Preparation

TBI is usually preceded by high-dose cyclophosphamide given 48-72 hours before treatment. Experimental results suggest the possible benefit of giving cyclophosphamide after TBI as used in the Memorial Sloan Kettering protocol. Other combinations of chemotherapy may also be used before TBI.

Anti-emetics, including a 5HT antagonist, are given with dexa-methasone, intravenously, 1 hour before treatment starts. If additional sedation is required phenobarbitone or diazepam may be used. For very young children, anaesthesia with ketamine may be necessary.

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