Total body irradiation and pneumonitis risk: a review of outcomes

Abstract

A review was undertaken of all patients treated at Royal Adelaide Hospital, South Australia with total body irradiation (TBI) for the purpose of assessing the incidence of interstitial pneumonitis (IP) and possible prognostic factors for its development. The aim was also to assess the impact of IP and other prognostic factors on long-term survival outcome following bone marrow transplantation. A total of 84 patients received TBI, with 12 Gy in six fractions delivered using two different instantaneous dose rates of 7.5 and 15 cGy min À1 . This series included 26 cases of acute lymphoblastic leukaemia, 26 of multiple myeloma and 15 of acute myelogenous leukaemia. On multivariate analysis, a higher dose rate was independently significant for an increased risk of IP.

Simvastatin Attenuates Radiation-Induced Murine Lung Injury and Dysregulated Lung Gene Expression

“…Radiation-induced lung injury (RILI) is a disabling and potentially fatal, dose-limiting toxicity of thoracic radiotherapy for lung cancer, breast cancer, lymphoma, thymoma, esophageal cancer (1), and total body radiation (2). Although understanding of RILI (or radiation pneumonitis) is limited, RILI is characterized by a subacute course developing over 12-20 weeks, and numerous risk factors have been identified, including the overall radiation dose, daily dose increment, volume of irradiated lung, various comorbidities, and unknown genetic factors (3).…”

20 Years of Experience in Static Intensity-Modulated Total-Body Irradiation and Lung Toxicity

“…The higher the dose rate, the higher the incidences are [4,9,35]. With respect to dose rate, however, a high dose rate with relatively low total dose can be better than a large single dose at a low dose rate.…”

“…CMV-seropositive patients or transplanted patients with developing CMV or Pneumocystis carinii infections are at high risk of IP [9,17]. Acute and chronic GVHD of the lung in combination with TBI are also associated with a high risk of developing IP or chronic respiratory insufficiency [21,48].…”

The first Russian experience of TomoTherapy for total body irradiation in children

“…Учитывая потенциальную радиочувствительность здоровых ор-ганов и основываясь на литературных данных [6][7][8][9][10][11], были выбраны следующие органы риска: легкие, почки и передняя камера глаза.…”

“…Однако облучение здоровых органов и тканей, обладающих высокой чув-ствительностью к ионизирующему излучению (легкие, почки), может приводить к развитию серьезных и за-частую смертельных осложнений [6][7][8][9][10][11].…”