Name of the Procedure:

Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)

Summary

This procedure involves various forms of radiation therapy that target specific areas or the whole body. It is commonly used in the treatment and management of cancer. Techniques can vary from irradiating the entire body to targeting specific regions or cavities within the body.

Purpose

Radiation therapy aims to destroy cancer cells, shrink tumors, or prepare the body for other treatments like bone marrow transplants. The goal is either curative, to eliminate the cancer, or palliative, to relieve symptoms and improve quality of life.

Indications

• Malignant tumors and cancer treatment
• Preparation for stem cell or bone marrow transplant
• Relieving pain or symptoms caused by cancer

Specific patient criteria include:

• Diagnosis of a condition that responds well to radiation
• Overall health allowing for radiation exposure
• Absence of certain contraindications like pregnancy

Preparation

• Fasting may be required before certain irradiation types.
• Discontinuing certain medications as advised by the doctor.
• Diagnostic tests such as imaging scans or blood tests to assess health status.
• Consultation with a radiation oncologist.

Procedure Description

1. Planning: Detailed imaging scans to plan the radiation fields.
2. Positioning: Patient is positioned on a treatment table; precise positioning is crucial.
3. Radiation Delivery: High-energy radiation is directed at the targeted area:
   • Total Body Irradiation: Treats the entire body, often in fractions.
   • Hemibody Radiation: Targets either the upper or lower half of the body.
   • Per Oral/Endocavitary Irradiation: Radiation is delivered to cavities within the body, such as the mouth or rectum.

Tools include linear accelerators and specialized radiation machines. Procedures may involve the use of anesthesia or sedation.

Duration

The time for these procedures varies:

• Total body irradiation can take several hours over several sessions.
• Hemibody and local irradiation sessions typically are shorter, around 10-30 minutes.

Setting

Performed in:

• Hospitals
• Specialized cancer treatment centers
• Outpatient radiation therapy clinics

Personnel

• Radiation oncologists
• Medical physicists
• Radiation therapists
• Nurses
• Anesthesiologists (if sedation is needed)

Risks and Complications

Common risks:

• Skin irritation or burns
• Fatigue
• Nausea

Rare complications:

• Damage to surrounding healthy tissues
• Long-term side effects, including secondary cancers
• Organ-specific risks depending on the targeted area

Benefits

• Reduction or elimination of tumors
• Relief from cancer-related symptoms
• Improved outcomes for bone marrow or stem cell transplants

Benefits may be realized within weeks to months, depending on the response to treatment.

Recovery

• Follow-up appointments to monitor progress.
• Instructions for skin care and managing side effects.
• Gradual return to daily activities, depending on individual recovery.

Alternatives

• Chemotherapy
• Surgical options
• Targeted therapy and immunotherapy

Each alternative has its pros and cons compared to radiation therapy, such as different side effect profiles and effectiveness based on cancer type.

Patient Experience

Patients might experience:

• Mild discomfort during positioning
• Varying degrees of fatigue post-procedure
• Pain management strategies will be provided, and support for managing symptoms.

Comfort measures include:

• Warm blankets
• Music or relaxation techniques during procedures
• Support from care teams throughout the process.