Back to Search
Start Over
Factors associated with pulmonary toxicity after myeloablative conditioning using fractionated total body irradiation
- Source :
- Radiation Oncology Journal
- Publication Year :
- 2017
- Publisher :
- Korean Society for Therapeutic Radiology and Oncology, 2017.
-
Abstract
- Purpose Pulmonary toxicities, including infectious pneumonia (IP) and idiopathic pneumonia syndrome (IPS), are serious side effects of total body irradiation (TBI) used for myeloablative conditioning. This study aimed to evaluate clinical factors associated with IP and IPS following TBI. Materials and methods Fifty-eight patients with hematologic malignancies who underwent TBI before allogeneic hematopoietic stem cell transplantation between 2005 and 2014 were reviewed. Most patients (91%) received 12 Gy in 1.5 Gy fractions twice a day. Pulmonary toxicities were diagnosed based on either radiographic evidence or reduced pulmonary function, and were subdivided into IP and IPS based on the presence or absence of concurrent infection. Results Pulmonary toxicities developed in 36 patients (62%); 16 (28%) had IP and 20 (34%) had IPS. IP was significantly associated with increased treatment-related mortality (p = 0.028) and decreased survival (p = 0.039). Multivariate analysis revealed that the risk of developing IPS was significantly higher in patients who received stem cells from a matched unrelated donor than from a matched sibling donor (p = 0.021; hazard ratio [HR] = 12.67; 95% confidence interval [CI], 1.46-110.30). Combining other conditioning agents with cyclophosphamide produced a higher tendency to develop IP (p = 0.064; HR = 6.19; 95% CI, 0.90-42.56). Conclusion IP and IPS involve different risk factors and distinct pathogeneses that should be considered when planning treatments before and after TBI.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Cyclophosphamide
Pulmonary toxicity
medicine.medical_treatment
Hematopoietic stem cell transplantation
Idiopathic pneumonia syndrome
Gastroenterology
Pulmonary function testing
03 medical and health sciences
0302 clinical medicine
Total body irradiation
Internal medicine
Medicine
Radiology, Nuclear Medicine and imaging
Clinical Investigation
business.industry
Hazard ratio
Stem cell transplantation
medicine.disease
Infectious pneumonia
Surgery
Pneumonia
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Original Article
business
medicine.drug
Subjects
Details
- ISSN :
- 22343156 and 22341900
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Radiation Oncology Journal
- Accession number :
- edsair.doi.dedup.....90136ce735d6a3aaaae825d0092989b8