A Ten Year Experience in Total Body Irradiation in BMT Patients

骨髓移植病人之全身放射線照射－臺大醫院十年之經驗

雷德(Louis Tak Lui) ； 丁禮莉(Lai-Lei Ting) ； 王博民(Po-Ming Wang) ； 鍾娜娜(Na-Na Chung) ； 方麗麗(Lily Fong)

《中華放射線醫學雜誌》 21卷2期 (1996/04) Pp. 77-80

摘要

全身放射線照射被廣泛使用於血癌及淋巴瘤的骨髓移植，多分次放射治療療程是採用總劑量為1200cGy，分八次投予，每日三次，共進行兩天半。一個半值層之合金肺遮塊被用來減少肺毒性。急性毒性反應包括可逆性腸胃炎、口腔黏膜炎及骨髓抑制。延遲性毒性反應包括間質性肺炎、白內障及GVHD。間質性肺炎是骨髓移植後之主要致命原因之一。肺毒性反應發生於二十六例(56.5%)病人，其中有十六例死於間質性肺炎。在其中十五例(57.5%)可找到傳染病原，而五例為巨細胞病毒感染，如果找不到傳染病原則歸類為自發性間質性肺炎，我們的結果顯示接受全身放射線照射病人中有23.9%發生自發性間質性肺炎。

關鍵字

骨髓移植 ； 全身放射線照射

並列摘要

Total body irradiation is the popular treatment of lymphopoietic malignancies and preparation for bone marrow transplantation. Hyperfractionated radiation regimen was to deliver a total dose of 1200 cGy in 8 fractions, 3 fractions a day for 2.5 days. One HVL (half value layer) alloy lung shield is being used to minimize pulmonary toxicitiy. Acute toxic effects included reversible gastroenteritis, mucositis, and myelosuppression. Delayed toxic effects include interstitial pneumonitis, cataract formation and GVHD. Interstitial pneumonitis is one of the major causes of morbidity and mortality after bone marrow transplantation. Pulmonary toxicity occurred in 26 (56.5%) cases and 16 of them died from IP. In 15 infected cases, 5 were classified as IP with infectious agent of cytomegalo-virus. The other cases without infectious agent were classified as idiopathic IP (IIP), which occurred in 23.9% of the TBI patients.

並列關鍵字

Total body irradiation ； Bone marrow transplantation