Whole Body Irradiation - Uses, Side-Effects, and Procedure

Introduction

Radiation therapy is a treatment method for cancer that uses high doses of radiation to shrink tumors and kill cancer cells. At low doses, X-rays use radiation to look inside the body, such as X-rays of teeth and fractures. High-dose radiation therapy kills cancer cells or damages their DNA (deoxyribonucleic acid) to slow their growth. Cancer cells with irreparably damaged DNA stop dividing or die. As damaged cells die, the body breaks them down and removes them. Radiation therapy does not kill cancer cells instantly. Days to weeks of treatment are required to damage DNA enough to kill cancer cells. Cancer cells then continue to die for weeks or months after radiation therapy ends.

What Is Whole Body Irradiation?

Whole-body irradiation, also known as total body irradiation (TBI), is a radiation therapy delivered to the whole body. Many people have whole-body irradiation prior to stem cell transplantation. It can also be done for any or all of the following reasons:

• To destroy cancer cells in areas that chemotherapy cannot easily reach (such as the nervous system, bones, skin, and testicles).

• To suppress the immune system reaction. If a person is having an allogeneic stem cell transplant (bone marrow or stem cells from a donor), the body may perceive the cells as foreign particles. When this happens, the immune system tries to destroy them. A pre-transplant traumatic brain injury can help prevent this.

• To make room for the new bone marrow to grow (engraft).

Some people may need only radiation therapy. However, radiation therapy is given as an adjunct to other cancer treatments, such as surgery, chemotherapy, or immunotherapy. Radiation therapy is given before, during, or after these other treatments to make them more likely to work. The duration of radiation therapy depends on the type of cancer treated and if the radiation therapy is used for treatment or relieving symptoms.

What Is the Normal Dose for Whole Body Irradiation?

Whole-body irradiation is usually given in several doses, two to three times a day for two to five days. This is said to increase the likelihood that normal tissue cells, such as the lungs, will be able to self-repair and withstand treatment, while abnormal cells will be affected and killed. The total dose of radiation available is much less than if only a small area of ​​the body is treated. This is to ensure that normal cells' ability to repair damage from the treatment is not compromised. For this reason, TBI is not used alone to kill large numbers of malignant or abnormal cells but is generally part of a larger treatment regimen that includes localized radiation, chemotherapy, or surgery. The 10-12 Gy (gray- a unit of measurement of radiation) is typically delivered across multiple doses to minimize toxicities to the patient.

What Are the Side Effects of Whole Body Irradiation?

One may get side effects from the application of whole-body irradiation. The severity and type of the symptoms depend on many factors. These include the dose of radiation given, the number of times the radiation is given, and the overall health.

Short-Term Side Effects: The most common side effects develop days or weeks after the treatment and do not last for a long duration. These include:

• Headache.

• Nausea and vomiting.

• Diarrhea.

• Fatigue.

• Skin reactions.

• Bone marrow suppression (low blood counts).

• Swelling of salivary glands.

Long-Term Side Effects: Some side effects appear months or years after treatment and may persist for a long time. These include:

• Infertility (Inability to have biological children).

• Low levels of thyroid hormone.

• Inflammation of the sac around the heart.

• Lung inflammation.

• Cataract (cloudy eye lens).

• A new type of cancer.

How Will the Whole Body Irradiation Be Performed?

The entire procedure during whole-body irradiation is explained below:

• The Treatment Planning: First, there is a planning session of approximately 90 minutes to create a treatment plan. All jewelry, watches, eyeglasses, and dentures containing metal should also be removed. The patient will either lie down on the treatment table or stand in a special frame.

• Treatment While Lying Down: X-ray technicians measure the thickness of various body parts. They place small radiation monitors called diodes on the body. Padding materials or gel bags can be used between the knees, chest, and neck. This is to ensure that the entire body receives an even dose of radiation. During the planning session, patients lie down on the sofa. They receive a very small amount of radiation from a radiotherapy machine next to the treatment table. Since the sofa moves, half-body treatment is possible. The couch then rotates to allow the machine to treat the other side.

• Treatment While Standing: The patient is made to stand in a specially designed frame. First, they stand facing the radiation therapy machine, then turn so that the back is facing the machine.

• The Procedure: The X-ray technician will help the patient assume exactly the same position as decided in the treatment plan. This can take up to 30 minutes. They tape small radiation monitors to several areas of the body to monitor the dose. The lights in the room are dimmed for a few minutes while the X-ray technician positions them. They will leave the room while the machine is working. However, they can watch the patient closely during treatment on closed-circuit television. It is important to remain still and calm while still being able to breathe comfortably. Treatment lasts up to 15 minutes on each side of the body. There is a buzzer that the patient can press whenever they need to stop treatment. They will not feel or see anything but will only hear a beep when the device turns on.

Conclusion

Radiation therapy uses high-energy radiation for the treatment of cancer. The rays of radiation cannot be seen or felt. Radiation therapy works by destroying the cancer cells by preventing them from reproducing. The body can naturally get rid of the damaged cancer cells. Radiation therapy also affects normal cells. However, normal cells can repair themselves in ways that cancer cells cannot. The whole body irradiation is a procedure that may weaken a person, but it is a safe and effective adjunct in the treatment of cancer of metastatic nature.