Evolution of methods of Total Body Irradiation

Cellular Therapy and Transplantation

Aleksander M. Chervyakov¹  Nikolay V. Ilyin¹  Julia N. Vinogradova¹ 

关键词: total body irradiation;    methods;   

DOI  :  10.3205/ctt-2011-No12-abstract02

学科分类：肿瘤学

来源: Universitaetsklinikum Hamburg - Eppendorf / University Medical Center Hamburg - Eppendorf

【 摘 要 】

Totalbodyirradiation(TBI)isoneofkindsofsystemicradiationtherapythatsupposestotal(systemic)antitumoreffectsbyusingionizingradiation.TBIisdistinguishedbysingleandfractionated,byunitandcumulativedoses(low,average,andhighdosevariants);tobeusedasanindependentmethodoftherapyintumorchemoresistance(lowdosevariant),orasanelementofaconditioningregimenwithorwithoutchemotherapybeforeauto-orallogeneichematopoieticstemcelltransplantation.IndependentlyoftheTBIcumulativedose,radiationshouldbeinducedtothewholebody,includingtheskin,uniformlyandprecisely.TBIhasseveraladvantagesoverchemotherapy.Astumorandstemcellsarehighlysensitive,cross-resistancebetweenradiationandchemotherapyispracticallyabsent.Duringirradiation,theabsorptioneffectdoesnotdevelopasitdoeswithchemotherapy,butadirectlineardependencebetweentheeffectofTBIandthecumulativedosehasbeenobserved.Moreover,TBIaffectsnon-dividingstemcells,independentlyoftheoxygeniceffect.Finally,itpossessesanimportantandsignificantimmunosuppressiveeffectinconditioning.Overthe50-yearperiodthatTBIhasbeeninuse,therehavebeenmanydifferentsources,beammodifications,singleandcumulativedoses,dosepower,andfractionationschemes.Theeffectofthedosepoweronhyperfractionationhasreduced,ashasthefrequencyoflatepulmonarycomplicationsinirradiation.Overthepast25yearsRRCRSThasbeenworkingonperfectingitsTBImethods.In2009theyregisteredapatentcalled“Methodofthetotalpatient'sbodyirradiation”,wherefirstlyanecessaryuniformityofbodyirradiationisachievedatsufficientdosepower,whichenablestheuseofmostlylow-andaveragedosevariantsofTBIforoncohematologicalneeds,andprovideshighprecisionofdoseabsorption.Low-andaveragedosevariantsofTBIwillbeusedasanindependentmethodoftherapyandconditioningregimen,aswellasbeforetransplantationofstemcellsjointlywithleadinghematologicalcenters.

【 授权许可】

Unknown