短疗程全淋巴照射治疗难治性心脏移植排斥反应。
Short-course total lymphoid irradiation for refractory cardiac transplantation rejection.
作者信息
Lim Tee Sin, O'Driscoll Gerry, Freund Jerry, Peterson Vicki, Hayes Helen, Heywood Jonelle
机构信息
Department of Perth Radiation Oncology, Royal Perth Hospital, Perth, Australia.
出版信息
J Heart Lung Transplant. 2007 Dec;26(12):1249-54. doi: 10.1016/j.healun.2007.09.002. Epub 2007 Nov 26.
BACKGROUND
Total lymphoid irradiation (TLI) has been used as an effective therapy for refractory allograft cardiac transplantation rejection. In this study we assessed our short-course TLI regimen for treatment of this condition.
METHODS
A short course of TLI (4.5 Gy in 4 fractions) was given to 6 patients with recalcitrant allograft cardiac transplant rejection at the Royal Perth Hospital.
RESULTS
Treatment compliance was excellent with most patients having no acute toxicity. With a median follow-up of 25 months, 83% of patients remain alive and disease-free.
CONCLUSIONS
To date, no convincing evidence of radiation-related late effects have been documented with TLI. Nonetheless, larger scale trials are required for validation before this approach can be widely incorporated into the current transplantation (Tx) rejection regimen.
背景
全身淋巴照射（TLI）已被用作治疗难治性同种异体心脏移植排斥反应的有效疗法。在本研究中，我们评估了用于治疗这种情况的短疗程TLI方案。
方法
在皇家珀斯医院，对6例顽固性同种异体心脏移植排斥反应患者给予短疗程TLI（4.5 Gy，分4次照射）。
结果
治疗依从性良好，大多数患者无急性毒性反应。中位随访25个月时，83%的患者仍存活且无疾病。
结论
迄今为止，尚无关于TLI导致辐射相关迟发效应的确凿证据。尽管如此，在这种方法能够广泛纳入当前移植（Tx）排斥反应治疗方案之前，还需要进行更大规模的试验以进行验证。
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