Outpatient total body irradiation as a component of a comprehensive outpatient transplant program
Outpatient total body irradiation as a component of a comprehensive outpatient transplant program
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DOI：
10.1038/sj.bmt.1703516
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发表时间：
2002-04-01
影响因子：
4.8
通讯作者：
Huebsch, L
中科院分区：
文献类型：
--
作者：
Bredeson, C;Perry, G;Huebsch, L
门诊全身照射（TBI）作为一个全面的门诊移植计划的一部分，提供给142 167（85%）连续接受TBI为基础的预处理治疗的患者。门诊患者在3天内接受500 cGy（110例患者）或1200 cGy分6次（32例患者）的单次治疗。每天对患者进行评估，并给予口服昂丹司琼和地塞米松预防恶心和呕吐以及静脉补液。在门诊TBI为基础的空调住宿要么是病人的家，如果在30分钟的医院，在医院的理由或在一个封闭的医院病房的酒店。142名患者在TBI期间均不需要住院治疗。接受TBI的门诊患者（9%）与住院患者（16%）的100天死亡率没有差异。在移植后的前14天内发生的4例死亡中，没有一例可归因于作为门诊患者接受TBI。通过门诊TBI的交付节省了206个住院日。一个全面的门诊计划，适当的病人选择，每日水化，使用预防性5HT3拮抗剂止吐治疗都有助于门诊TBI的安全交付。
Outpatient total body irradiation (TBI) as part of a comprehensive outpatient transplant program was delivered to 142 of 167 (85%) consecutive patients receiving TBI-based conditioning therapy. Outpatients received either a single fraction of 500 cGy (110 patients) or 1200 cGy in six fractions over 3 days (32 patients). Patients were assessed daily and were administered oral ondansetron and dexamethasone for prophylaxis of nausea and vomiting as well as i.v. hydration. Accommodation during outpatient TBI-based conditioning was either the patient's home if within 30 min of the hospital, a hotel on the hospital grounds or on a closed hospital ward. None of the 142 patients required admission to the inpatient program during their TBI. There was no difference in 100-day mortality between those receiving TBI as an outpatient (9%) vs as an inpatient (16%). Of four deaths occurring within the first 14 days post transplant, none could be attributed to receiving TBI as an outpatient. Two hundred and six inpatient days were saved through the delivery of outpatient TBI. A comprehensive outpatient program, appropriate patient selection, daily hydration, the use of prophylactic 5HT3 antagonist anti-emetic therapy all contribute to the safe delivery of outpatient TBI.