PURPOSE: A retrospective analysis was conducted on the outcome of total-body irradiation (TBI) followed by bone marrow transplantation (BMT) on leukemia patients. Also studied was the risk of renal dysfunction after TBI/BMT with or without the use of selective renal shielding blocks. PATIENTS AND METHODS: The cases of 109 leukemia patients who received TBI as a component of the conditioning regimen for their BMT were reviewed. They received 12 Gy of TBI in six fractions over 3 consecutive days. Doses to eyes and lungs were reduced to 7 Gy and 8 Gy, respectively, by customized organ shielding blocks. After March 1999, renal shielding blocks were used to constrain the renal dose to 10 Gy. The patients were followed for a median period of 16.6 months (range: 0.3-180.1 months). RESULTS: The 2-year and 5-year overall survival rates were 55.4% and 43.2%, respectively. Renal dysfunction-free rates were different between those with and without renal shielding blocks: 100% and 78.5%, respectively, at 2 years. Overall survivals were not significantly different among these patients: 60.4% and 52.9%, respectively, at 2 years in patients with and without renal shielding blocks (p = 0.53). CONCLUSION: The use of selective renal shielding blocks provided evidence for reducing radiation-induced renal toxicities without decreasing the overall survival rate.
PURPOSE: A retrospective analysis was conducted on the outcome of total-body irradiation (TBI) followed by bone marrow transplantation (BMT) on leukemiapatients. Also studied was the risk of renal dysfunction after TBI/BMT with or without the use of selective renal shielding blocks. PATIENTS AND METHODS: The cases of 109 leukemiapatients who received TBI as a component of the conditioning regimen for their BMT were reviewed. They received 12 Gy of TBI in six fractions over 3 consecutive days. Doses to eyes and lungs were reduced to 7 Gy and 8 Gy, respectively, by customized organ shielding blocks. After March 1999, renal shielding blocks were used to constrain the renal dose to 10 Gy. The patients were followed for a median period of 16.6 months (range: 0.3-180.1 months). RESULTS: The 2-year and 5-year overall survival rates were 55.4% and 43.2%, respectively. Renal dysfunction-free rates were different between those with and without renal shielding blocks: 100% and 78.5%, respectively, at 2 years. Overall survivals were not significantly different among these patients: 60.4% and 52.9%, respectively, at 2 years in patients with and without renal shielding blocks (p = 0.53). CONCLUSION: The use of selective renal shielding blocks provided evidence for reducing radiation-induced renal toxicities without decreasing the overall survival rate.
Authors: Johanna Gerstein; Andreas Meyer; Karl-Walter Sykora; Jörg Frühauf; Johann H Karstens; Michael Bremer Journal: Strahlenther Onkol Date: 2009-11-10 Impact factor: 3.621
Authors: N Shingai; T Morito; Y Najima; T Kobayashi; N Doki; K Kakihana; K Ohashi; M Ando Journal: Bone Marrow Transplant Date: 2015-08-24 Impact factor: 5.483
Authors: Ruud G H van Leeuwen; Drean Verwegen; Peter G M van Kollenburg; Marc Swinkels; Richard W M van der Maazen Journal: Phys Imaging Radiat Oncol Date: 2020-10-01
Authors: Jose R Teruel; Sameer Taneja; Paulina E Galavis; K Sunshine Osterman; Allison McCarthy; Martha Malin; Naamit K Gerber; Christine Hitchen; David L Barbee Journal: J Appl Clin Med Phys Date: 2021-02-10 Impact factor: 2.102
Authors: Lotte S Fog; Vibeke N Hansen; Flemming Kjær-Kristoffersen; Tim Egholm Berlon; Peter Meidahl Petersen; Henry Mandeville; Lena Specht Journal: Tech Innov Patient Support Radiat Oncol Date: 2019-06-21