gms | German Medical Science

27th German Cancer Congress Berlin 2006

German Cancer Society (Frankfurt/M.)

22. - 26.03.2006, Berlin

“Wiesbaden”-Results of Conditioning Therapy for Stem-Cell-Transplantation after Total Body Irradiation (TBI)

Meeting Abstract

  • corresponding author presenting/speaker Berthold J. Scharding - RNS-Strahlentherapie, Wiesbaden, Deutschland
  • Rainer Schwerdtfeger - KMT-Zentrum der DKD, Wiesbaden
  • Hanna Schmitz - RNS-Strahlentherapie, Wiesbaden
  • Herrad Baurmann - KMT-Zentrum der DKD, Wiesbaden
  • Eva Schlehuber - RNS-Strahlentherapie, Wiesbaden
  • Gabriele Lochhas - RNS-Strahlentherapie, Wiesbaden
  • Franz-Josef Prott - RNS-Strahlentherapie, Wiesbaden

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO385

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dkk2006/06dkk495.shtml

Published: March 20, 2006

© 2006 Scharding et al.
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Outline

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Background: TBI is an integral part of several conditioning protocols in stem cell transplan- tion. We report survival and toxicity data of TBI administered in cooperation with Transplant-Center of Deutsche Klinik für Diagnostik (DKD).

Material and Methods: Between 1997 and 2005 280 patients underwent a TBI (40.1% with AML, 19.2% with ALL, 17.4 with CML, 15.6 with NHL and 7.8 with MDS) in 856 fractions. 151 men and 129 women with a mean age of 42 years (16 to 63 years) were treated. The TBI was applied in a sitting position with bilateral open radiation fields using 15-MV-photons of a linear accelerator. Modelling bags (water-sacks) compensate the irregular surface of patient body to homogenize the dose distribution. Anterior-posterior opposed X-ray portals with individual designed lung shields adjust the radiation dose in mediastinum and lateral chestwall. Reduced TBI-dose (<= 8 Gy) was given in 131 patients (46.7%) and myeloablative TBI-dose (> 8 Gy) in 149 patients (53.2 %).

Results: After conditioning with radio- and chemotherapy in 166 cases (59.3%) allogenic unrelated, in 84 cases (30%) allogenic related and in 30 cases (10.7%) autologous stem cell transplantation followed. With a median follow up of 2.1 years 152 patients (54%) are alive, 125 (44%) died. 3 patients are lost of follow up. 134 living patients are in complete remission. CTC grade 3 and 4 toxicity associated with conditioning was found for oral mucosa in up to 90%, for genitourinary tract up to 47%, for gastrointestinal tract in up to 30%, for cutis in up to 24% and for lung up to 8%, mostly occurring combined with the chemotherapy drug VP16. Up to now irradiation induced late effects are rare (cataract in 2 cases).

Conclusion: The “Wiesbaden”-approach is established as a simple, reliable and feasible TBI-method with acceptable toxicity.