ABSORBED DOSES IN THE HEAD AND ORAL CAVITY DURING TOTAL-BODY IRRADIATION

Conditioning before bone marrow transplantation (BMT) with total body irradiation (TBI) and cyclophosphamide carries the risk of severe long -term complications. The aim of the present study was to determine abs orbed doses in the craniofacial area during TBI, using thermoluminesce nt dosimeters for both in vivo techniques and phantom measurements. Th e results from the phantom study showed that the mean deviation from t he reference dose varied between -5.1 and +11.1%. The superficial part of left parotid gland received 11.1+/-1.5% more radiation compared wi th the reference. In patients, deviations from the reference dose vari ed in individual patients between -22.4 and +20.1% in various intra-or al sites. Since a small increase in dose can result in a significantly increased risk of pathology, the observed dose inhomogeneities for st ructures receiving tangentially directed radiation therapy, such as th e parotid glands, may contribute to salivary dysfunction after TBI. (C ) 1998 Elsevier Science Ltd. All rights reserved.