Influence of radiation dose rate and lung dose on interstitial pneumonitis after fractionated total body irradiation: Acute parotitis may predict interstitial pneumonitis
Influence of radiation dose rate and lung dose on interstitial pneumonitis after fractionated total body irradiation: Acute parotitis may predict interstitial pneumonitis
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DOI：
10.1532/ijh97.05046
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发表时间：
2006-01-01
影响因子：
2.1
通讯作者：
Hiraoka, M
中科院分区：
文献类型：
--
作者：
Oya, N;Sasai, K;Hiraoka, M
本研究评估了准备同种异体骨髓移植（BMT）时分次全身照射（TBI）的剂量率和肺部剂量对患者随后发生间质性肺炎（IP）的影响。我们研究所的 66 名患者接受了 TBI 治疗，随后接受了 BMT。所有患者在3天内接受了总TBI剂量12 Gy，分6次给予，根据辐射剂量率和肺部剂量分为3组：A组，肺部剂量8 Gy（n = 18）； B 组，肺剂量为 12 Gy，8 cGy/min (n = 25)； C 组，肺部剂量为 12 Gy，剂量为 19 cGy/min (n = 23)。结合未来IP的各种潜在指标评估总生存率、累积复发率和IP累积发生率。A组患者与B组和C组合并的生存率和复发率没有显着差异。13名患者发生了临床显着的IP。发生急性腮腺炎的患者中，IP 的累积发生率显着较高，表现为血清淀粉酶水平升高或 1 至 2 级腮腺疼痛。A、B 和 C 组之间的 IP 发生率没有差异。8 Gy（有肺屏蔽）和 12 Gy（无肺屏蔽）的肺剂量值以及 8 cGy/min 和 19 cGy/min 的剂量率值之间，IP 发生率没有显着差异。当 TBI 分 6 次给予时最少。 TBI 期间或之后出现急性腮腺炎可能是 IP 的预测因素。
This study evaluated patients for the influence of the dose rate and lung dose of fractionated total body irradiation (TBI) in preparation for allogeneic bone marrow transplantation (BMT) on the subsequent development of interstitial pneumonitis (IP). Sixty-six patients at our institute were treated with TBI followed by BMT. All of the patients received a total TBI dose of 12 Gy given in 6 fractions over 3 days and were divided into 3 groups according to the radiation dose rate and lung dose: group A, lung dose of 8 Gy (n = 18); group B, lung dose of 12 Gy at 8 cGy/min (n = 25); and group C, lung dose of 12 Gy at 19 cGy/min (n = 23). The overall survival rate, the cumulative incidence of relapse, and the cumulative incidence of IP were evaluated in relation to various potential indicators of future IP There were no significant differences in survival and relapse rates between patient group A and combined groups B and C. Clinically significant IP occurred in 13 patients. The cumulative incidence of IP was significantly higher in patients who developed acute parotitis as indicated by either an elevation in the serum amylase level or parotid pain of grade 1 to 2. There was no difference in IP incidence among groups A, B, and C. There was no significant difference in IP incidence between lung dose values of 8 Gy (with lung shielding) and 12 Gy (without lung shielding) and between dose rate values of 8 cGy/min and 19 cGy/min, at least when TBI was given in 6 fractions. The presence of acute parotitis during or just after TBI may be a predictor of IP.