Towards homogenization of total body irradiation practices in pediatric patients across SIOPE affiliated centers. A survey by the SIOPE radiation oncology working group
Towards homogenization of total body irradiation practices in pediatric patients across SIOPE affiliated centers. A survey by the SIOPE radiation oncology working group
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DOI：
10.1016/j.radonc.2020.10.032
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发表时间：
2021-02-01
影响因子：
5.7
通讯作者：
Janssens, Geert O.
中科院分区：
文献类型：
--
作者：
Hoeben, Bianca A. W.;Pazos, Montserrat;Janssens, Geert O.
背景和目的：为了降低复发风险，全身照射（TBI）是儿童急性白血病造血干细胞移植（HSCT）预处理方案的一部分。本研究的目的是评估临床实践TBI，如分馏，器官屏蔽和交付技术，SIOPE附属radiotherapy centers.Methods：电子调查发送到233 SIOPE附属中心，包含57个问题TBI的临床实践。调查可以回答anonymous.Results：从超过25个国家，收集了82个答复。对于TBI执行中心，40/48接受了辐照25）。大多数适应症涉及急性淋巴细胞白血病（ALL）或急性髓细胞白血病（AML）。采用4种不同的分割方案，其中12戈伊分6次应用，ALL的有效率为91%，AML为86%。28/33家ALL中心和19/21家AML中心将肺剂量降低至平均剂量8-10戈伊，相比之下，对肾脏的剂量降低较少（7/33 ALL和7/21 AML）、甲状腺（2/33 ALL和2/21 AML）、肝脏（4/33 ALL和3/21 AML）和晶状体（4/33 ALL和4/21 AML）。传统的TBI技术使用的24/29响应中心，而5/29使用先进的优化规划technology.Conclusion：在整个SIOPE，有一个高水平的均匀性，在分馏和使用肺屏蔽。关于其他危险器官的屏蔽和先进技术的实施，做法各不相同。将建立一个SIOPE放射治疗工作组，以确定儿科TBI的国际指南。(C)2020作者（S）由爱思唯尔公司出版
Background and purpose: To reduce relapse risk, Total Body Irradiation (TBI) is part of conditioning regimens for hematopoietic stem cell transplantation (HSCT) in pediatric acute leukemia. The study purpose was to evaluate clinical practices regarding TBI, such as fractionation, organ shielding and delivery techniques, among SIOPE affiliated radiotherapy centers.Methods: An electronic survey was sent out to 233 SIOPE affiliated centers, containing 57 questions about clinical practice of TBI. Surveys could be answered anonymously.Results: From over 25 countries, 82 responses were collected. For TBI-performing centers, 40/48 irradiated 25). Most indications concerned acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML). Four different fractionation schedules were used, of which 12 Gy in 6 fractions was applied in 91% for ALL and 86% for AML. Dose reduction to the lungs, mostly to a mean dose of 8-10 Gy, was applied by 28/33 centers for ALL and 19/21 centers for AML, in contrast to much less applied dose reduction to the kidneys (7/33 ALL and 7/21 AML), thyroid (2/33 ALL and 2/21 AML), liver (4/33 ALL and 3/21 AML) and lenses (4/33 ALL and 4/21 AML). Conventional TBI techniques were used by 24/29 responding centers, while 5/29 used advanced optimized planning techniques.Conclusion: Across SIOPE, there is a high level of uniformity in fractionation and use of lung shielding. Practices vary regarding other organs-at-risk shielding and implementation of advanced techniques. A SIOPE radiotherapy working group will be established to define international guidelines for pediatric TBI. (C) 2020 The Author(s). Published by Elsevier B.V.