TBI aims to destroy any remaining
cancer cells in the body and suppress the immune system to prevent
graft-versus-host disease (GVHD) after a transplant. The process involves delivering a uniform dose of
ionizing radiation to the entire body, which can damage both cancerous and normal cells. This is why it is often combined with
chemotherapy to enhance its effectiveness.
TBI is most commonly indicated for patients undergoing a bone marrow or stem cell transplant for:
It is also used in some cases of
multiple myeloma and other hematologic malignancies.
The side effects of TBI can be both short-term and long-term. Short-term side effects include:
Long-term side effects can be more serious and may include:
TBI is typically administered in a hospital setting. The patient is positioned to ensure even distribution of radiation, often using special equipment to minimize exposure to sensitive areas such as the lungs. The total dose is usually fractionated, meaning it is given in smaller doses over several days to reduce the risk of severe side effects.
The primary benefit of TBI is its ability to prepare the body for a successful bone marrow or stem cell transplant. By eliminating remaining cancer cells and suppressing the immune system, TBI helps to:
Reduce the risk of
relapse Minimize the chance of GVHD
Enhance the engraftment of transplanted cells
Yes, there are alternatives to TBI, including high-dose chemotherapy alone or chemotherapy combined with localized radiation. The choice of treatment depends on various factors such as the type of cancer, the patient's overall health, and the specific goals of therapy. For some patients, especially those who are older or have other health issues, these alternatives may be more suitable.
Conclusion
Total Body Irradiation (TBI) is a crucial component in the treatment of certain cancers, particularly when combined with bone marrow or stem cell transplants. While it has significant benefits, it also carries risks and potential side effects that must be carefully managed. Ongoing research continues to refine TBI techniques to improve outcomes and reduce complications.
