Details of TBI Treatment

TBI in maximal doses is usually given in 6 fractions over 3 days. Total doses vary between 12 Gy and 14.4 Gy. A total dose of 12 Gy TBI is given on Monday, Tuesday and Wednesday. Thursday is used if the protocol calls for a 4^th day. It is given at approximately 0730 and 1630. This is scheduled monthly or in consultation with the Oncology TBI team. Single dose TBI, as prescribed for RIC (2-4 Gy), is usually scheduled for Friday at 1230. This is negotiated with the TBI team.

Dose Regimens

The TBI schedule to be used will be recommended by the SCT Committee and is stated on the referral letter to the Radiation Oncologist, Dr. Brendon Anderson (or Dr. Stephen Williams if Dr Anderson is not available).

Radiology will produce a consultation letter to the Transplant Committee regarding the planned radiation. After TBI has occurred, Radiology will place a final summary report of the radiation therapy that was administered to the patient in the patient's file, or alternatively details of dates and doses of radiation therapy can be viewed electronically on MOSAIQ.

Adverse Effects

Adverse effects include nausea and vomiting, diarrhoea, mucositis, reversible alopecia, parotitis, pancreatitis, erythema, hyperpigmentation and fever. Late side effects include cataract formation, growth retardation, intellectual impairment, delayed puberty in children, hypothyroidism, carcinogenesis and sterility.

Note: For MRC and COG ALL trials, and possibly other patients with initial CNS involvement it will be necessary to give additional cranial irradiation prior to TBI. Refer to specific protocols and discuss with the SCT Committee.

Instructions for Patients Attending TBI

Instructions for bone marrow transplant unit staff and patients attending department for TBI.


About this Canterbury DHB document (9201):
Document Owner:	Andrew Butler (see Who's Who)
Last Reviewed:	December 2016
Next Review:	December 2018
Keywords:
Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer The Haematology Department Protocols and Guidelines (the Red Book) are intended as a guide for registered health professionals to communicate guidelines and share best practices with supporting health professionals within New Zealand district health boards. They are not intended to be provided to or used as a reference for patients or non-registered health professionals. All health professionals must exercise their own clinical judgement and use pertinent clinical data when treating patients. The authors and editors of this publication have checked with sources believed to be reliable in their effort to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical science, neither the authors, editors, publisher, nor any other party who has been involved in preparing or publishing this work warrants that the information contained in it is accurate or complete in every respect. They therefore have no liability (whether in tort (including negligence) or otherwise) for any loss or damage arising out of any reliance on this information. This publication has been compiled by the staff and contractors of Canterbury District Health Board (CDHB) and as such CDHB has copyright for this book. Amendments must be authorised in accordance with the documented process. No release of part of, or all of, this publication to any other party or organisation is permissible without the prior approval of the designated document owner.
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