The Safety and Efficacy of Total Body Irradiation Before Allogeneic Stem Cell Transplantation for Lymphomas and Acute Leukemia Using Novel uRT-linac 506c Accelerator

Deng D, Shen J, Jiang D, Chen X and Xiong Y

Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, China
Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, China
Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, China
Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, China
These authors contributed equally to this work

^*Correspondance to: Yu Xiong 

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Abstract:

Purpose: The conditioning strategy for Hematopoietic Stem Cell Transplantation (HSCT) has frequently included Total Body Irradiation (TBI), however this has serious toxicities. uRT-linac 506c allows precise and homogeneous tumor coverage and excellent sparing of organs at risk. The purpose of this study was to evaluate the clinical outcomes of TBI using novel uRT-linac 506c accelerator before HSCT for lymphomas and acute leukemia.
Methods and Materials: 31 patients (4 Acute Myelogenous Leukemia (AML), 17 Acute Lymphoblastic Leukemia (ALL), 9 Non-Hodgkin’s Lymphoma (NHL), 1 Mixed Acute Leukemia (MAL)) received conditioning radiation treatment with TBI (8 Gy to bone marrow, 10 Gy to total body, 12 Gy to involved field in 2 fractions per day) in conjunction with chemotherapy before transplantation.
Results: The median age of the 31 TBI patients was 27 (13 to 55) years. Median dose of Organs at Risk (OARs) was down-regulated by 39.2% to 85.7% of the prescription dose. The majority of the acute toxicity were grade 1 to 2. Six reported nausea and vomiting, 3 headaches, 5 fatigue, 3 oral mucositis, 2 parotitis, 1 temporary loss of taste, as well as 2 fever and 3 enteritis. Late toxicities include 6 infectious pneumonia and one cytomegalovirus infection. The 2-year Progression-Free Survival (PFS) and Overall Survival (OS) rates post-transplant were 84.8% (95% CI: - 0.039, 0.006) and 57.0% (95% CI: -0.075, -0.026), respectively.
Conclusion: This study demonstrates that TBI using novel uRT-linac 506c accelerator as a conditioning regimen for lymphoma and acute leukemia was feasible and the clinical outcomes were acceptable.

Keywords:

Total body irradiation; Allogeneic hematopoietic cell transplantation; uRT-linac 506c; Lymphoma; Acute leukemia

Cite the Article:

Deng D, Shen J, Jiang D, Chen X, Xiong Y. The Safety and Efficacy of Total Body Irradiation Before Allogeneic Stem Cell Transplantation for Lymphomas and Acute Leukemia Using Novel uRT-linac 506c Accelerator. Clin Oncol. 2022;7:1973..