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Updated: Jun 21, 2026

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

Published on: February 6, 2019

[Total body irradiation: present and future].

T Zilli¹, R Miralbell, M Ozsahin

¹Service de radio-oncologie, hôpitaux universitaires de Genève, 24, 1211 Genève 14, Suisse. Thomas.Zilli@hcuge.ch

Cancer Radiotherapie : Journal De La Societe Francaise De Radiotherapie Oncologique

|July 21, 2009

Summary

Total body irradiation (TBI) is a key preparative regimen for bone-marrow transplantation, but causes significant toxicity. Intensity-modulated TBI shows promise in reducing toxicity, potentially expanding treatment options for hematological malignancies.

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Published on: March 11, 2021

Area of Science:

Radiation Oncology
Hematology
Medical Physics

Context:

Total body irradiation (TBI) is a standard preparative regimen for bone-marrow transplantation in hematological malignancies.
While effective, TBI is associated with significant acute and late toxicities, limiting its application.

Purpose:

To review current indications for TBI in clinical practice.
To analyze technological advancements in TBI delivery.
To evaluate the potential of intensity-modulated TBI (IM-TBI) in reducing toxicity and expanding indications.

Summary:

Randomized trials confirm the efficacy of TBI combined with cyclophosphamide for hematological malignancies.
Intensity-modulated radiotherapy (IMRT) enables selective irradiation of hematopoietic and lymphoid organs, forming the basis of IM-TBI.
Preliminary results suggest IM-TBI can mitigate treatment-related toxicity, potentially allowing for dose escalation and broader patient eligibility.

Impact:

Reduced treatment-related toxicity may overcome a major limitation in bone-marrow transplantation preparative regimens.
IM-TBI could expand TBI indications to older patients (>50 years) and permit dose escalation.
Further clinical trials are necessary to validate the impact of IM-TBI on disease control and long-term toxicity.