Objective To investigate the safety and clinical outcome of total body irradiation (TBI) and the real-time in vivo dosimetry with semiconductor dosimeter in hematogenous stem cell transplantation (HSCT). Methods Fifty-seven patients requiring HSCT were treated with TBI. The TBI was given with the semi-sitting or standing position or lateralcumbent posture, using 6 MV X-ray beams and opposed parallel fields technique (two or four fields, AP/PA fields) in a single fraction or multiple fractions. The real-time in vivo dosimetry was performed with six diodes positioned on the surface of patients to adjust the dose homo-geneity of the midplane using the different thickness lead sheets. Results Mild to moderate nausea, vomi-ting and swollen parotid occurred in 41 patients after TBI, which were relieved after allopathy therapy. No radiation-induced interstitial pneumonia was observed. All patients fulfilled the HSCT. The homogeneity of relative dose (normalize to umbilicus dose) in the different positions accorded with the requirement of the prescription dose. Conclusions The opposed parallel radiation, with the semi-sitting or standing positions or lateralcumbent posture, combined with the real-time in vivo dosimetry with semiconductor dosimeter is an effective and safe technique for TBI.%目的 探讨全身照射及半导体实时剂量监测方法 在造血干细胞移植中应用的安全性和临床疗效.方法 采用6 MV X线对57例需造血干细胞移植的患者行半坐立姿或侧卧式两野或四野前后平行对穿野单次或分次照射,并在照射中使用6个半导体探头对患者不同部位进行实时剂量监测,根据监测结果 采用不同厚度的铅皮调整人体中平面受照剂量的均匀性.结果 接受分次照射的41例患者疗后均有轻度和中度恶心、呕吐、腮腺肿胀等症状,但均能耐受,经对症治疗后好转,顺利完成造血干细胞的移植,无一发生间质性肺炎.实时监测也表明,患者全身照射剂量均匀性符合临床治疗要求.结论 采用半导体探测器实时剂量监测与半坐立姿或侧卧式前后平行对穿照射技术是一种安全、有效的全身照射方法 .
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