title: Single dose versus hyperfractionated total body irradiation before allogeneic bone marrow transplantation: a non-randomized comparative study of 54 patients at the Institut Gustave-Roussy.
abstract: At the Institut Gustave-Roussy (IGR), from January 1982 to December 1986, 54 patients received total body irradiation (TBI) as a part of the conditioning regimen before allogeneic bone marrow transplantation. The patients were non-randomly assigned to either single dose TBI (STBI) (31 patients receiving 10 Gy at a 4.5 cGy/min dose rate, 8 Gy to the lungs) or to a hyperfractionated scheme (HTBI) (23 patients receiving 13.2 Gy in 11 fractions, 3 fractions per day, 9 Gy to the lungs). Relapse rate and overall survival were not significantly different in the two STBI and HTBI groups, in spite of a larger number of 2nd and 3rd remission patients in the HTBI subset. The incidence of interstitial pneumonitis (IP) was significantly reduced in the HTBI group (13%, versus 45% after STBI, p = 0.02). Lethality by IP was also lower after HTBI (4%, versus 26% after STBI, p = 0.08). There was no case of veno-occlusive disease of the liver in the HTBI group, whereas three cases were observed after STBI. Based on these results, the IGR activated, in January 1987, a randomized trial comparing the single dose 10 Gy TBI (8 Gy to the lung) to a new hyperfractionated schedule (11 fractions of 1.35 Gy, 3 fractions per day, 9 Gy to the lungs).
authors.affiliation: Department of Radiotherapy, Institut Gustave-Roussy, Villejuif, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Cosset
authors.forename: D
authors.initials: D
authors.lastname: Baume
authors.forename: J L
authors.initials: JL
authors.lastname: Pico
authors.forename: B
authors.initials: B
authors.lastname: Shank
authors.forename: T
authors.initials: T
authors.lastname: Girinski
authors.forename: E
authors.initials: E
authors.lastname: Benhamou
authors.forename: E
authors.initials: E
authors.lastname: Briot
authors.forename: E
authors.initials: E
authors.lastname: Malaise
authors.forename: M
authors.initials: M
authors.lastname: Hayat
authors.forename: J
authors.initials: J
authors.lastname: Dutreix
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D005260:Female; D006084:Graft Rejection; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D007938:Leukemia / Q000628:therapy; D008297:Male; D011879:Radiotherapy Dosage; D014916:Whole-Body Irradiation / Q000379:methods*