Total body irradiation (TBI) before bone marrow transplantation in leukaemia: a co-operative study from the European Group for Bone Marrow Transplantation.

A survey was carried out of 15 centres in Europe giving total body irradiation before bone marrow transplantation to determine modalities of treatment. Linear accelerators and cobalt machines were used to deliver doses of 750 to 1050 cGy in single fractions at dose rates ranging from 2.5 to 35 cGy min-1. The incidence of interstitial pneumonitis was not affected by quality of radiation but for total lung doses of more than 800 cGy incidence correlated with dose rate. Many centres chose to limit lung doses to 800 cGy. Overall treatment time (including interruptions) was less important than the actual dose rate during treatment. Nausea and vomiting occurred when doses of 300 cGy had been delivered, so that time of onset varied with dose rate. Sedation appeared as successful as specific anti-emetics in controlling this.