Radiotherapy for acute lymphoblastic leukaemia | Cancer Research UK
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Radiotherapy for acute lymphoblastic leukaemia

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This page tells you about radiotherapy for acute lymphoblastic leukaemia (ALL). You can find information about

 

A quick guide to what's on this page

Radiotherapy uses high energy rays to treat cancer. For acute lymphoblastic leukaemia (ALL), doctors might use radiotherapy to treat leukaemia that has spread to the brain or spinal cord or to prevent it from spreading. Or they may recommend radiotherapy to the whole body (total body irradiation) as part of a stem cell transplant or bone marrow transplant

Radiotherapy to the brain or spinal cord

For radiotherapy to the brain you have a mask made to keep you completely still. For treatment to the spinal cord you may not need a mask. 

You have a CT scan to plan your treatment. To have the treatment you lie on a radiotherapy couch. You might move through the radiotherapy machine or it may rotate around your body. Once you are in the right position the staff leave you alone in the room for a few minutes or longer. They watch you carefully on a closed circuit television screen.

Radiotherapy as part of a transplant

You have radiotherapy to your whole body (total body irradiation – TBI) to kill off all your bone marrow, including the leukaemia cells. You might have TBI twice a day for 3 or 4 days, or as a single treatment. 

For the planning and treatments you lie on a couch or stand in a specially designed frame. You have treatment for up to 15 minutes on both sides of your body. Once the treatment has ended you have donor bone marrow or stem cells (or your own stem cells) into your bloodstream through a drip.

ALL radiotherapy side effects

The side effects depend on the part of the body being treated. Both TBI and treatment to the brain and spinal cord most often cause sickness and tiredness. They also cause hair loss. Radiotherapy makes the treated area of skin more sensitive, so protect any exposed skin from the sun for a few months.

TBI can also cause diarrhoea, a sore mouth, and an increased risk of infection. You will need to be in hospital for some time after this treatment. You might develop clouding of the lens of the eyes (cataract) some years afterwards. This can be treated with surgery to take out the clouded lens and put in a false one.

 

CR PDF Icon You can view and print the quick guides for all the pages in the treating ALL section.

 

 

About radiotherapy for ALL

Radiotherapy uses high energy rays to treat cancer. For ALL, doctors sometimes use radiotherapy to treat leukaemia that has spread to the central nervous system (CNS) or has a high chance of doing so. The CNS includes the brain and spinal cord. 

As part of a stem cell or bone marrow transplant, you might have radiotherapy to the whole body (total body irradiation). This is called intensive treatment.

 

Planning radiotherapy

Before you begin your treatment, the radiotherapy team carefully plans your radiotherapy. This means working out how much radiation you need and exactly where you need it. Your planning appointment might take from 15 minutes up to a couple of hours. You have a planning CT scan. 

CT scanner

 

Making a mask

If you are having radiotherapy to the brain you have a mask made before the planning scan. The mask is sometimes called a shell or mould. It covers the whole of your face and the front of your head. 

The mask keeps your head completely still while you have treatment. You can see through it. Any marks that the radiographers need to line up the radiotherapy machine can be made on the mask.

Here is a picture of a treatment mask.

Photograph of a radiotherapy mask

If you have treatment to the spinal cord you might not need to have a mask made.

 

Having treatment to the brain or spinal cord

To have the treatment you lie on a radiotherapy couch. The radiographers put your mask in place. 

Radiotherapy machines are very big and may make you feel nervous when you see them for the first time. 

The machine might be fixed in one position so that you move through it or it may be able to rotate around your body to give treatment from different directions. Before your first treatment your radiographers will explain what you will see and hear.

In some departments the treatment rooms have docks for you to plug in music players. So you can listen to your own music while you have treatment.

A photo of a linear accelerator, which gives radiotherapy

You can't feel radiotherapy when you actually have the treatment. It usually takes just a few minutes. Your position is very important, so the radiographers may take a little while to get you ready.

Once you are in the right position the staff leave you alone in the room. This is so they are not exposed to the radiation. You will be alone for around 10 minutes. The radiographers watch you carefully on a closed circuit television screen.

 

Radiotherapy during a transplant

You might have radiotherapy as part of a stem cell or bone marrow transplant. In this case you have radiotherapy to your whole body. This is called whole body irradiation (WBI) or total body irradiation (TBI). The radiotherapy kills off all your bone marrow, including the leukaemia cells. You might have TBI twice a day for 3 or 4 days, or as a single treatment. 

First you have a planning session of about 90 minutes to create the treatment plan. You lie on a hard couch or stand supported by a specially designed frame.

The radiographers measure the thickness of various parts of your body. They make sure the treatment couch or frame is in exactly the right position. During this session you have a very small dose of radiotherapy aimed at your body from a machine next to the treatment couch or frame. You have half your body treated for 10 to 15 minutes. Then you turn and have the other half treated.

For the treatment sessions the radiographers help you to lie or stand in the correct position. This may take up to half an hour. Then you have treatment for 10 to 15 minutes on both sides of your body.

Once the treatment has ended you have donor stem cells or bone marrow (or your own stem cells) into your bloodstream through a drip. This happens on the ward.

 

Radiotherapy side effects

The side effects of radiotherapy depend on the part of the body being treated. Both TBI and treatment to the brain and spine most often cause sickness and tiredness. It also causes hair loss. But you might have already lost your hair from your chemotherapy. 

You shouldn't sunbathe for several months after the treatment because radiotherapy makes the treated area of skin more sensitive to the sun. Talk to your radiographers about protecting your skin in the sun.

TBI can also cause diarrhoea, a sore mouth, and an increased risk of infection. You will need to be in hospital for some time after this treatment. 

You might develop eyesight problems many years after the treatment. The lens inside your eye can cloud over so that you can’t see very well. This is called a cataract. To try to prevent it, your doctor will shield your eyes during the total body irradiation. If you do get cataracts, they can be treated with simple surgery. Doctors take out the clouded lens and put a false one in its place.

 

More information about radiotherapy

Find out about

TBI (Total Body Irradiation)

External radiotherapy

Planning external radiotherapy

Radiotherapy moulds and masks

Bone marrow transplants for ALL

For general information and support

Contact the Cancer Research UK nurses on freephone 0808 800 4040 (open 9am to 5pm, Monday to Friday)

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Updated: 4 May 2016