What Is Total Marrow and Lymphoid Irradiation - How It Works - video Dailymotion

Kauvery Hospital

Total Marrow and Lymphoid Irradiation என்றால் என்ன? இது எப்படி செயல்படுகிறது?  What is TMLI?  Total Marrow Lymphoid Irradiation (TMLI) is an advanced radiation therapy that targets the marrow and lymphoid tissues, often used before bone marrow transplantation. It offers precise radiation, sparing healthy tissues — a major step forward compared to earlier total body radiation methods.  Discover the latest in precision cancer care with Dr. A. N. Vaidhyswaran, one of the Best Oncologists in Chennai, Kauvery Hospital, the best cancer hospital in the city, as he shares expert insights on advanced radiation treatment – Total Marrow & Lymphoid Irradiation.

Transcript

00:00I am Dr. Ian Vaidisharan, Director and Senior Consultant in Oncology, Kaveri Cancer Institute, Kaveri Hospitals, Alwarpet Chennai.

00:09We are proud to tell you that we have started BMT programs in our hospital.

00:15Today, I am going to talk to you about Total Marrow and Lymphoid Radiation, TMLI,

00:21which is a new concept of treatment of radiating the marrow and the lymphoid tissue to abelate the cells in these areas.

00:30When do we do TMLI?

00:32TMLIs or Total Marrow and Lymphoid Radiations are done for refractory AMLs,

00:39people who undergo bone marrow transplantations or BMT.

00:42Now, before telling about TMLI, I would like to state that previously we were doing Total Body Radiation,

00:50the Total Body Radiation disadvantage for this technique is that we are radiating the entire body,

00:56including the structures, that is normal structures.

00:59In TMLI, which is Total Marrow and Lymphoid Radiation,

01:04not only we radiate the marrow and the lymphoid tissue,

01:07we are able to selectively spare the normal structures in the body,

01:13namely the lung, the heart, the oral cavity, the kidneys, etc.

01:19So, when you are selectively trying to radiate only the marrow and the lymphoid tissue,

01:25you have a better tolerance for the radiation and a better abelation of the marrow.

01:30This is a part of the program of the BMT because in a BMT,

01:35we have to abelate the marrow that the bad cells which are in the marrow have to be totally destroyed

01:40and the new cells are incorporated into the system or infused into the system of the patient

01:45by an allogenic blood collected from a donor and re-infused into the body of the patient

01:51or into the marrow of the patient.

01:53So, new cells are formed during the next process

01:56when totally the entire marrow has been destroyed with all the bad cells.

01:59How do you go about this process?

02:01It's a very cumbersome process.

02:02It's a very time-consuming process which I will tell you.

02:04Patient is selected according to the nature or discussed with the medical oncologist

02:10or the hematologist and hemato-oncologist and the radiation oncologist.

02:14The patient selection is being done.

02:16Patients with refractory abelial who want to have a bone marrow transplant

02:19as a second line of treatment are selected.

02:22Patient lies down in this kind of a special backlog.

02:25It's called a whole body backlog.

02:26It's totally different from the regular backlog.

02:28That is the leg of the patient.

02:30The entire body is immobilized and also the head is immobilized.

02:32So, the process is the entire body of the patient is totally immobilized

02:36during the process of this treatment.

02:39Why?

02:40Because when there is a movement, you may miss it.

02:42Areas of the marrow and the lymphoid tissue

02:44because you're selectively treating a small structure

02:46in the marrow as well as lymphoid tissue.

02:49Now, looking at this, we do a CT scan, entire CT scan of the body.

02:53And after doing the CT scan, we draw the critical structures.

02:58What will be the structures?

02:59The marrow and the lymphoid tissue has to be drawn.

03:02Not only that, we have to draw all the organs, namely the heart,

03:06the brain, the lung, the kidneys, the stomach, liver, spleen, everything is drawn.

03:12So, the idea of the whole technology is to radiate selectively the entire marrow,

03:20destroying the marrow and the lymphoid tissue.

03:22We deliver it twice a day for five days, something like 1500 centigrade.

03:28We deliver over a period of 10 fractions.

03:30This is the idea of the treatment.

03:33And during the process of every treatment,

03:35we will check or verify the entire body.

03:39You can't treat the entire body in one stretch.

03:41So, we have to divide the body into various sections.

03:45So, we have about five to six sections of body being divided.

03:49And each section, the arc or the machine rolls down and treats the patient.

03:53Before treating the patient, the verification is done and the matching is done so that

03:58the precision of first field and the second field is absolutely matched.

04:02Otherwise, you may get an overdose.

04:04This is the distribution of the patient where this color represents all the area to be radiated.

04:11This is the anteroposter view and this is the lateral view.

04:14Treating the entire marrow and the lymphoid tissue.

04:16This is how the patient is being positioned and the machine rolls down 360 degrees to treat

04:22the entire patient.

04:23As I was telling you, we have divided the patient into various sections.

04:26First section, second section, third section, fourth section, fifth and sixth section.

04:30So, six divisions have been done for the entire patient.

04:33And each division or each portion is matched with the other.

04:37So, that exact matching takes place and overdose doesn't take place.

04:40This is how the rotation goes on.

04:41So, the entire treatment takes about nearly one to one and a half hours is the total duration

04:47of one treatment.

04:48So, looking at it, morning one and a half hours to two hours and evening one and a half hours

04:52to two hours depending on the situation.

04:54So, patient is lying down in this couch.

04:56The machine is totally immobilized.

04:59Machine rolls for a 360 degrees angle, goes to the entire treatment from the head to the foot.

05:05That is the concept of total lymphoid and marrow radiation.

05:08Very tolerable to the patient, very encouraging results with BMT, especially refractory ALS.

05:14We have started this program and we are proud to say that we will be in the future, we will

05:18be having a large amount of patients being treated with TMLIs.

What Is Total Marrow and Lymphoid Irradiation - How It Works

Category

Transcript

Be the first to comment

Recommended