WHAT IS RADIATION?
Radiation Therapy is used to treat many different cancers and medical conditions. Radiation Therapy uses high energy x-rays, similar to the radiation used for taking x-ray images. These high energy x-rays are produced by a machine called a linear accelerator (linac), which uses electricity to create the radiation. Since the radiation is electrically produced, patients will not be radioactive after treatment. Mycosis fungoides is often treated with a specialized type of radiation that delivers the treatment directly to the skin to avoid going deeper into the body.
TREATMENT OPTIONS
Spot treatments are used for patients with Mycosis Fungoides whose disease is only in certain areas of the body, rather than those with disease over the entire body. The treatment machine (linac) has the ability to treat in the exact shape of the affected skin, which avoids treating the surrounding skin that is disease-free.
Total Skin Electron Irradiation (TSEI) is a type of radiation treatment delivery for patients with Mycosis Fungoides that has affected the skin over the entire body. In TSEI, the whole body is treated with radiation. To do this, patients are placed in specific positions to make sure the radiation reaches all areas of the body.
SPOTÂ TREATMENTS
TREATMENT
Spot treatments only deliver radiation to the area affected by mycosis fungoides. Â Therapists are able to control where the radiation is being delivered by creating metal blocks that are made specifically for each individual patient. The custom blocks are able to stop radiation from reaching any areas outside of what needs to be treated. The custom blocking is attached to the linear accelerator and does not touch the patient. The number of treatments a patient receives will depend on the stage of disease and the doctor's preferences.
DAILY SET UP
Patients will be positioned the same way for each treatment and receive the same amount of radiation at each treatment. The patient will lie down on the treatment table and the therapists will position the patient in a way that isolates the treatment area, so that other parts of the body won't receive radiation. Once the patient is set up perfectly, the therapists will step out of the room and deliver the radiation treatment.
TOTAL SKIN ELECTRON IRRADIATION
TREATMENT
TSEI treatments are used to treat patients with extensive disease spread over most/all of the patient's body.  A linear accelerator is used to deliver electrons to the patient's entire body.  During treatment patients will stand on a treatment box.  The treatment box ensures that the radiation can reach all parts of the body where disease is present.
DAILY SET UP
During treatment patients will be asked to hold different positions while standing in a treatment box. The treatment positions are described on the websites Preparation page. The linear accelerator is angled toward the patient and will rotate to multiple positions to ensure that the patient's entire body is covered.
BOOST TREATMENT
If you are getting TSEI treatments you may also receive a "Boost" treatment. These treatments are designed to deliver radiation to areas that may not have gotten proper radiation dose from TSEI treatment. Boost treatments can be given before or after TSEI treatments depending on doctor preference.
References
Hoppe, R. T., Harrison, C., Tavallaee, M., Bashey, S., Sundram, U., Li, S., Million, L., Dabaja, B., Gangar, P., Duvic, M., & Kim, Y. H. (2015). Low-dose total skin electron beam therapy as an effective modality to reduce disease burden in patients with mycosis fungoides: results of a pooled analysis from 3 phase-II clinical trials. Journal of the American Academy of Dermatology, 72(2), 286–292.
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Nabavizadeh, N. (2020, January 15). Personal Interview.
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Neelis, K. J., Schimmel, E. C., Vermeer, M. H., Senff, N. J., Willemze, R., & Noordijk, E. M. (2009). Low-dose palliative radiotherapy for cutaneous B- and T-cell lymphomas. International journal of radiation oncology, biology, physics, 74(1), 154–158.
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