Radiotherapy for acute lymphoblastic leukaemia

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
About radiotherapy for ALL
Radiotherapy side effects
More information about radiotherapy

Radiotherapy for acute lymphoblastic leukaemia

Radiotherapy uses high energy rays to treat cancer. Chemotherapy is the main treatment for ALL but, if the leukaemia has spread to your brain you may have radiotherapy to kill the leukaemic cells there. Even if they haven’t found leukaemia cells there, your specialist may suggest radiotherapy to your brain and spinal cord to kill off any leukaemic cells that may be present but don't show up on tests. This type of preventative treatment is called prophylactic treatment.

Intensive treatment

You may have radiotherapy as part of intensive treatment – such as a bone marrow transplant. You have radiotherapy to your whole body (total body irradiation or TBI). The radiotherapy kills off all your bone marrow, including the leukaemia cells. You then have donor marrow or your own marrow given back through your drip. You may have the radiotherapy as a single treatment or twice a day for 3 or 4 days.

ALL radiotherapy side effects

Whole body radiotherapy and treatment to the brain and spine most often cause sickness and tiredness. TBI can also have long term effects. You should not sunbathe for several months after treatment. Talk to your specialist about the exact precautions you should take. There is a risk of the lens of your eye clouding over (cataract) many years later. This can be easily treated with surgery.

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Radiotherapy uses high energy waves to treat cancer. You may have radiotherapy

To treat the brain and spinal cord
To kill off any leukaemia cells that may be in the CNS
As part of intensive treatment

Radiotherapy to treat the brain and spinal cord

Chemotherapy is the main treatment for ALL but, if the leukaemia has spread to your brain you may have radiotherapy to kill the leukaemic cells there. You have a lumbar puncture when you are diagnosed, to check for cancer cells in the fluid around your brain and spinal cord (cerebrospinal fluid). The brain and spinal cord form the central nervous system, which doctors often refer to as the CNS.

Killing off any leukaemia cells that may be in the CNS

Chemotherapy into a vein may not kill leukaemia cells in the brain and spinal cord (central nervous system). Most chemotherapy drugs cannot cross from the bloodstream into the central nervous system. Even if they haven’t found leukaemia cells in your lumbar puncture, your specialist may suggest that you have radiotherapy to your brain and spinal cord. This is to be on the safe side and kill off any cells that may still be present. This type of preventative treatment is called prophylactic treatment.

Intensive treatment

You may have radiotherapy as part of intensive treatment - a bone marrow transplant. You have radiotherapy to your whole body. This is known as whole body irradiation or total body irradiation (TBI). The radiotherapy kills off all your bone marrow, including the leukaemia cells. You then have donor marrow or your own marrow given back through your drip. You may have TBI as a single treatment or twice a day for 3 or 4 days.

These depend on the part of the body being treated. Both TBI and radiotherapy to the brain and spine most often cause

Sickness
Tiredness

Radiotherapy also causes hair loss. But you will have already lost your hair from your chemotherapy.

TBI can have long term effects. You should not sunbathe for several months after treatment. Talk to your specialist about the exact precautions you should take.

You may develop sight problems many years after the treatment. The lens inside your eye can cloud over and you can’t see very well. This is called a cataract. To try to prevent it, the radiographer may shield your eyes during the total body irradiation. Cataracts are fairly easy to treat with simple surgery. Doctors take out the clouded lens and put a false one in its place.

The radiotherapy section tells you more about this type of treatment, including