Total Body Irradiation (TBI)
Total body irradiation (TBI) is a type of radiation therapy. It uses high energy x-rays. TBI helps prepare patients for hematopoietic stem cell transplant (HSCT). It works with chemotherapy to kill cancer cells. In the short term, these treatments affect how well the immune system works.
TBI treatments are given Monday through Friday. You will get eight treatments. Most patients start treatment on Monday or Tuesday. Two treatments per day are given, with at least six hours between treatments. This schedule helps to reduce unwanted side effects. Each TBI treatment takes about 30 minutes.
Getting ready for your treatment
- Remove all metal before you leave home. This includes jewelry and clothing that contains metal like a bra or blue jeans. Leave eye glasses with the friend or family member that brings you to TBI.
- Contact lenses should be removed.
- You may want to use the restroom before coming to clinic.
- You can listen to music during the treatment. The staff has many types of music or you can bring your own.
- You may also watch a movie or video during your treatment. Let the Radiation Oncology staff know 2 days in advance so they can arrange this for you.
During the treatment
For the treatment, you will be seated on a cart as shown here.
It is important that you be able to maintain this position during the treatment. The staff in Radiation Oncology will help you. You can use pillows, a cushion (bolster) and towels to support your body. Your arms will be placed as shown; at the side of the chest with hands together at the waist. This placement helps to decrease the radiation dose to the lungs. A cushion (bolster) is placed under your knees and secured with a Velcro strap. Both sides of your body will get exposed to the radiation from the treatment machine. After one side of your body is treated, the cart is turned around so that the other side can be treated.
During the treatment you will be able to breathe normally. You should try to remain as still as you can. You will be alone in the room during the treatment. A closed circuit TV and intercom is used. The treatment can be paused, and the staff can help you if needed.
After each treatment, you may return home or to the hotel. There is no radiation in your body after the treatments.
Side Effects from Total Body Irradiation
Some side effects may occur soon after your treatments start. Tell your radiation oncology nurse in clinic if you notice any side effects that bother you.
- nausea and vomiting
- mouth and throat sores
- pain
- diarrhea
- jaw pain
- swollen salivary glands
- dry mouth
- skin redness
- hair loss
- fatigue
- low blood counts
Other side effects may occur 6 months to several years after treatments
- cataracts
- decrease in growth
- hormone problems
- sterility
- lung, heart, and kidney problems
These later side effects can develop slowly over time. Report any problems to your doctor. Your cancer doctors will watch for these types of problems when you are seen for follow-up visits.
Taking Care of Yourself during TBI
- Practice good oral care. Follow your mouth care routine. Ask your nurse about products to use or avoid. See HFFY # 4494 Cancer Treatment Related Mucositis.
- Practice good skin care and avoid products that may irritate your skin. Common skin irritants include lanolin, perfumes and dyes and products containing camphor, menthol, zinc, alluminum, and alcohol. Your pharmacist, doctor, nurse or radiation therapist can help you understand product labels.
- Unscented lotions, creams, and ointments may be used during the week of your radiation treatments. Do not use them at least 2 hours before your treatment. Your skin should be clean and dry during your TBI treatments. See HFFY# 4621 Skin Care for Radiotherapy Patients.
- When you shower or bathe, use a mild, fragrance-free soap, such as Dove®,Ivory®, Basis®, Neutrogena®, or Cetaphil®.
- Avoid extremes of hot and cold on treated skin as they may cause further damage to the skin. The use of ice packs and heating pads is not recommended.
- If you go outside, use a good sunscreen (SPF 30 or higher). Irradiated skin burns more easily.
Controlling Nausea during TBI
You will be given medications to take prior to each treatment, and as needed to reduce nausea and vomiting. This section tells you how to take each medication.
Take these medications 30-60 minutes prior to every treatment, before you leave home or the hotel:
1. Ondansetron (Zofran®) 12mg tablets. This medicine has few side effects. Some patients have had headaches linked with it.
2. Dexamethasone (Decadron®) 8mg tablets. This is a steroid drug but when given in small anti-nausea doses, the side effects are very few, if any. Take this medicine with food to prevent upset stomach.
Take these medications if you have nausea at other times of the day:
1. Prochlorperazine (Compazine®) 10mg tablets every 6 hours as needed. This is the best medication to take if you have nausea during the day. Side effects are most often mild and include feeling drowsy and having a dry mouth. Some rare side effects are feeling restless or muscle rigidity. If these rare side effects occur you need to report them to your nurse, doctor, or pharmacist.
2. Ondansetron (Zofran®) 8mg tablets once a day if needed for nausea. Take this medication if you have nausea between the hours of 8:00pm and 8:00am.
3. Lorazepam (Ativan®) 0.5 – 1mg every 6 hours as needed. This medication causes drowsiness and is a good choice to take around bedtime if you are having nausea. Side effects can include muscle relaxation, decreased anxiety, sedation, and poor coordination. You should not drive or work with machinery until you know how it affects you.
The staff is here to help you with any questions or concerns. Let us know if we can make these treatments easier for you in any way.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/02/2012
Copyright © 08/02/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6275
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