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目的:观察螺旋断层放疗系统进行骨髓移植前全身照射的剂量评价及急性毒副反应。方法:2011年8月至2012年8月采用螺旋断层放疗对6例白血病患者在异基因造血干细胞移植预处理期间实施全身照射,其中4例为急性淋巴细胞白血病(ALL)、1例为急性混合细胞白血病(MAL)、1例为T细胞性淋巴细胞白血病/T淋巴母细胞性淋巴瘤(T-LBL)。毒副反应的评价按CTCAE v3.0。结果:全部患者按计划完成全身照射。截至2013年12月1日,2例生存、4例死亡。急性毒副反应:腹泻4例,口腔黏膜炎4例,恶心、呕吐6例,未发现放射性肺炎和皮肤毒性。结论:应用螺旋断层放疗技术进行全身照射的剂量分布评价直观简便。肺的剂量限制对胸部和上腹部器官的剂量分布有明显影响。胃肠道3级或3级以上副反应常见。
OBJECTIVE: To evaluate the dose of whole-body irradiation and its acute toxicity in patients undergoing spiral CT system after bone marrow transplantation. METHODS: Six patients with leukemia underwent whole-body irradiation during pre-treatment of allogeneic hematopoietic stem cell transplantation from August 2011 to August 2012. Four of them were acute lymphoblastic leukemia (ALL) and one was acutely mixed Cell leukemia (MAL), and 1 case of T-cell lymphocytic leukemia / T-lymphoblastic lymphoma (T-LBL). Toxicity evaluation according to CTCAE v3.0. Results: All patients completed the whole body irradiation as planned. As of December 1, 2013, two survived and four died. Acute side effects: 4 cases of diarrhea, 4 cases of oral mucositis, nausea and vomiting in 6 cases, no radiation pneumonitis and skin toxicity was found. Conclusion: The dose distribution evaluation using whole-body radiation with helical CT is intuitive and easy. Lung dose limits have a significant effect on the dose distribution in the thoracic and upper abdominal organs. Gastrointestinal grade 3 or more common side effects.