. Thomas ED, Buckner CD, Clift RA; et al. (1979). "Marrow transplantation for acute nonlymphoblastic leukemia in first remission". N. Engl. J. Med. 301 (11): 597–9. PMID 381925. Unknown parameter |month= ignored (help)
  5. Thomas ED, Clift RA, Hersman J; et al. (1982). "Marrow transplantation for acute nonlymphoblastic leukemic in first remission using fractionated or single-dose irradiation". Int. J. Radiat. Oncol. Biol. Phys. 8 (5): 817–21. PMID 7050046. Unknown parameter |month= ignored (help)
  6. Kinsella TJ, Glaubiger D, Diesseroth A; et al. (1983). "Intensive combined modality therapy including low-dose TBI in high-risk Ewing's Sarcoma Patients". Int. J. Radiat. Oncol. Biol. Phys. 9 (12): 1955–60. PMID 9463099. Unknown parameter |month= ignored (help)
  7. Burdach S, Meyer-Bahlburg A, Laws HJ; et al. (2003). "High-dose therapy for patients with primary multifocal and early relapsed Ewing's tumors: results of two consecutive regimens assessing the role of total-body irradiation". J. Clin. Oncol. 21 (16): 3072–8. doi:10.1200/JCO.2003.12.039. PMID 12915596. Unknown parameter |month= ignored (help)

Template:Organ transplantation


Template:WH Template:WS