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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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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. |
format | Online Article Text |
id | pubmed-6145366 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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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