title: [Fractionated homogeneous whole body irradiation prior to bone marrow transplantation].
abstract: At the University of Kiel, myeloid and acute lymphatic leukemia is treated since 1983 by total-body irradiation applied prior to bone marrow transplantation. Dose deviations in the midplane caused by the irregular surface and tissue inhomogeneities of the patient are reduced down to +/- 3.5% compared to the central ray, with the help of CT-based individual compensators. This method prevents above all an excessive dose to the lungs. The radiobiologic advantages of fractionated irradiation have been employed for all patients treated hitherto (n = 9). At present, a total body dose of 12 Gy in six fractions is applied within three days. There were no undesired acute radiogenic reactions except a mild acute mucositis found in all patients. Chronic side effects, especially in the lungs, were not demonstrated, too. However, the average follow-up time of 149 days has been rather short. One patient died from relapse of leukemia after a total dose of 10 Gy, another patient died because the transplanted bone marrow was rejected, and a third died from catheter sepsis. Six out of nine patients are in complete remission with a maximum index of Karnofsky. The limited experiences gained hitherto show that the homogenous accelerated-fractionated total-body irradiation offers essential advantages compared to non-compensated single dose irradiation with respect to the prevention of undesired radiogenic effects in sound tissues and that its therapeutic efficacy is at least the same.
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D005260:Female; D006801:Humans; D007945:Leukemia, Lymphoid / Q000532:radiotherapy / Q000628:therapy*; D007951:Leukemia, Myeloid / Q000532:radiotherapy / Q000628:therapy*; D015470:Leukemia, Myeloid, Acute / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D014916:Whole-Body Irradiation
vernacular_title: Fraktionierte homogene Ganzkörperbestrahlung vor Knochenmarktransplantation.