This document discusses hemi body irradiation (HBI) technique used to treat metastatic cancer. HBI involves irradiating only the upper or lower half of the body using parallel opposed radiation fields. It has advantages over total body irradiation like smaller field size and less side effects. HBI is used to palliate widely metastatic disease and as adjuvant therapy for certain cancers. Potential complications include nausea, diarrhea, pneumonitis and hematological effects. The document also provides an overview of cancer registries in India, which systematically collect cancer data to help understand cancer patterns and guide control programs. Population-based and hospital-based registries use active and passive methods to collect data on cancer incidence, stages and survival.

1. HEMI BODY IRRADIATION
&
TUMOR REGISTRY
Dr. Taruni Bhattacharya
D.N.B. Resident

2. Difference with TBI
• Field size needed is smaller.
• Less side effects
• Stem cell support not needed
• Different therapeutic goal.

3. AIM
• To give a sufficiently high dose to alleviate
effects of symptomatic diseases & at the same
time,maintaining a sufficiently low dose to
minimize complications.
• Delay progression of existing asymptomatic
mets & clinical development of new mets

4. CLINICAL INDICATION
1) Palliation of widely disseminated metastatic
disease
2) Adjuvant therapy for Ewing’s Sarcoma &
Brochogenic Ca
3) Lower Hemi Body Irradiation for ovarian
ablation in Metastatic Breast Cancer.

5. TECHNIQUE
• Bottom of L4 separates upper & lower HBI
• A/P parallel opposed fields used
• Patient positioned with vertical beam
allowing coverage of hemibody
• Shielding of previously irradiated areas to
reduce toxicity(salivary glands,lungs)
• Dose prescribed to mid-plane of the patient
at the central axis of the beam.

8. DOSE
• 6Gy:upper HBI
• 8Gy:lower HBI and Middle HBI
• For treating the other half of the body
wait for 6-8 weeks apert to allow a sufficient
recovery of blood cells & irradiated marrow.
• Planned sequential upper and lower HBI 6-8
wks apart,used to treat multiple
myeloma,malignant lymphoma.

9. COMPLICATIONS
• M/C S/E: nausea and vomiting(when abdomen is
included within fields)
Occur shortly after radiation admin & last a few
hours.
Rx:Premedication with steroids & antiemetics.
• Intestines:diarrohea occurs when significant volume
is irradiated.It’s severity can be limited by limiting
dose to 6Gy
• Hematological recovery:within 4-6 wks usually

10. • Lungs: HBI can cause interstitial pneumonitis,
with cough and breathlessness at around 6
weeks, although this may be delayed by up to
6 months
R/o pneumonitis is less with single fraction
dose 7Gy
For 8Gy Upper body TBI use lung blocks.
• Reversible alopecia, dry mouth, parotid
swelling, stomatitis and fatigue are other s/e
seen.

15. CANCER REGISTRY
• CANCER registration is the process of
systematically and continuously collecting
information on malignant neoplasm.
• Broadly, there are two types of cancer
registries:
1.Hospital
2.population based

17. National Cancer Registry Programme
Commenced by ICMR with a network of cancer
registries across the country in December 1981.
Started with three PBCR -Bangalore, Chennai and
Mumbai and three HBCR -Chandigarh, Dibrugarh
and Thiruvananthapuram
Now there are 28 PBCR and 7 HBCR sites in India

18. USES
• Resource of information for clinicians,
researchers, scientists, policy makers,and the
public
• Identifying High-Risk Groups
• Increasing Screening in underserved areas
• Investigating possible cancer causes
• Evaluating patterns of clinical care

20. Objectives of this programme
• To generate reliable data on magnitude and
patterns of cancer
• Undertake epidemiological studies based on results
of registry data
• Help in designing, planning, monitoring and
evaluation of cancer control activities under the
National Cancer Control Programme (NCCP)
• Develop training programmes in cancer registration
and epidemiology

21. Cancer registration in India is active and voluntary
– Active method: The workers from registry,
scan through the patient records in different
hospitals, clarify incomplete or contradictory
information, and abstract data with collection of data
from hospital record interviews of patients.
– Passive method: The hospitals in areas with
compulsory notification and the hospital
cancer registries, abstract the information
from the patient records on a specified
proforma and send it to the registry.

22. POPULATION BASED CANCER
REGISTRY
Data collection by-
1.Facilities
2.Clinicians and pathologists
3.Death certificates

23. Hospital Based Cancer Registries
• The primary purpose -to contribute to patient care by
providing readily accessible information on the patients
• Data - used for clinical research and for epidemiological
purposes
• Within the hospital: a registry is maintained which is an
integral part of the hospital ’s cancer programme or
health care delivery system
• HBCR have no denominator of population at risk .
Incidence rate cannot be derived from such data.
However, cancer extent,stages,therapy and
survival rate information are more reliable on such
data

24. THANK YOU