PROSPECTIVE-STUDY OF THE CLINICAL SYMPTOMS OF THERAPEUTIC WHOLE-BODY IRRADIATION

Thirty-one selected patients with various haematological malignancies who received a 10 Gy-4 h total body irradiation (TBI) at the Institut Gustave Roussy 24 h before high dose cyclophosphamide for bone marrow transplantation, were prospectively evaluated for gastrointestinal sym ptoms, body temperature, consciousness, headache, xerostomia, parotidi tis, ocular symptoms, blood pressure, and respiratory and cutaneous si gns for 24 h. In spite of prophylactic administration of various anti- emetic agents, 90% of the patients experienced nausea and 80% experien ced vomiting. An almost constant body temperature peak-up to 40.8-degr ees-C-was registered 6 h after the start of irradiation. No drowsiness was reported since the introduction of the new anti-emetic agent Onda nsetron. Nearly half the patients (42%) complained of headache. The pr oportion of patients experiencing early (during TBI) xerostomia was 61 %. 74% of patients complained of parotiditis in the first 24 b. Althou gh this low dose rate whole body irradiation is not likely to be exact ly replicated in many accidental human exposures, the incidence rate a nd the time-course of the observed prodromal phase symptoms may prove helpful for early triage in the case of accidental irradiation.