Whole body irradiation

Whole-body irradiation is part of the overall interdisciplinary treatment of primarily haemato-oncological diseases (ALL, AML, CML, MDS). It is an important part of myeloablative high-dose radio-chemotherapy (conditioning) with subsequent transplantation of haematopoietic stem cells (HSCT), bone marrow stem cells or peripheral blood progenitor stem cells.
The entire body is irradiated in order to irreversibly destroy the malignant cells, suppress the body's own defence cells and thus prevent rejection of the foreign bone marrow. This can significantly increase the success of a stem cell transplant. This whole-body irradiation is carried out in collaboration with colleagues from haemato-oncology and nuclear medicine.

Fig.1: The linear accelerator rotated by 180°.

For whole-body irradiation, the gantry is rotated by 180° so that the irradiation opening is orientated towards the ceiling (Figure 1). The whole-body treatment room is located one floor higher, directly above the linear accelerator (Figure 2). With this method, the distance between the radiation source and the radiation field is large enough so that the field size covers the patient's entire body due to the radiation divergence. The treatment itself takes about 30 minutes.

Fig.2: A schematic representation of whole-body irradiation in radiotherapy at Ulm University Hospital.


In the whole-body treatment room there is a special couch on which the patient is treated. Depending on the disease, dose concepts are created and vary between 2-12 Gy total dose. A dose of 2 Gy per fraction is applied per treatment, which is divided into 1 Gy in the prone position and 1 Gy in the supine position. If a high radiation dose is applied, lead lung blocks are cast individually for each patient and positioned accordingly to protect the lungs. To ensure the exact positioning of the blocks, control images of the lungs are taken and assessed by a specialist. Precise positioning of the patient is crucial for the treatment, which is why continuous monitoring by our radiotherapy team takes place during the entire procedure. At Ulm University Hospital, 30-40 patients are irradiated using this technique every year.