Twenty years of experience of a tertiary cancer center in total body irradiation with focus on oncological outcome and secondary malignancies.
Strahlenther Onkol
; 198(6): 547-557, 2022 06.
Article
en En
| MEDLINE
| ID: mdl-35318487
ABSTRACT
PURPOSE:
Total body irradiation (TBI) is a common part of the myelo- and immuno-ablative conditioning regimen prior to an allogeneic hematopoietic stem cell transplantation (allo-HSCT). Due to concerns regarding acute and long-term complications, there is currently a decline in otherwise successfully established TBI-based conditioning regimens. Here we present an analysis of patient and treatment data with focus on survival and long-term toxicity.METHODS:
Patients with hematologic diseases who received TBI as part of their conditioning regimen prior to allo-HSCT at Frankfurt University Hospital between 1997 and 2015 were identified and retrospectively analyzed.RESULTS:
In all, 285 patients with a median age of 45 years were identified. Median radiotherapy dose applied was 10.5â¯Gy. Overall survival at 1, 2, 5, and 10 years was 72.6, 64.6, 54.4, and 51.6%, respectively. Median follow-up of patients alive was 102 months. The cumulative incidence of secondary malignancies was 12.3% (nâ¯= 35), with hematologic malignancies and skin cancer predominating. A TBI dose ≥â¯8â¯Gy resulted in significantly improved event-free (pâ¯= 0.030) and overall survival (pâ¯= 0.025), whereas a total dose ≤â¯8â¯Gy and acute myeloid leukemia (AML) diagnosis were associated with significantly increased rates of secondary malignancies (pâ¯= 0.003, pâ¯= 0.048) in univariate analysis. No significant correlation was observed between impaired renal or pulmonary function and TBI dose.CONCLUSION:
TBI remains an effective and well-established treatment, associated with distinct late-toxicity. However, in the present study we cannot confirm a dose-response relationship in intermediate dose ranges. Survival, occurrence of secondary malignancies, and late toxicities appear to be subject to substantial confounding in this context.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Leucemia Mieloide Aguda
/
Neoplasias Primarias Secundarias
/
Trasplante de Células Madre Hematopoyéticas
/
Enfermedad Injerto contra Huésped
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Humans
/
Middle aged
Idioma:
En
Revista:
Strahlenther Onkol
Asunto de la revista:
NEOPLASIAS
/
RADIOTERAPIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Alemania