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Bone Marrow Transplant

 

TBI

 

Technique

Method

  • Initially Cobalt 60 and single dose of RT used.
  • Now typically fractionated: decrease toxicity and increase tolerability.
  • Partial lung shielding to reduce potential for irreversible lung injury.
  • Maximally tolerated dose of TBI = 15 Gy

 

TBI techniques (often institutionally determined)

  • Multi-sources
  • Short SSD  (skin to source distance)
  • Translation
  • Extended SSD  (skin to source distance)
  • Sweeping
  • Multi-fields

BCCA           

  • Sweeping Cobalt 60 source at extended SSD  (160 cm vs the standard 100cm)
  • 1200 cGy / 6 fractions
  • 100 cGy at mid-sep / field / fraction
  • Twice a day, 6 hrs apart over 3 day

 

Diagram to show BCCA Technique:

 

Disadvantages - Sweeping Co head
Advantages - Custom lung compensators

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