Total body irradiation: clinical experience at the Institute Jules Bordet

Our clinical experience with 58 patients receiving TBI as part of their treatment for a malignant hematopoietic disease suggests the following comments: 6 daily fractions of 2 Gy given over 6 days have a similar antitumoral effect as a single dose of 10 Gy, using a low dose rate, but with less toxicity. 7 daily fractions of 2.25 Gy given over 8 days exceed normal lung tolerance. No leukemia recurrence was observed among patients treated with 6 times 2 Gy but the maximal period of observation is only 560 days. On the other hand, a relapse was seen 2 years after 7 times 2.25 Gy. This may suggest the necessity to find a more effective drug regimen or to deliver additional radiation to possible sanctuary sites for chemotherapy.