Renal dysfunction after total body irradiation: Dose-effect relationship
Renal dysfunction after total body irradiation: Dose-effect relationship
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DOI：
10.1016/j.ijrobp.2006.02.021
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发表时间：
2006-07-15
影响因子：
7
通讯作者：
Van Kempen-Harteveld, M. Loes
中科院分区：
文献类型：
--
作者：
Kal, Henk B.;Van Kempen-Harteveld, M. Loes
目的：作为造血干细胞移植调理方案的一部分，全身照射（TBI）相关的晚期并发症越来越受到关注。我们回顾并比较了各种TBI方案的治疗结果，并试图得出晚期肾功能不全的剂量效应关系。目的是找出TBI时肾脏的耐受剂量。方法和材料：在PubMed上检索报道晚期肾功能不全的文章。为了相互比较，使用线性二次模型对各种TBI方案进行归一化，并计算生物有效剂量（BEDs）。结果：11份报告描述了TBI后肾功能不全的频率。得到了肾功能不全的频率与BED的关系。对于BED bbbb16 Gy，观察到功能障碍的频率增加。结论：脑外伤肾组织的耐受性BED约为16 Gy。该BED可通过高分级TBI实现（例如，6 x 1.7 Gy或9 x 1.2 Gy，剂量率bbb50 cGy/min）。为了预防晚期肾功能障碍，BED值为> - 16gy的TBI方案（几乎所有已发表的报告都有）应在适当的肾脏屏蔽下应用。(c) 2006爱思唯尔公司
Purpose: Late complications related to total body irradiation (TBI) as part of the conditioning regimen for hematopoietic stem cell transplantation have been increasingly noted. We reviewed and compared the results of treatments with various TBI regimens and tried to derive a dose-effect relationship for the endpoint of late renal dysfunction. The aim was to find the tolerance dose for the kidney when TBI is performed.Methods and Materials: A literature search was performed using PubMed for articles reporting late renal dysfunction. For intercomparison, the various TBI regimens were normalized using the linear-quadratic model, and biologically effective doses (BEDs) were calculated.Results: Eleven reports were found describing the frequency of renal dysfunction after TBI. The frequency of renal dysfunction as a function of the BED was obtained. For BED > 16 Gy an increase in the frequency of dysfunction was observed.Conclusions: The tolerance BED for kidney tissue undergoing TBI is about 16 Gy. This BED can be realized with highly fractionated TBI (e.g., 6 x 1.7 Gy or 9 x 1.2 Gy at dose rates > 5 cGy/min). To prevent late renal dysfunction, the TBI regimens with BED values > 16 Gy (almost all found in published reports) should be applied with appropriate shielding of the kidneys. (c) 2006 Elsevier Inc.