Total body radiation (also known as total body irradiation, or TBI) is sometimes given prior to stem cell transplantation. There are numerous protocols, each with a different treatment schedule. Two examples are:

• 200 cGy given twice a day for three days
• 120 cGy given three times a day for four days

Prior to treatment, the child will be weighed and measured by the radiation therapist. The therapist will give the family a tour and show them the two machines that will be on either side of the stretcher in the middle of the room. Different institutions use different techniques to deliver TBI, so during the tour, the position of the child and how long each session will last will be explained.

On the first day of treatment, the child will be brought to the room (at some institutions, small children ride a tricycle or are pulled in a wagon) and may choose to watch TV or a movie, or listen to music. The therapist will remove all metal from the child’s body and clothing—watches, rings, zippers, clamps. Anything with tight elastic, such as diapers or tight socks, will also be loosened or removed. The child or teen will lie on the stretcher, and the therapist will position her. Anti-nausea drugs are given to prevent vomiting, and these often make children drowsy enough to doze through the treatment. Some young or very active children will need to be sedated.

The radiation was easy. When I wasn’t sleeping, I watched TV or listened to the radio. I threw up once, but they gave me Benadryl® and I never was sick again from the radiation. The room was neat; it was painted lots of bright colors and had two big blue machines, one on each side of me.