Years of Experience in Static Intensity-Modulated Total-Body Irradiation and Lung Toxicity Results in 257 Consecutive Patients
Years of Experience in Static Intensity-Modulated Total-Body Irradiation and Lung Toxicity Results in 257 Consecutive Patients
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多年静态调强全身照射经验以及 257 名连续患者的肺部毒性结果
DOI：
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发表时间：
2007
期刊：
影响因子：
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通讯作者：
B. Kimmig
中科院分区：
文献类型：
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作者：
R. Schneider;J. Schultze;J. M. Jensen;D. Hebbinghaus;R. Galalae;B. Kimmig
目的：分析同种异体或自体移植后补偿器全身照射(SIMRT)后肺部并发症的发生情况。患者和方法：1983~1998年间，257例不同恶性血液病患者在同种异体移植(n=174)或自体移植(n=83)前连续3d内(212例，肺部剂量为11Gy.)，分6次进行全身照射，总剂量为12Gy.40例患者年龄16岁。最短随访时间为5年。中位随访期110个月(13-231个月)。结果：5年生存率为47.9%，5年肿瘤相关死亡率为23%，5年治疗相关死亡率为29.2%(12Gy肺剂量：53.3%±14.6%，11Gy量：24.1%±5.7%)。257例中发生间质性肺炎28例(10.9%±3.8%)。异体组和自体组IP发生率分别为14.4%(±5.6%)和3.6%(0~7.6%)。12/11Gy肺剂量组IP发生率为22%(±12%)/8.5%(±3.7%)。IP死亡率为9.3%(±3.6%)。28例IP患者中13例为巨细胞病毒感染，5例为急性移植物抗宿主病IV级。16岁和16岁组肺剂量12/11GyIP发生率分别为25%(9-50%)和4.2%(0.2-19.1%)，老年患者移植后IP发生率分别为20.7%(9.4-37.4%)和13.3%(±6.5%)。结论：代偿器静态调强TBI总剂量为12GY，肺部剂量为11GY，是一种肺毒性适中、剂量不均匀小、移植前设置失败少的现代舒适的治疗方法。尤其是16岁的患者受益于肺部剂量的减少。
Purpose: To analyze lung complications after allogeneic or autologous transplantation following total-body irradiation (TBI) with compensators, so-called sIMRT (static intensity-modulated radiotherapy). Patients and Methods: Between 1983 and 1998, 257 patients with different hematologic malignancies underwent TBI in six fractions to a total dose of 12 Gy within 3 consecutive days (212 with 11 Gy lung dose) prior to allogeneic (n = 174) or autologous (n = 83) transplantation. 40 patients were < 16 years of age. Minimum follow-up time was 5 years. Median follow-up period was 110 months (13–231 months). Results: 5-year survival rate was 47.9%, 5-year tumor-related mortality 23%, 5-year treatment-related mortality 29.2% (12 Gy lung dose: 53.3% ± 14.6%, 11 Gy: 24.1% ± 5.7%). Interstitial pneumonitis (IP) developed in 28 of 257 patients (10.9% ± 3.8%). IP incidences in the allogeneic and autologous groups were 14.4% (± 5.6%) and 3.6% (0–7.6%), respectively. IP incidences with 12/11 Gy lung dose were 22% (± 12%)/8.5% (± 3.7%). IP mortality was 9.3% (± 3.6%). 13 of 28 patients with IP had a cytomegalovirus infection, five an acute graft-versus-host disease grade IV of the lungs. IP incidences with 12/11 Gy lung dose were 25% (9–50%)/4.2% (0.2–19.1%) in patients < 16 years, and 20.7% (9.4–37.4%) and 13.3% (± 6.5%) in older patients after allogeneic transplantation. Conclusion: Compensator-generated static intensity-modulated TBI with a total dose of 12 Gy and a lung dose of 11 Gy is a modern and comfortable treatment with moderate lung toxicity, small dose inhomogeneities and little setup failure before transplantation. Especially patients < 16 years of age benefit from lung dose reduction.
骨髓移植后巨细胞病毒肺炎。
影响因子：
6.2
作者：
Enright,H;Haake,R;Weisdorf,D;Ramsay,N;McGlave,P;Kersey,J;Thomas,W;McKenzie,D;Miller,W
通讯作者：
Miller,W
白消安和环磷酰胺作为既往胸部放疗患者骨髓移植的准备方案。
影响因子：
4.8
作者：
VanderJagt,RH;Appelbaum,FR;Petersen,FB;Bigelow,CL;Fisher,LD;Schoch,GH;Buckner,CD;Sanders,JE;Storb,R;Sullivan,KM
通讯作者：
Sullivan,KM
首次缓解期急性非淋巴细胞白血病的骨髓移植：接受单剂量或分次全身照射的患者的毒性和长期随访。
影响因子：
4.8
作者：
Deeg,HJ;Sullivan,KM;Buckner,CD;Storb,R;Appelbaum,FR;Clift,RA;Doney,K;Sanders,JE;Witherspoon,RP;Thomas,ED
通讯作者：
Thomas,ED