Outcomes of allogeneic hematopoietic stem cell transplantation with intensity-modulated total body irradiation: A 2-year follow-up prospective study
Intensity-modulated radiation therapy (IMRT) helps achieve good radiation dose conformity and precise dose evaluation. We conducted a single-center prospective study to assess the safety and efficacy of total body irradiation with IMRT (IMRT-TBI) in allogeneic hematopoietic stem cell transplantation. Thirty-nine patients with hematological malignancy who received 12 Gy IMRT-TBI were enrolled with a median follow-up of 934.5 (range, 617–1,254) days. The mean doses for the lungs and kidneys were 7.50 and 9.11 Gy, respectively. The mean maximum dose for the lens (right/left) was 5.75/5.87 Gy. The 2-year overall survival, disease-free survival, cumulative incidence of relapse, and non-relapse mortality were 69%, 64%, 18%, and 18%, respectively. Thirty-six patients developed early adverse events (including four patients with grade 3/4 toxicities). No patient developed primary graft failure, grade III–IV acute graft-versus-host disease, radiation pneumonitis, or cataracts. In conclusion, IMRT-TBI is feasible and efficacious for hematological malignancies with acceptable clinical outcomes.
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This is the final report of a prospective study (UMIN Clinical Trials Registry (UMIN-CTR: 000033248)).