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Total body irradiation

Kevin Rakszawski, Kosuke Miki, David Claxton, Henry Wagner, Hiroko Shike, Shin Mineishi, Seema Naik
Approximately 30-40% of patients with acute myeloid leukemia (AML) experience induction failures. In these patients who do not achieve remission with two cycles of standard induction therapies, the probability of achieving remission with subsequent inductions is very limited. Hematopoietic stem cell transplantation (HSCT) is the only curative option for these patients, but high relapse rate and transplant-related mortality often preclude them to proceed to transplant. Thus, AML not in remission at time of HSCT remains a huge unmet need in current HSCT practice, particularly if the patient does not have an HLA-matched donor identified by the time of two induction failures...
March 14, 2018: International Journal of Hematology
Tünde Szatmári, Eszter Persa, Enikő Kis, Anett Benedek, Rita Hargitai, Géza Sáfrány, Katalin Lumniczky
PURPOSE: Radiation-induced bystander effects (RIBE) imply the involvement of complex signaling mechanisms, which can be mediated by extracellular vesicles (EVs). Using an in vivo model, we investigated EV-transmitted RIBE in blood plasma and radiation effects on plasma EV miRNA profiles. MATERIALS AND METHODS: C57Bl/6 mice were total-body irradiated with 0.1 and 2Gy, bone marrow-derived EVs were isolated, and injected systemically into naïve, "bystander" animals...
March 13, 2018: International Journal of Radiation Biology
Yoshikazu Maeda, Yoshitaka Sato, Hiroki Minami, Yutaka Yasukawa, Kazutaka Yamamoto, Hiroyasu Tamamura, Satoshi Shibata, Sayuri Bou, Makoto Sasaki, Yuji Tameshige, Kyo Kume, Hiroshi Ooto, Shigeru Kasahara, Yasuhiro Shimizu, Yusuke Saga, Akira Omoya, Makoto Saitou
PURPOSE: To evaluate the effectiveness of CT image-guided proton radiotherapy for prostate cancer by analyzing the positioning uncertainty and assessing daily dose change due to anatomical variations. MATERIALS AND METHODS: Patients with prostate cancer were treated by opposed lateral proton beams based on a passive scattering method using an in-room CT image-guided system. The system employs a single couch for both CT scanning and beam delivery. The patient was positioned by matching the boundary between the prostate and the rectum's anterior region identified in the CT images to the corresponding boundary in the simulator images after bone matching...
March 12, 2018: Medical Physics
John A Cook, Sarwat Naz, Miriam R Anver, Anastasia L Sowers, Kristin Fabre, Murali C Krishna, James B Mitchell
Amifostine is a potent antioxidant that protects against ionizing radiation effects. In this study, we evaluated the effect of Amifostine administered before total-body irradiation (TBI), at a drug dose that protects against TBI lethality, for potential protection against radiation-induced late effects such as a shortened lifespan and cancer. Three groups of mice were studied: 0 Gy control; 10.8 Gy TBI with Amifostine pretreatment; and 5.4 Gy TBI alone. Animals were monitored for their entire lifespan. The median survival times for mice receiving 0, 5...
March 12, 2018: Radiation Research
Delphine Barnoud, Claire Pinçon, Bénédicte Bruno, Johana Béné, Sophie Gautier, Annie Lahoche, Nadine Petitpain, Michèle Vasseur, Christine Barthélémy, Bertrand Décaudin, Nicolas Simon, Pascal Odou
BACKGROUND: Etoposide phosphate (EP; single injection, 60 mg/kg) followed by total body irradiation (TBI) at 12 Gy has been used as an allogeneic stem cell transplantation (allo-SCT) conditioning regimen for children since 2010. In our institution, EP has been suspected of leading to acute nephrotoxicity. The aim of this study was to assess the potential renal toxicity of EP in this context. MATERIALS AND METHODS: A retrospective study was carried out on children hospitalized between 2007 and 2015 for allo-SCT with TBI-based myeloablative conditioning associated with cyclophosphamide (CY, 60 mg/kg/day × 2 days) or EP...
March 12, 2018: Pediatric Blood & Cancer
Jay Burmeister, Adrian Nalichowski, Michael Snyder, Robert Halford, Geoff Baran, Brian Loughery, Ahmad Hammoud, Joe Rakowski, Todd Bossenberger
We describe the commissioning of the first dedicated commercial total body irradiation (TBI) unit in clinical operation. The Best Theratronics GammaBeam 500 is a Co-60 teletherapy unit with extended field size and imaging capabilities. Radiation safety, mechanical and imaging systems, and radiation output are characterized. Beam data collection, calibration, and external dosimetric validation are described. All radiation safety and mechanical tests satisfied relevant requirements and measured dose distributions meet recommendations of American Association of Physicists in Medicine (AAPM) Report #17...
March 11, 2018: Journal of Applied Clinical Medical Physics
Dakshika A Gunaratne, Michael J Veness
Radiation oncologists are increasingly tasked with the management of elderly patients with non-melanoma skin cancer, unsuitable for surgical intervention due to inoperable lesions and/or poor performance status. In this cohort, hypofractionated radiotherapy, delivered either daily, alternative daily or once weekly is highly effective. A systematic literature search was conducted of PUBMED, MEDLINE and EMBASE databases using the algorithm ('radiotherapy' OR 'radiation therapy' OR 'brachytherapy') AND ('hypofraction' OR 'hypofractionated' OR 'hypofractionation') AND ('skin neoplasms' OR 'carcinoma' OR 'malignancy') AND ('skin' OR 'epidermis' OR 'epidermal' OR 'cutaneous')...
March 9, 2018: Journal of Medical Imaging and Radiation Oncology
Panagiotis Delinikolas, Georgios Patatoukas, Vasilios Kouloulias, Maria Dilvoi, Agapi Plousi, Efstathios Efstathopoulos, Kalliopi Platoni
PURPOSE: Certain radiation responsive skin diseases may develop symptoms on the upper or the lower half of the body. The concept of a novel Hemi-Body Electron Irradiation (HBIe- ) technique, described in this work, provides a low cost, LINAC based, intermediate treatment option in between extremely localized and Total Skin irradiation techniques. MATERIALS AND METHODS: The HBIe- technique, developed in our department, incorporates a custom crafted treatment chamber equipped with adjustable Pb shielding and a single electron beam in extended Source-Skin Distance (SSD) setup...
February 2018: Physica Medica: PM
Kohei Chida, Atsushi Sugawara, Takahiro Koji, Takaaki Beppu, Yoshiharu Mue, Tamotsu Sugai, Knuaki Ogasawara
A 79-year-old man presented with primary intramedullary malignant lymphoma with a presyrinx state in the cervical cord manifesting as left hemiparesis and hemidysesthesia. The magnetic resonance imaging (MRI) scan showed an intramedullary mass in the cervical spinal cord at the level of C1 and T2-weighted image prolongation from the medulla to the level of C5. According to the progression of hemiparesis, he underwent an emergency removal of the tumor under general anesthesia. The tumor was totally removed, and the peritumoral signal abnormality was not present in the postoperative MRI...
December 30, 2017: Curēus
Adrien Paix, Delphine Antoni, Waisse Waissi, Marie-Pierre Ledoux, Karin Bilger, Luc Fornecker, Georges Noel
Hematologic malignancies may require, at one point during their treatment, allogeneic bone marrow transplantation. Total body irradiation combined with chemotherapy or radiomimetic used in allogeneic bone marrow transplantation is known to be very toxic. Total body irradiation (TBI) induces immunosuppression to prevent the rejection of donor marrow. TBI is also used to eradicate malignant cells and is in sanctuary organs that are not reached by chemotherapy drugs. TBI has evolved since its introduction in the late fifties, but acute and late toxicities remain...
March 2018: Critical Reviews in Oncology/hematology
Simone Cesaro, Gloria Tridello, Nicole Blijlevens, Per Ljungman, Charles Craddock, Mauricette Michallet, Alexander Martin, John A Snowden, Mohamad Mohty, Johan Maertens, Jacob Passweg, Eefke Petersen, Anne Nihtinen, Cecilia Isaksson, Noel Milpied, Pierre-Simon Rohlich, Eric Deconinck, Charles Crawley, Marie-Pierre Ledoux, Jennifer Hoek, Arnon Nagler, Jan Styczynski
Objectives: To assess the incidence of, and risk factors for, Candida infection in the first 100 days after allogeneic hematopoietic stem cell transplantation (HSCT) and the impact on long-term survival. Methods: outcome analysis of 28,542 acute leukemia patients who underwent HSCT from 2000 to 2012: 347 with candidemia by day +100, and 28,195 without candidemia or any other type of Candida infection. Results: The incidence of candidemia by day +100 was 1...
February 22, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Ales Tichy, Sylwia Kabacik, Grainne O'Brien, Jaroslav Pejchal, Zuzana Sinkorova, Adela Kmochova, Igor Sirak, Andrea Malkova, Caterina Gomila Beltran, Juan Ramon Gonzalez, Jakub Grepl, Matthaeus Majewski, Elizabeth Ainsbury, Lenka Zarybnicka, Jana Vachelova, Alzbeta Zavrelova, Marie Davidkova, Marketa Markova Stastna, Michael Abend, Eileen Pernot, Elisabeth Cardis, Christophe Badie
The increasing risk of acute large-scale radiological/nuclear exposures of population underlines the necessity of developing new, rapid and high throughput biodosimetric tools for estimation of received dose and initial triage. We aimed to compare the induction and persistence of different radiation exposure biomarkers in human peripheral blood in vivo. Blood samples of patients with indicated radiotherapy (RT) undergoing partial body irradiation (PBI) were obtained soon before the first treatment and then after 24 h, 48 h, and 5 weeks; i...
2018: PloS One
Zimin Sun, Huilan Liu, Chenhui Luo, Liangquan Geng, Changcheng Zheng, Baolin Tang, Xiaoyu Zhu, Juan Tong, Xingbing Wang, Kaiyang Ding, Xiang Wan, Lei Zhang, Wen Yao, Kaiding Song, Xuhan Zhang, Yue Wu, Huizhi Yang, Yongsheng Han, Xin Liu, Weibo Zhu, Jingsheng Wu, Zuyi Wang
Cord blood transplantation (CBT) is an effective option for treating hematological malignancies, but graft failure (GF) remains the primary cause of therapy failure. Thus, based on myeloablative conditioning (MAC) of busulfan with cyclophosphamide (Bu/Cy) or total body irradiation with Cy (TBI/Cy), fludarabine (Flu) was added to Bu/Cy and cytarabine (CA) to TBI/Cy for a modified myeloablative conditioning (MMAC). To compare the prognosis of MMAC with MAC, we conducted a retrospective study including 58 patients who underwent CBT with MAC or MMAC from 2000 to 2011...
February 23, 2018: International Journal of Cancer. Journal International du Cancer
Nina K Steckel, Christoph Groth, Jan-Henrik Mikesch, Rudolf Trenschel, Hellmut Ottinger, Lambros Kordelas, Carsten Mueller-Tidow, Christoph Schliemann, Christian Reicherts, Joern C Albring, Gerda Silling, Eva Schmidt, Wolfgang E Berdel, Georg Lenz, Markus Ditschkowski, Dietrich W Beelen, Matthias Stelljes
Considering the unsatisfactory results of salvage therapies for patients with relapsed/refractory acute myeloid leukaemia (R/R-AML), their value before allogeneic haematopoietic stem cell transplantation (HSCT) remains questionable. However, direct allogeneic HSCT following established conditioning regimens applied in patients with R/R-AML during active disease has been equally disappointing. In this retrospective observational study, high-dose melphalan, as part of a sequential preparative regimen, followed by a total body irradiation (4 × 2 Gy)-based or a treosulfan-based dose-adapted conditioning therapy for allogeneic HSCT was administered to 292 adult patients (median age 56 years, range 17-74) with primary refractory (144 patients), secondary refractory (97 patients) or relapsed AML (51 patients)...
February 21, 2018: British Journal of Haematology
Michael V Accardi, Oreola Donini, Adam Rumage, Alexis Ascah, Julius Haruna, Mylène Pouliot, Kim Bujold, Hai Haung, Wieslaw Wierzbicki, John Stamatopoulos, Houman Naraghi, Thomas Measey, Simon Authier
PURPOSE: Characterization of a novel partial body irradiation (PBI) shielding strategy in nonhuman primates (NHP; rhesus macaques), aimed at protecting the oral cavity, with respect to various gastrointestinal (GI-ARS) syndrome parameters as well as buccal ulceration development. MATERIALS AND METHODS: NHPs were irradiated using a Cobalt-60 gamma source, in a single uniform dose, ranging from 9-13 Gy and delivered at 0.60-0.80 Gy min -1 . Animals were either partially shielded via oral cavity shielding (PBI OS ) or underwent total body irradiation (TBI)...
February 15, 2018: International Journal of Radiation Biology
Zhi-Jian Sun, Yi-Zhe Zhang, Fan Liu, Juan-Juan Chen, Dong-Xue Chen, Hong-Bao Liu, Liang Liang, Hua Han
Intestine is vulnerable to irradiation injury, which induces cell death and compromises regeneration of intestinal crypts. It is well accepted that cryptic stem cells, which are responsible for cryptic regeneration under physiological and pathological conditions, are controlled by multiple cell-intrinsic and environmental signals such as Notch signaling. Therefore in this study, we tested whether a soluble Notch ligand tethered to endothelial cells -- mD1R -- ¬¬¬the DSL domain of mouse Notch ligand Delta-like1 fused with a RGD motif, could protect cryptic cells from irradiation-induced intestinal injury...
February 14, 2018: Bioscience Reports
Jason J Luke, Jeffrey M Lemons, Theodore G Karrison, Sean P Pitroda, James M Melotek, Yuanyuan Zha, Hania A Al-Hallaq, Ainhoa Arina, Nikolai N Khodarev, Linda Janisch, Paul Chang, Jyoti D Patel, Gini F Fleming, John Moroney, Manish R Sharma, Julia R White, Mark J Ratain, Thomas F Gajewski, Ralph R Weichselbaum, Steven J Chmura
Purpose Stereotactic body radiotherapy (SBRT) may stimulate innate and adaptive immunity to augment immunotherapy response. Multisite SBRT is an emerging paradigm for treating metastatic disease. Anti-PD-1-treatment outcomes may be improved with lower disease burden. In this context, we conducted a phase I study to evaluate the safety of pembrolizumab with multisite SBRT in patients with metastatic solid tumors. Patients and Methods Patients progressing on standard treatment received SBRT to two to four metastases...
February 13, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Ivetta Danylesko, Avichai Shimoni
Second malignancies are a rare but well-defined late complication after autologous and allogeneic hematopoietic stem-cell transplantation (SCT). Solid malignancies occur in up to 15% of patients 15 years after SCT with myeloablative conditioning, with no plateau in the incidence rates. They are responsible for 5-10% of late deaths after SCT. The incidence is increased with advanced age at SCT. The major risk factors are the use of total body irradiation, which is associated with adenocarcinomas and with chronic graft-versus-host disease which is associated with squamous cell cancers...
February 8, 2018: Current Treatment Options in Oncology
Kaichi Nishiwaki, Koji Sano, Yutaro Kamiyama, Kazumi Hayashi, Susumu Tanoue, Mituji Katori, Hidekazu Masuoka, Keisuke Aiba
Allogeneic hematopoietic stem cell transplantation is recommended as a curative treatment option for fulminant aplastic anemia with no neutrophil despite the administration of granulocyte-colony stimulating factor. In the absence of an HLA-matched donor, unrelated cord blood transplantation (UCBT) is a treatment option that can be performed quickly. However, the optimal conditioning regimen of UCBT is yet to be established. We report two cases of fulminant aplastic anemia in adult patients who received UCBT...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Ryouta Imanaka, Yuta Katayama, Koji Iwato, Kouhei Kyo, Takeshi Okatani, Mitsuhiro Itagaki, Shinya Katsutani, Hideki Asaoku
The poor prognosis of extramedullary recurrence of acute leukemia following allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains a therapeutic challenge, and thus far no effective treatment method has been established. Here, we report two patients who presented with relapsed leukemia as extramedullary tumor in the ovary following allo-HSCT. Case 1: A 23-year-old female underwent unrelated allogeneic bone marrow transplantation during the second remission of acute myeloid leukemia. After 706 days post-transplant, bilateral ovarian tumors were detected during the pelvic ultrasound, and extramedullary recurrence in the bilateral ovaries was subsequently established on right salpingo-oophorectomy and biopsy of the left ovary...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
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