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Effect of dose rate on pulmonary toxicity in patients with hematolymphoid malignancies undergoing total body irradiation

BACKGROUND: This study evaluated the effect of radiation dose rate in patients with hematolymphoid malignancies undergoing myeloablative conditioning with total body irradiation (TBI), for hematopoietic stem cell transplantation. METHODS: The incidence of pulmonary toxicity (PT) and treatment effica...

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Autores principales: Kim, Dong-Yun, Kim, Il Han, Yoon, Sung-Soo, Kang, Hyoung Jin, Shin, Hee Young, Kang, Hyun-Cheol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145366/
https://www.ncbi.nlm.nih.gov/pubmed/30227866
http://dx.doi.org/10.1186/s13014-018-1116-9
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author Kim, Dong-Yun
Kim, Il Han
Yoon, Sung-Soo
Kang, Hyoung Jin
Shin, Hee Young
Kang, Hyun-Cheol
author_facet Kim, Dong-Yun
Kim, Il Han
Yoon, Sung-Soo
Kang, Hyoung Jin
Shin, Hee Young
Kang, Hyun-Cheol
author_sort Kim, Dong-Yun
collection PubMed
description BACKGROUND: This study evaluated the effect of radiation dose rate in patients with hematolymphoid malignancies undergoing myeloablative conditioning with total body irradiation (TBI), for hematopoietic stem cell transplantation. METHODS: The incidence of pulmonary toxicity (PT) and treatment efficacy were compared between the conventional (≥ 6 cGy/min) and reduced dose rate (< 6 cGy/min). Seventy-seven patients receiving once-daily TBI between 2000 and 2016 were reviewed. We compared the cumulative rate of PT, overall survival (OS), relapse, and transplantation-related mortality (TRM) between conventional (n = 54) and reduced (n = 23) groups. Factors associated with PT were assessed in the presence of competing risks. RESULTS: The median follow-up time was 40.7 months, and PT occurred in 50 patients (64.9%). On multivariate analyses, the groups classified by the dose rate (P = 0.010), total dose (P = 0.025), and conditioning regimen (P = 0.029) were significant factors for the development of PT. OS was significantly reduced when PT occurred (P < 0.001). However, the OS, relapse, and TRM were not different between the two groups. CONCLUSIONS: In summary, about two-thirds of the patients undergoing daily TBI experienced PT, which affected OS. Therefore, reducing the dose rate (less than 6 cGy/min) of TBI can decrease the risk of PT, without compromising the treatment efficacy.
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spelling pubmed-61453662018-09-24 Effect of dose rate on pulmonary toxicity in patients with hematolymphoid malignancies undergoing total body irradiation Kim, Dong-Yun Kim, Il Han Yoon, Sung-Soo Kang, Hyoung Jin Shin, Hee Young Kang, Hyun-Cheol Radiat Oncol Research BACKGROUND: This study evaluated the effect of radiation dose rate in patients with hematolymphoid malignancies undergoing myeloablative conditioning with total body irradiation (TBI), for hematopoietic stem cell transplantation. METHODS: The incidence of pulmonary toxicity (PT) and treatment efficacy were compared between the conventional (≥ 6 cGy/min) and reduced dose rate (< 6 cGy/min). Seventy-seven patients receiving once-daily TBI between 2000 and 2016 were reviewed. We compared the cumulative rate of PT, overall survival (OS), relapse, and transplantation-related mortality (TRM) between conventional (n = 54) and reduced (n = 23) groups. Factors associated with PT were assessed in the presence of competing risks. RESULTS: The median follow-up time was 40.7 months, and PT occurred in 50 patients (64.9%). On multivariate analyses, the groups classified by the dose rate (P = 0.010), total dose (P = 0.025), and conditioning regimen (P = 0.029) were significant factors for the development of PT. OS was significantly reduced when PT occurred (P < 0.001). However, the OS, relapse, and TRM were not different between the two groups. CONCLUSIONS: In summary, about two-thirds of the patients undergoing daily TBI experienced PT, which affected OS. Therefore, reducing the dose rate (less than 6 cGy/min) of TBI can decrease the risk of PT, without compromising the treatment efficacy. BioMed Central 2018-09-18 /pmc/articles/PMC6145366/ /pubmed/30227866 http://dx.doi.org/10.1186/s13014-018-1116-9 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Kim, Dong-Yun
Kim, Il Han
Yoon, Sung-Soo
Kang, Hyoung Jin
Shin, Hee Young
Kang, Hyun-Cheol
Effect of dose rate on pulmonary toxicity in patients with hematolymphoid malignancies undergoing total body irradiation
title Effect of dose rate on pulmonary toxicity in patients with hematolymphoid malignancies undergoing total body irradiation
title_full Effect of dose rate on pulmonary toxicity in patients with hematolymphoid malignancies undergoing total body irradiation
title_fullStr Effect of dose rate on pulmonary toxicity in patients with hematolymphoid malignancies undergoing total body irradiation
title_full_unstemmed Effect of dose rate on pulmonary toxicity in patients with hematolymphoid malignancies undergoing total body irradiation
title_short Effect of dose rate on pulmonary toxicity in patients with hematolymphoid malignancies undergoing total body irradiation
title_sort effect of dose rate on pulmonary toxicity in patients with hematolymphoid malignancies undergoing total body irradiation
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145366/
https://www.ncbi.nlm.nih.gov/pubmed/30227866
http://dx.doi.org/10.1186/s13014-018-1116-9
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