PMID- 11872296
OWN - NLM
STAT- MEDLINE
DCOM- 20020311
LR  - 20190708
IS  - 0360-3016 (Print)
IS  - 0360-3016 (Linking)
VI  - 52
IP  - 2
DP  - 2002 Feb 1
TI  - Lethal pulmonary complications significantly correlate with individually assessed 
      mean lung dose in patients with hematologic malignancies treated with total body 
      irradiation.
PG  - 483-8
AB  - PURPOSE: To assess the impact of lung dose on lethal pulmonary complications 
      (LPCs) in a single-center group of patients with hematologic malignancies treated 
      with total body irradiation (TBI) in the conditioning regimen for bone marrow 
      transplantation (BMT). METHODS: The mean lung dose of 101 TBI-conditioned 
      patients was assessed by a thorough (1 SD around 2%) in vivo transit dosimetry 
      technique. Fractionated TBI (10 Gy, 3.33 Gy/fraction, 1 fraction/d, 0.055 Gy/min) 
      was delivered using a lateral-opposed beam technique with shielding of the lung 
      by the arms. The median lung dose was 9.4 Gy (1 SD 0.8 Gy, range 7.8--11.4). The 
      LPCs included idiopathic interstitial pneumonia (IIP) and non-idiopathic IP 
      (non-IIP). RESULTS: Nine LPCs were observed. LPCs were observed in 2 (3.8%) of 52 
      patients in the group with a lung dose < or = 9.4 Gy and in 7 (14.3%) of 49 
      patients in the >9.4 Gy group. The 6-month LPC risk was 3.8% and 19.2% (p = 
      0.05), respectively. A multivariate analysis adjusted by the following variables: 
      type of malignancy (acute leukemia, chronic leukemia, lymphoma, myeloma), type of 
      BMT (allogeneic, autologous), cytomegalovirus infection, graft vs. host disease, 
      and previously administered drugs (bleomycin, cytarabine, cyclophosphamide, 
      nitrosoureas), revealed a significant and independent association between lung 
      dose and LPC risk (p = 0.02; relative risk = 6.7). Of the variables analyzed, BMT 
      type (p = 0.04; relative risk = 6.6) had a risk predictive role. CONCLUSION: The 
      mean lung dose is an independent predictor of LPC risk in patients treated with 
      the 3 x 3.33-Gy low-dose-rate TBI technique. Allogeneic BMT is associated with a 
      higher risk of LPCs.
FAU - Della Volpe, Aldo
AU  - Della Volpe A
AD  - Centro Trapianti di Midollo, Ospedale Maggiore di Milano IRCCS, Milano, Italy.
FAU - Ferreri, Andres Jose Maria
AU  - Ferreri AJ
FAU - Annaloro, Claudio
AU  - Annaloro C
FAU - Mangili, Paola
AU  - Mangili P
FAU - Rosso, Alberto
AU  - Rosso A
FAU - Calandrino, Riccardo
AU  - Calandrino R
FAU - Villa, Eugenio
AU  - Villa E
FAU - Lambertenghi-Deliliers, Giorgio
AU  - Lambertenghi-Deliliers G
FAU - Fiorino, Claudio
AU  - Fiorino C
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Analysis of Variance
MH  - *Bone Marrow Transplantation/mortality
MH  - Child
MH  - Female
MH  - Hematologic Neoplasms/mortality/therapy
MH  - Humans
MH  - Leukemia/mortality/*therapy
MH  - Lung Diseases/*etiology/mortality
MH  - Lymphoma/mortality/*therapy
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Radiation Dosage
MH  - Radiation Injuries/*complications
MH  - Transplantation Conditioning
MH  - Whole-Body Irradiation/*adverse effects/methods/mortality
EDAT- 2002/03/02 10:00
MHDA- 2002/03/12 10:01
CRDT- 2002/03/02 10:00
PHST- 2002/03/02 10:00 [pubmed]
PHST- 2002/03/12 10:01 [medline]
PHST- 2002/03/02 10:00 [entrez]
AID - S0360301601025895 [pii]
AID - 10.1016/s0360-3016(01)02589-5 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2002 Feb 1;52(2):483-8. doi: 
      10.1016/s0360-3016(01)02589-5.