Current practice in total-body irradiation: results of a Canada-wide survey.

BACKGROUND: Total-body irradiation (tbi) is used to condition patients before bone marrow transplant. A variety of tbi treatment strategies have been described and implemented, but no consensus on best practice has been reached. We report on the results of a survey created to assess the current state of tbi delivery in Canada. RESULTS: A 19-question survey was distributed to 49 radiation oncology programs in Canada. Responses were received from 20 centres, including 12 centres that perform tbi. A variety of tbi dose prescriptions was reported, although 12 Gy in 6 fractions was used in 11 of the 12 centres performing tbi. Half of the centres also reported using a dose prescription unique to their facility. Most centres use an extended-distance parallel-opposed-pair technique, with the patient standing or lying on a stretcher against a wall. Others translate the patient under the beam, sweep the beam over the patient, or use a more complicated multi-field technique. All but 1 centre indicated that they attenuate the lung dose; only 3 centres indicated attenuating the dose for other organs at risk. The survey also highlighted the considerable resources used for tbi, including extra staff, prolonged planning and treatment times, and use of locally developed hardware or software. CONCLUSIONS: At transplant centres, tbi is commonly used, but there is no commonly accepted approach to planning and treatment delivery. The important discrepancies in practice between centres in Canada creates an opportunity to prompt more discussion and collaboration between centres, improving consistency and uniformity of practice.

Methodology for examining polarized light interactions with tissues and tissuelike media in the exact backscattering direction.

The properties of polarized light emerging from turbid media in the exact backscattering direction are studied by modulating the incident light polarization state and isolating the synchronous signal with lock-in amplifier detection. The results are reported for polystyrene microsphere suspensions in distilled water, with and without glucose, and for both ex vivo and in vivo biological tissues. A new theoretical formulation based on Mueller calculus is developed to describe the observed behavior of the backscattered light in terms of two sample parameters: optical rotation and depolarization. This technique proved successful in modeling both phantom and tissue samples. Results showed the presence of a significant surviving polarization fraction in the backscattering direction even in extremely dense optical phantom media, an important finding that has not been observed at other detection angles. Substantial polarized light preservation in biological tissue samples is also demonstrated for this detection geometry. This illustrates the potential of using polarized light to investigate turbid biological materials in vivo in retroreflection geometry.