Pulmonary Toxicities in Pediatric Patients Treated With Total Body Irradiation Using the Lateral Opposed Fields Technique.

IF 2.4 3区医学 Q2 HEMATOLOGY

Pediatric Blood & Cancer Pub Date : 2025-04-15 DOI:10.1002/pbc.31713

Natalie Boyce, Safia Ahmed, W Scott Harmsen, Sharon Boyce, Robert Dahl, Nadia Laack

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引用次数: 0

Abstract

Purpose: Pulmonary toxicity (PT) remains a concern following total body irradiation (TBI). This study describes the incidence and factors associated with PT in a cohort of patients homogeneously treated with the lateral opposed fields technique.

Methods: Medical records of 61 patients ≤21 years of age treated with TBI as a component of stem cell transplantation from 1993-2017 were retrospectively reviewed. The incidences of PT, graft-versus-host disease (GVHD), and other toxicities were recorded for each patient. PT was subdivided into its etiologies, and symptomatic PT was established by clinical diagnosis. The association of PT with other variables was examined using chi-square tests, and overall survival (OS) was estimated using Kaplan-Meier.

Results: Three-year OS was 65% (54%-79%). Median TBI dose rate was 7.7 cGy/min (4.0-10 cGy/min). PT occurred in 20 patients (33%). A higher rate of PT was observed in patients with GVHD (65% vs. 35%, p ≤ 0.01). TBI dose rate (

Conclusions: This cohort of patients treated with a low dose rate, bilateral technique, and total dose of 1000-1320 cGy experienced an acceptable incidence of PT, comparable to other published studies. Because PT correlated with reduced survival, current practice should seek to address factors associated with PT by aiming to prevent GVHD and by choosing low dose rates, such as in the range of 4.0-10 cGy/min.

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采用侧对野技术进行全身照射治疗的儿科患者的肺毒性。

目的：全身照射（TBI）后肺毒性（PT）仍然是一个值得关注的问题。本研究描述了一组采用侧对野技术均匀治疗的患者中PT的发生率和相关因素。方法：回顾性分析1993-2017年61例≤21岁的TBI干细胞移植患者的医疗记录。记录每位患者的PT、移植物抗宿主病（GVHD）和其他毒性反应的发生率。将PT细分为病因，通过临床诊断确立症状性PT。使用卡方检验检验PT与其他变量的相关性，并使用Kaplan-Meier估计总生存期（OS）。结果：3年OS为65%（54% ~ 79%）。TBI中位剂量率为7.7 cGy/min （4.0-10 cGy/min）。20例（33%）发生PT。GVHD患者PT发生率较高（65% vs. 35%, p≤0.01）。结论：该队列患者采用低剂量率、双侧技术和总剂量为1000- 1320cgy的治疗，其PT发生率可接受，与其他已发表的研究相当。由于PT与生存率降低相关，目前的做法应该通过预防GVHD和选择低剂量率（如4.0-10 cGy/min）来寻求解决与PT相关的因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Blood & Cancer 医学-小儿科

CiteScore

4.90

自引率

9.40%

发文量

546

审稿时长

1.5 months

期刊介绍： Pediatric Blood & Cancer publishes the highest quality manuscripts describing basic and clinical investigations of blood disorders and malignant diseases of childhood including diagnosis, treatment, epidemiology, etiology, biology, and molecular and clinical genetics of these diseases as they affect children, adolescents, and young adults. Pediatric Blood & Cancer will also include studies on such treatment options as hematopoietic stem cell transplantation, immunology, and gene therapy.