Similar Survival for Patients Undergoing Reduced-Intensity Total Body Irradiation (TBI) Versus Myeloablative TBI as Conditioning for Allogeneic Transplant in Acute Leukemia

Mikell, J.L.; Waller, Edmund K.; Switchenko, Jeffrey M.; Rangaraju, Sravanti; Ali, Zahir; Graiser, Michael; Hall, William A.; Langston, Amelia; Esiashvili, Natia; Khoury, H. Jean

doi:10.1016/j.ijrobp.2014.02.032

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…Allogeneic haematopoietic stem cell transplantation (allo‐HSCT) is a potentially curative treatment for patients with haematological malignancies (Giralt et al., ; Majhail et al., ), which is increasingly being used worldwide (Nivison‐Smith et al., ; Passweg et al., ; Yoshimi et al., ). The standard procedure for myeloablative allo‐HSCT includes a conditioning regimen of high‐dose chemotherapy, often in combination with total‐body irradiation (TBI), followed by infusion of stem cells harvested from a donor's bone marrow or peripheral blood (Imamura & Shigematsu, ; Mikell et al., ). This conditioning regimen produces a 2–4 week period of cytopenia, characterised by severe leukopenia and thrombocytopenia, requiring the patient to be in a single‐bed isolation room for 4–6 weeks (Morishita, Kaida, Setogawa, et al., ).…”

Section: Introductionmentioning

confidence: 99%

Relationship of physical activity with physical function and health-related quality of life in patients having undergone allogeneic haematopoietic stem-cell transplantation

et al. 2017

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In this study, we investigated the differences in physical activity before and after transplantation, and the relationship between physical activity and physical function and health-related quality of life (QOL) in 30 patients who underwent allogeneic haematopoietic stem cell transplantation (allo-HSCT). Duration and intensity of physical activity were quantified using a three-dimensional accelerometer. Physical function was quantified by handgrip and knee-extensor strength, with the 6-minute walk test (6MWT) used as a measure of exercise capacity. Health-related QOL was assessed using the 36-item Short-Form Health Survey. The proportion of daily activities performed at an intensity >3.0 metabolic equivalents (METs) increased significantly after allo-HSCT (p < .05). Daily activity time performed at an intensity of 1.6-2.9 METs significantly correlated only with left knee strength (p < .05). In contrast, the total number of daily steps and the proportion of activity performed at 1.6-2.9 METs and >3.0 METs were positively correlated with the 6MWT (p < .05). Additionally, physical functioning and general health subscales in health-related QOL positively correlated with daily activities performed at >3.0 METs (p < .05). Physical activity was associated with 6MWT and health-related QOL. These findings have implications for rehabilitation planning for patients undergoing allo-HSCT.

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Section: Introductionmentioning

confidence: 99%

Relationship of physical activity with physical function and health-related quality of life in patients having undergone allogeneic haematopoietic stem-cell transplantation

et al. 2017

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“…[ 4 ] The unique advantage of TBI over conditioning regimens based on cytotoxic chemotherapy is that it has better tissue penetration since it is not dependent on either blood supply or hepatic/renal parameters; hence, even sanctuary sites such as central nervous system and testes are not spared. [ 5 6 7 8 ] The disadvantages associated with TBI are risks associated with acute and late toxicities including second malignancy which contributes to increased morbidity and mortality, need for specialized equipment, and challenging logistics of administration. [ 9 10 ] Recent developments have been focusing on simplifying treatment delivery, decreasing the risk of toxicity while achieving better efficacy.…”

Section: Introductionmentioning

confidence: 99%

A Phantom Study on Feasibility of Manual Field-in-Field Clinical Implementation for Total Body Irradiation and Comparison of Midplane Dose with Different Bilateral TBI Techniques

Khanna

Pandu

Mohandass

et al. 2023

Journal of Medical Physics

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Objective: The aim of this study is to implement a new treatment technique in total body irradiation (TBI) using the manual field-in-field-TBI (MFIF-TBI) technique and dosimetrically verifying its results with respect to compensator-based TBI (CB-TBI) and open field TBI technique. Materials and Methods: A rice flour phantom (RFP) was placed on TBI couch with knee bent position at 385 cm source to surface distance. Midplane depth (MPD) was calculated for skull, umbilicus, and calf regions by measuring separations. Three subfields were opened manually for different regions using the multi-leaf collimator and jaws. The treatment Monitor unit (MU) was calculated based on each subfield size. In the CB-TBI technique, Perspex was used as a compensator. Treatment MU was calculated using MPD of umbilicus region and the required compensator thickness was calculated. For open field TBI, treatment MU was calculated using MPD of umbilicus region, and the treatment was executed without placing compensator. The diodes were placed on the surface of RFP to measure the delivered dose and the results were compared. Results: The MFIF-TBI results showed that the deviation was within ± 3.0% for the different regions, except for the neck for which the deviation was 8.72%. In the CB-TBI delivery, the dose deviation was ± 3.0% for different regions in the RFP. The open field TBI results showed that the dose deviation was not within the limit ± 10.0%. Conclusion: The MFIF-TBI technique can be implemented for TBI treatment as no TPS is required, and laborious process of making a compensator can be avoided while ensuring that the dose uniformity in all the regions within the tolerance limit.

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“…For myeloablative conditioning, a prescribed dose ranging from 12 to 13.2 Gy has been commonly used to attenuate the immunity of the recipient and to destroy cancer cells [ 4 ]. For reduced-intensity stem cell transplantation (RIST) combined with TBI, a prescribed dose ranging from 2 to 6 Gy has been used [ 5 , 6 ]. To irradiate the whole patient body, various techniques, such as long source-to-surface distance (SSD), moving bed [ 7 , 8 ] and helical tomotherapy [ 9 , 10 ], have been used.…”

Section: Introductionmentioning

confidence: 99%

Commissioning of total body irradiation using plastic bead bags

Akino

Maruoka

Yano

et al. 2020

Journal of Radiation Research

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The goal of total body irradiation (TBI) is to deliver a dose to the whole body with uniformity within ±10%. The purpose of this study was to establish the technique of TBI using plastic bead bags. A lifting TBI bed, Model ORP-TBI-MN, was used. The space between the patient’s body and the acrylic walls of the bed was filled with polyacetal bead bags. Patients were irradiated by a 10 MV photon beam with a source to mid-plane distance of 400 cm. The monitor unit (MU) was calculated by dose-per-MU, tissue-phantom-ratio and a spoiler factor measured in solid water using an ionization chamber. The phantom-scatter correction factor, off-center ratio and the effective density of the beads were also measured. Diode detectors were used for in vivo dosimetry (IVD). The effective density of the beads was 0.90 ± 0.09. The point doses calculated in an I’mRT phantom with and without heterogeneity material showed good agreement, with measurements within 3%. An end-to-end test was performed using a RANDO phantom. The mean ± SD (range) of the differences between the calculated and IVD-measured mid-plane doses was 1.1 ± 4.8% (−5.9 to 5.0%). The differences between the IVD-measured doses and the doses calculated with Acuros XB of the Eclipse treatment planning system (TPS) were within 5%. For two patients treated with this method, the differences between the calculated and IVD-measured doses were within ±6% when excluding the chest region. We have established the technique of TBI using plastic bead bags. The TPS may be useful to roughly estimate patient dose.

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Similar Survival for Patients Undergoing Reduced-Intensity Total Body Irradiation (TBI) Versus Myeloablative TBI as Conditioning for Allogeneic Transplant in Acute Leukemia

Cited by 7 publications

References 18 publications

Relationship of physical activity with physical function and health-related quality of life in patients having undergone allogeneic haematopoietic stem-cell transplantation

Relationship of physical activity with physical function and health-related quality of life in patients having undergone allogeneic haematopoietic stem-cell transplantation

A Phantom Study on Feasibility of Manual Field-in-Field Clinical Implementation for Total Body Irradiation and Comparison of Midplane Dose with Different Bilateral TBI Techniques

Commissioning of total body irradiation using plastic bead bags

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