造血干细胞移植X射线全身照射21例临床分析

TOTAL BODY IRRADIATION OF PREPARATIVE REGIMEN BEFORE HSCT

目的:探讨适合国人TBI剂量及方法。方法:回顾分析21例HSCT前TBI顶处理方案的毒性和机体重要器官吸收剂量及对植入、生存的影响。结果:TBI毒性未见明显增多,21例全部植入。ABMT 10例中复发死亡1例,1例出院后3个月死于感染,1例术后3年复发;另7例目前仍无病存活已4-10年;11例Allo-HSCT中8例仍无病存活。结论:国人TBI照射总剂量7—8Gy,一天内分两次给予,剂量率为4.99—6.96cGy/min,是安全、有效的;该方法双肺、双眼无挡铅,简便易行、适合基层单位开展TBI技术。

Objective： To study the total dose and way of total body irradiation （TBI） suit to Chinese. Method： To retrospectively analyses the toxicity and absorbed dose in the organs from TBI of preparative regimen and its effect on graft; and survival. Results： Toxicity from TBI didn＇t increase obviously and all the 21 cases had treatment, of 10 cases ABMT, 1 case died of relapse, 1 case died of infection, 1 case relapse in three years, other 7 cases had DFS for 4 to 10 year; of 11 cases Allo - HSCT, 8 cases remained in DFS more than 27 months. Conclusion： The total dose of 7- 8Gy, dose ratio of 4.99 - 6.96cGy/min and being delivered 2 times a day are suitable for Chinese.