PURPOSE:Fractionated total-body irradiation (HTBI) is considered to induce less toxicity to normal tissues and probably has the same efficacy as single-dose total-body irradiation (STBI) in patients with acute myeloid leukemia. We decided to determine whether this concept can be applied to a large number of patients with various hematologic malignancies using two dissimilar fractionation schedules. PATIENTS AND METHODS: Between December 1986 and October 1994, 160 patients with various hematologic malignancies were randomized to receive either a 10-Gy dose of STBI or 14.85-Gy dose of HTBI. RESULTS:One hundred forty-seven patients were assessable. The 8-year overall survival rate and cause-specific survival rate in the STBI group was 38% and 63.5%, respectively. Overall survival rate and cause-specific survival rate in the HTBI group was 45% and 77%, respectively. The incidence of interstitial pneumonitis was similar in both groups. However, the incidence of veno-occlusive disease (VOD) of the liver was significantly higher in the STBI group. In the multivariate analysis with overall survival as the end point, the female sex was an independent favorable prognostic factor. On the other hand, when cause-specific survival was considered as the end point, the multivariate analysis demonstrated that sex and TBI were independent prognostic factors. CONCLUSION: The efficacy of HTBI is probably higher than that of STBI. Both regimens induce similar toxicity with the exception of VOD of the liver, the incidence of which is significantly more pronounced in the STBI group.
RCT Entities:
PURPOSE: Fractionated total-body irradiation (HTBI) is considered to induce less toxicity to normal tissues and probably has the same efficacy as single-dose total-body irradiation (STBI) in patients with acute myeloid leukemia. We decided to determine whether this concept can be applied to a large number of patients with various hematologic malignancies using two dissimilar fractionation schedules. PATIENTS AND METHODS: Between December 1986 and October 1994, 160 patients with various hematologic malignancies were randomized to receive either a 10-Gy dose of STBI or 14.85-Gy dose of HTBI. RESULTS: One hundred forty-seven patients were assessable. The 8-year overall survival rate and cause-specific survival rate in the STBI group was 38% and 63.5%, respectively. Overall survival rate and cause-specific survival rate in the HTBI group was 45% and 77%, respectively. The incidence of interstitial pneumonitis was similar in both groups. However, the incidence of veno-occlusive disease (VOD) of the liver was significantly higher in the STBI group. In the multivariate analysis with overall survival as the end point, the female sex was an independent favorable prognostic factor. On the other hand, when cause-specific survival was considered as the end point, the multivariate analysis demonstrated that sex and TBI were independent prognostic factors. CONCLUSION: The efficacy of HTBI is probably higher than that of STBI. Both regimens induce similar toxicity with the exception of VOD of the liver, the incidence of which is significantly more pronounced in the STBI group.
Authors: Mitchell Sabloff; Saurabh Chhabra; Tao Wang; Caitrin Fretham; Natasha Kekre; Allistair Abraham; Kehinde Adekola; Jeffery J Auletta; Christopher Barker; Amer M Beitinjaneh; Christopher Bredeson; Jean-Yves Cahn; Miguel Angel Diaz; Cesar Freytes; Robert Peter Gale; Siddhartha Ganguly; Usama Gergis; Eva Guinan; Betty K Hamilton; Shahrukh Hashmi; Peiman Hematti; Gerhard Hildebrandt; Leona Holmberg; Sanghee Hong; Hillard M Lazarus; Rodrigo Martino; Lori Muffly; Taiga Nishihori; Miguel-Angel Perales; Jean Yared; Shin Mineishi; Edward A Stadtmauer; Marcelo C Pasquini; Alison W Loren Journal: Biol Blood Marrow Transplant Date: 2019-08-29 Impact factor: 5.742
Authors: Vaibhav Agrawal; Praveen Ranganath; Kirsten D Ervin; Caitlin A Schmidt; Elizabeth A Cox; Robert P Nelson; Jennifer E Schwartz; Mohammad Abu Zaid; Rafat Abonour; Michael J Robertson; Bryan J Brinda; Shawn P Griffin; Teresa C Thakrar; Sherif S Farag Journal: Bone Marrow Transplant Date: 2020-07-04 Impact factor: 5.483
Authors: Jason A Coppell; Paul G Richardson; Robert Soiffer; Paul L Martin; Nancy A Kernan; Allen Chen; Eva Guinan; Georgia Vogelsang; Amrita Krishnan; Sergio Giralt; Carolyn Revta; Nicole A Carreau; Massimo Iacobelli; Enric Carreras; Tapani Ruutu; Tiziano Barbui; Joseph H Antin; Dietger Niederwieser Journal: Biol Blood Marrow Transplant Date: 2009-09-18 Impact factor: 5.742
Authors: Hwa Kyung Byun; Hong In Yoon; Jaeho Cho; Hyun Ju Kim; Yoo Hong Min; Chuhl Joo Lyu; June-Won Cheong; Jin Seok Kim; Hyo Sun Kim; Soo-Jeong Kim; Andrew Jihoon Yang; Byung Min Lee; Won Hee Lee; Joongyo Lee; Ki Jung Ahn; Chang-Ok Suh Journal: Radiat Oncol J Date: 2017-09-29
Authors: Jay Burmeister; Adrian Nalichowski; Michael Snyder; Robert Halford; Geoff Baran; Brian Loughery; Ahmad Hammoud; Joe Rakowski; Todd Bossenberger Journal: J Appl Clin Med Phys Date: 2018-03-11 Impact factor: 2.102