[Total body irradiation: techniques, dosimetry, and complications]

Area of Science:

• Radiation Oncology
• Hematology
• Pediatric Oncology

Background:

• Total-body irradiation (TBI) is a key component of conditioning regimens for bone marrow transplantation (BMT).
• Advances in TBI techniques and dosimetry have improved dose homogeneity and critical tissue sparing.
• Improved survival rates necessitate thorough evaluation of early and late complications associated with TBI.

Purpose of the Study:

• To review and compare different TBI techniques and dosimetry.
• To analyze the influence of TBI on dose distribution and homogeneity.
• To explore the relationship between TBI parameters and the risk of complications.

Main Methods:

• Comparative review of existing literature on TBI techniques and dosimetry.
• Analysis of dose distribution and homogeneity data.
• Correlation of TBI parameters with reported acute and late complications.

Main Results:

• Different TBI techniques and dosimetry approaches result in varying dose distributions and homogeneity.
• Acute complications include veno-occlusive disease and interstitial pneumonitis.
• Late complications encompass endocrinal effects, growth issues, cataracts, neurological deficits, secondary tumors, and quality of life alterations.

Conclusions:

• Optimizing TBI techniques and dosimetry is crucial for minimizing complications.
• Careful patient follow-up is essential to manage and understand TBI-related adverse effects.
• Distinguishing TBI-induced complications from those of chemotherapy, graft-versus-host disease, or other therapies is challenging.