INTERSTITIAL PNEUMONITIS FOLLOWING TOTAL-BODY IRRADIATION FOR BONE-MARROW TRANSPLANTATION USING 2 DIFFERENT DOSE-RATES
INTERSTITIAL PNEUMONITIS FOLLOWING TOTAL-BODY IRRADIATION FOR BONE-MARROW TRANSPLANTATION USING 2 DIFFERENT DOSE-RATES
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DOI：
10.1016/0360-3016(85)90243-3
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发表时间：
1985-01-01
影响因子：
7
通讯作者：
FREEMAN, CR
中科院分区：
文献类型：
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作者：
KIM, TH;RYBKA, WB;FREEMAN, CR
共22例白血病患者（10例ALL [急性淋巴细胞白血病]，11例AML [急性髓细胞白血病]，1例CML [慢性髓细胞白血病]）接受了异基因骨髓移植（BMT）。所有患者在BMT前一天接受900 cGy [格雷]全身照射（TBI），单次分割。前11例患者接受钴单位在4.7至6.3 cGy/min的恒定剂量率治疗。这些患者中有6例发生间质性肺炎（IP）。3例患者（2例为特发性肺炎，1例为药物性肺炎）的临床病程较轻，均完全恢复。另外3例患者发生重度感染性IP，2例死亡。接下来的11例患者接受了治疗，在4 MV直线加速器上进行扫描射束技术，以6.0-6.5 cGy/min的平均剂量率提供900 cGy的肿瘤总剂量，但瞬时剂量率为21.0-23.5 cGy/min。8例患者发生了严重的IP。其中5例为特发性，4例死亡。三人感染，全部死亡。间质性肺炎的死亡率似乎更大的扫描束技术治疗组。
A total of 22 patients with leukemia (10 ALL [acute lymphocytic leukemia], 11 AML [acute myelogenic leukemia], 1 CML [chronic myelogenous leukemia]) have undergone allogeneic bone marrow transplantation (BMT). All patients received 900 cGy [grays] total body irradiation (TBI), in a single fraction, on the day preceding BMT. The first 11 patients were treated on a cobalt unit at a constant dose rate of 4.7 to 6.3 cGy/min. Six of these patients developed interstitial pneumonitis (IP). The clinical course of 3 patients, 2 with idiopathic and 1 with drug-induced pneumonitis, was mild and recovery was complete in all. The other 3 patients developed severe infectious IP and two died. The next 11 patients were treated with a sweeping beam technique on a 4 MV linear accelerator delivering a total tumor dose of 900 cGy at an average dose rate of 6.0-6.5 cGy/min but an instantaneous dose rate of 21.0-23.5 cGy/min. Eight patients developed severe IP. Five of these were idiopathic and 4 died. Three were infectious and all died. The fatality of interstitial pneumonitis appeared to be greater in the group treated with the sweeping beam technique.