Effect of dose-rate and lung dose in total body irradiation on interstitial pneumonitis after bone marrow transplantation.
The aim of this study is to evaluate the incidence of interstitial pneumonitis following fractionated total body irradiation conditioning for bone marrow transplantation with varying lung doses due to shielding technique and different dose-rates. Between 1987 and 2001, a total number of 105 patients have received total body irradiation conditioning for bone marrow transplantation for hematological malignancies at Gulhane Military Medical School. Twelve Gy fractionated total body irradiation was delivered in 6 fractions over 3 consecutive days with Co-60 teletherapy machine. Conditioning therapy included only cyclophosphamide (60 mg/ kg/day for two days) and total body irradiation. The median follow-up for patients was 12 months. Interstitial pneumonitis developed in 10 patients out of 105 patients (9.52%). The median total dose to lung was 9.60 Gy (8.88-10.90). The difference between total lung dose and interstitial pneumonitis was not significant. Pneumonitis development in the high dose-rate (>0.04 Gy/min) group versus low dose-rate (< or =0.04 Gy/min) group was statistically significant. Low dose-rate fractionated total body irradiation is a reliable conditioning program in bone marrow transplantation with effective lung sparing to avoid interstitial pneumonitis.
Beyzadeoglu
Murat
M
Department of Radiation Oncology, Gulhane Military Medical School, Ankara, Turkey. muratbeyzadeoglu@yahoo.com
Oysul
Kaan
K
Dirican
Bahar
B
Arpaci
Fikret
F
Balkan
Arzu
A
Surenkok
Serdar
S
Pak
Yucel
Y
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000379:methods; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D007938:Leukemia / Q000628:therapy; D008168:Lung / Q000528:radiation effects; D017563:Lung Diseases, Interstitial / Q000209:etiology*; D055370:Lung Injury; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy; D011832:Radiation Injuries / Q000209:etiology; D011835:Radiation Protection; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods; D014916:Whole-Body Irradiation / Q000009:adverse effects* / Q000379:methods