PMID- 36254468
OWN - NLM
STAT- MEDLINE
DCOM- 20221019
LR  - 20240222
IS  - 1365-2060 (Electronic)
IS  - 0785-3890 (Print)
IS  - 0785-3890 (Linking)
VI  - 54
IP  - 1
DP  - 2022 Dec
TI  - Outcomes of allogeneic haematopoietic stem cell transplantation with 
      intensity-modulated total body irradiation by helical tomotherapy: a 2-year 
      prospective follow-up study.
PG  - 2616-2625
LID - 10.1080/07853890.2022.2125171 [doi]
AB  - BACKGROUND AND OBJECTIVES: Intensity-modulated radiation therapy (IMRT) helps 
      achieve good radiation dose conformity and precise dose evaluation. We conducted 
      a single-centre prospective study to assess the safety and feasibility of total 
      body irradiation with IMRT (IMRT-TBI) using helical tomotherapy in allogeneic 
      haematopoietic stem cell transplantation (allo-HSCT). PATIENTS AND METHODS: 
      Thirty-nine adult patients with haematological malignancy (acute lymphoblastic 
      leukaemia [n = 21], chronic myeloid leukaemia [n = 6], mixed phenotype acute 
      leukaemia [n = 5], acute myeloid leukaemia [n = 4], and malignant lymphoma 
      [n = 3]) who received 12 Gy IMRT-TBI were enrolled with a median follow-up of 
      934.5 (range, 617-1254) d. At the time of transplantation, 33 patients (85%) 
      achieved complete remission. The conditioning regimen used IMRT-TBI (12 Gy in 6 
      fractions twice daily, for 3 d) and cyclophosphamide (60 mg/kg/d, for 2 d), seven 
      patients were combined with cytarabine, and five with etoposide. We set dose 
      constraints for the lungs, kidneys and lens as the organs at risk. RESULTS: The 
      mean doses for the lungs and kidneys were 7.50 and 9.11 Gy, respectively. The 
      mean maximum dose for the lens (right/left) was 5.75/5.87 Gy. The 2-year overall 
      survival (OS), disease-free survival (DFS), cumulative incidence of relapse (CIR) 
      and non-relapse mortality (NRM) were 69, 64, 18 and 18%, respectively. Thirty-six 
      patients developed early adverse events (AEs) (including four patients with Grade 
      3/4 toxicities), most of which were reversible oral mucositis and may partially 
      have been related to IMRT-TBI. However, the incidence of toxicity was comparable 
      to conventional TBI-based conditioning transplantation. None of the patients 
      developed primary graft failure, or Grade III-IV acute graft-versus-host disease 
      (GVHD). In late complications, chronic kidney disease was observed in six 
      patients, a lower incidence compared to conventional TBI-based conditioning 
      transplantation. No radiation pneumonitis or cataracts were observed in any of 
      the patients. CONCLUSIONS: IMRT-TBI is safe and feasible for haematological 
      malignancies with acceptable clinical outcomes.KEY MESSAGESIMRT-TBI-helical 
      tomotherapy aids in accurate dose calculation and conformity.It could be used 
      without any considerable increase in the rate of TBI-related AEs.Allo-HSCT with 
      IMRT-TBI may be an alternative to conventional TBI for clinical use.
FAU - Konishi, Tatsuya
AU  - Konishi T
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Ogawa, Hiroaki
AU  - Ogawa H
AD  - Department of Radiology, Division of Radiation Oncology, Tokyo Metropolitan 
      Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
FAU - Najima, Yuho
AU  - Najima Y
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Hashimoto, Shinpei
AU  - Hashimoto S
AD  - Department of Radiology, Division of Radiation Oncology, Tokyo Metropolitan 
      Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
FAU - Kito, Satoshi
AU  - Kito S
AD  - Department of Radiology, Division of Radiation Oncology, Tokyo Metropolitan 
      Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
FAU - Atsuta, Yuya
AU  - Atsuta Y
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Wada, Atsushi
AU  - Wada A
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Adachi, Hiroto
AU  - Adachi H
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Konuma, Ryosuke
AU  - Konuma R
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Kishida, Yuya
AU  - Kishida Y
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Nagata, Akihito
AU  - Nagata A
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Yamada, Yuta
AU  - Yamada Y
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Kaito, Satoshi
AU  - Kaito S
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Mukae, Junichi
AU  - Mukae J
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Marumo, Atsushi
AU  - Marumo A
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Noguchi, Yuma
AU  - Noguchi Y
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Shingai, Naoki
AU  - Shingai N
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Toya, Takashi
AU  - Toya T
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Igarashi, Aiko
AU  - Igarashi A
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Shimizu, Hiroaki
AU  - Shimizu H
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Kobayashi, Takeshi
AU  - Kobayashi T
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Ohashi, Kazuteru
AU  - Ohashi K
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Doki, Noriko
AU  - Doki N
AD  - Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, 
      Komagome Hospital, Tokyo, Japan.
FAU - Murofushi, Keiko Nemoto
AU  - Murofushi KN
AD  - Department of Radiology, Division of Radiation Oncology, Tokyo Metropolitan 
      Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Ann Med
JT  - Annals of medicine
JID - 8906388
RN  - 04079A1RDZ (Cytarabine)
RN  - 6PLQ3CP4P3 (Etoposide)
RN  - 8N3DW7272P (Cyclophosphamide)
SB  - IM
MH  - Cyclophosphamide/therapeutic use
MH  - Cytarabine
MH  - Etoposide/therapeutic use
MH  - Follow-Up Studies
MH  - *Graft vs Host Disease/drug therapy/etiology
MH  - *Hematologic Neoplasms/radiotherapy
MH  - *Hematopoietic Stem Cell Transplantation/adverse effects
MH  - Humans
MH  - Neoplasm Recurrence, Local
MH  - Prospective Studies
MH  - *Radiotherapy, Intensity-Modulated/adverse effects
MH  - Retrospective Studies
MH  - Transplantation Conditioning/adverse effects
MH  - Whole-Body Irradiation/adverse effects
PMC - PMC9624256
OTO - NOTNLM
OT  - Intensity-modulated radiation therapy
OT  - allogeneic stem cell transplantation
OT  - helical tomotherapy
OT  - total body irradiation
COIS- No potential conflict of interest was reported by the author(s).
EDAT- 2022/10/19 06:00
MHDA- 2022/10/20 06:00
PMCR- 2022/10/17
CRDT- 2022/10/18 03:03
PHST- 2022/10/18 03:03 [entrez]
PHST- 2022/10/19 06:00 [pubmed]
PHST- 2022/10/20 06:00 [medline]
PHST- 2022/10/17 00:00 [pmc-release]
AID - 2125171 [pii]
AID - 10.1080/07853890.2022.2125171 [doi]
PST - ppublish
SO  - Ann Med. 2022 Dec;54(1):2616-2625. doi: 10.1080/07853890.2022.2125171.