- 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)
- Short SSD (skin to source distance)
- Extended SSD (skin to source distance)
- 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: