title: Retrospective, monocentric analysis of late effects after Total Body Irradiation (TBI) in adults.
abstract: OBJECTIVE
  Total body irradiation (TBI) is a standard treatment modality within the multidisciplinary approach for allogeneous stem cell or bone marrow transplantation. However, surviving patients are at risk for developing a variety of late sequelae. This analysis aimed to retrospectively characterize late effects after TBI in adults treated in a single center.
  
  
  METHODS
  Patients ≥ 18 years treated with fractionated TBI (4-12 Gy) between 1996 and 2008 were included in this study. Treatment data were collected retrospectively from the treating departments. Late effects were evaluated using the clinic charts and/or were obtained from the general practitioners using a standardized questionnaire. Analyses were performed by calculation of the cumulative incidences using the Kaplan-Meier method and the log rank test.
  
  
  RESULTS
  A total of 308 patients ≥ 18 years were treated including a TBI of whom 78 patients were excluded from further analysis due to death within less than 1 year after TBI. Patients suffered from leukemia in most cases. Late toxicity follow-up was available in 120 patients (mean age 46.1 years; range, 18-70 years) after a mean follow-up of 23 months (range, 12-96 months). The cumulative incidences (CI) at 3 years were 28% for pulmonary event, 8% for pulmonary toxicity, 25% for kidney toxicity, 8% for cataract, 17% for bone toxicity, and 10% for secondary malignancy. The CI of bone toxicity was higher in female than in male patients (p = 0.019).
  
  
  CONCLUSIONS
  Late effects after TBI in the context of allogeneous stem cell or bone marrow transplantation can frequently be observed. Regular follow-up examinations are advised for the early registration and treatment of adverse effects.
authors.affiliation: Department of Radiotherapy, University Hospital of Münster, Münster, Germany. Tobias.Boelling@uni-muenster.de
authors.forename: Tobias
authors.initials: T
authors.lastname: Bölling
authors.forename: David Christoph
authors.initials: DC
authors.lastname: Kreuziger
authors.forename: Iris
authors.initials: I
authors.lastname: Ernst
authors.forename: Hassan
authors.initials: H
authors.lastname: Elsayed
authors.forename: Normann
authors.initials: N
authors.lastname: Willich
mesh_terms: D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation / Q000379:methods; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D033581:Stem Cell Transplantation / Q000379:methods; D013997:Time Factors; D014916:Whole-Body Irradiation / Q000009:adverse effects*; D055815:Young Adult