Effect of Dose-Rate and Lung Dose in Total Body Irradiation on Interstitial Pneumonitis after Bone Marrow Transplantation

Total Body Irradiation Compared With BEAM: Long-Term Outcomes of Peripheral Blood Autologous Stem Cell Transplantation for Non-Hodgkin's Lymphoma

“…This result was different from that of others' (20). Most published studies used #12 Gy before ASCT in NHL therapy, with some using anteroposteriorposteroanterior beams (21)(22)(23)(24)(25). The antitumor function of CY/E/TBI is directly related to the radiation dosage (25).…”

“…Second, we excluded BM-ASCT from the present study. PBSCT has a shortened engraftment time and a reduced rate of pulmonary infection and might have lowered the probability of IP (24,30,31) Third, the patients treated with CY/E/TBI conditioning in the present study received fractionated lateral field irradiation. The upper arm compensated the lung in the lateral technique (32).…”

Pulmonary function following total body irradiation (with or without lung shielding) and allogeneic peripheral blood stem cell transplant

“…[15][16][17][18][19][20][21][22] Studies have shown that the severity depends on both dose rate and total dose administered. [22][23][24][25][26] Several strategies have emerged to address this complication, including increasing the fractionation schedule to decrease the radiation dose administered at any one time [26][27][28][29][30][31][32][33][34] and reducing the lung dose directly by utilizing lung shielding. 17,28 Several studies have described an association between lung dose reduction and pulmonary-related mortality and overall survival.…”

Radiation Pneumonitis

“…Reports in the literature have described RP to be associated with severe morbidity and it is fatal in the half of the cases, with no effective treatment currently being available. 34,35 In TBI, this complication is related to the total lung dose received. There is a protective effect for fractionated TBI in comparison with a single-dose and for low-dose rate radiotherapy.…”

“…Moreover, the conditioning chemotherapy regimen is also related to RP. 2,34,35 In the literature, RP morbidity after TBI ranges between 2.5% and 22% after fractionated radiotherapy and 17% and 50% after single-dose TBI. 36 Sampath et al reported an incidence of 2.3% of RP when pulmonary shielding was performed in comparison to 11% without lung protection.…”