https://scholars.lib.ntu.edu.tw/handle/123456789/630869
標題: | A single institution experience of total lymphoid irradiation using helical tomotherapy as part of the conditioning regimen of transplantation for severe aplastic anemia patients | 作者: | Lee, Pei Hsuan Wu, Jian Kuen Wang, Miao Ci Lee, Sze Hwei SUNG-HSIN KUO YU-HSUAN CHEN |
關鍵字: | Aplastic anemia (AA) | helical tomotherapy | stem cell transplantation, hematopoietic | 公開日期: | 1-六月-2020 | 卷: | 4 | 來源出版物: | Therapeutic Radiology and Oncology | 摘要: | Background: Total lymphoid irradiation (TLI) plays a role in the conditioning of hematopoietic stem cell transplantation (HSCT) from non-sibling donors for severe aplastic anemia (SAA) patients. For the past decades, an anterior-posterior opposed technique has been used to deliver TLI. We present our single-institution experience of helical tomotherapy TLI. Methods: From October 2014 to February 2019, three consecutive patients of SAA who underwent tomotherapy TLI for pre-transplantation conditioning were enlisted. We retrospectively analyzed the survival, engraftment outcome, and toxicities of these patients and created a conventional TLI plan with anterior-posterior opposed fields for each patient to compare the dosimetry difference between helical tomotherapy and the conventional technique. Results: Among all three patients, the engraftment rate was 100%. The 18-month overall survival and event-free survival were both 66.7% among the 3 patients (2 underwent unrelated donor transplantation and 1 underwent haplo-identical related donor transplantation), and 100% for the patients who received transplantation from matched- or mismatched-unrelated donors. No patient experienced acute grade 3 or worse graft-versus-host disease (GVHD), and none of the three patients suffered from late GVHD. No significant acute or late adverse events of radiation were observed. Tomotherapy-based TLI provides better target volume coverage with an average 10% higher coverage along with greater sparing of normal tissues. The total body volume exposed to 5 Gy was an average 35% lower in the tomotherapy-based TLI. Conclusions: TLI with non-ablative conditioning regimen provided excellent engraftment and an acceptable survival in the SAA patients who underwent non-sibling donor HSCT. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/630869 | ISSN: | 26162768 | DOI: | 10.21037/tro.2020.04.02 |
顯示於: | 腫瘤醫學研究所 |
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