Total body irradiation followed by bone marrow transplantation: comparison of once-daily and twice-daily fractionation regimens.
OBJECTIVE
The purpose of this study was to evaluate the results of two sequential total body irradiation (TBI) regimens, especially focusing on pulmonary complications.


METHODS
Patients with malignant disease who underwent TBI followed by bone marrow transplantation were retrospectively reviewed. There were 86 patients (51 males, 35 females). Altogether, 36 patients were treated on twice-daily fractions of 2 Gy for 3 days to a total 12 Gy (group A). Another 50 patients were treated on once-daily fractions of 2.4 or 3.0 Gy for 4 or 5 days to a total 12 Gy (group B).


RESULTS
The 5-year overall survival rate was 49.2%, and relapse-free survival was 44.3%. There were no significant differences between the two groups regarding overall survival (P = 0.1237) or relapse-free survival (P = 0.1548). Two patients in group A had interstitial pneumonitis of grade 3 or higher severity compared with three patients in group B. There was no significant difference between patients in group A (5-year probability rate was 7.6%) and patients in group B (5-year probability rate was 13.9%) (P = 0.9519).


CONCLUSIONS
We concluded that our once-daily TBI regimen is feasible and had the benefit of reducing the complexity of TBI. We believe that further investigation of the TBI regimen is needed.
Soejima
Toshinori
T
Department of Radiation Oncology, Hyogo Cancer Center, Akashi, Hyogo, Japan. soe@hp.pref.hyogo.jp
Hirota
Saeko
S
Tsujino
Kayoko
K
Yoden
Eisaku
E
Fujii
Osamu
O
Ichimiya
Yukako
Y
Mizuno
Ishikazu
I
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007938:Leukemia / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D017563:Lung Diseases, Interstitial / Q000453:epidemiology / Q000209:etiology; D008223:Lymphoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D009190:Myelodysplastic Syndromes / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D014916:Whole-Body Irradiation / Q000009:adverse effects / Q000379:methods*