Pape H
Klinik für Strahlentherapie und Radiologische Onkologie, Universität Düsseldorf.
Praxis (Bern 1994). 1996 Jun 4;85(23):749-52.
Conditioning regimes before bone marrow transplantation serve a dual purpose. Firstly they have to destroy the host immune system sufficiently to allow permanent engraftment, secondly they have to eliminate the abnormal tumor cells. The special aim of total body irradiation is to eradicate those cells, which escape chemotherapy. The effectiveness of TBI is influenced by: delivered dose, fraction size and dose rate. Dose escalation improves the results of TBI. The seven year survival probability is 74%, if more than 9,9 Gy are administered and only 38% under 9,9 Gy. Combining TBI and chemotherapy promotes the outcome in patients with acute leukaemia and allogeneic bone marrow transplantation. The two year relapse rate is 16% with and 37% without TBI. Side effects are distinctly determined by fraction size and dose rate.
骨髓移植前的预处理方案有双重目的。首先，它们必须充分破坏宿主免疫系统以实现永久性植入，其次，它们必须消除异常肿瘤细胞。全身照射的特殊目的是根除那些逃避化疗的细胞。全身照射的有效性受以下因素影响：给予的剂量、分次剂量和剂量率。剂量递增可改善全身照射的效果。如果给予超过9.9戈瑞的剂量，七年生存率为74%，而低于9.9戈瑞时仅为38%。全身照射与化疗相结合可改善急性白血病患者和异基因骨髓移植患者的预后。有全身照射时两年复发率为16%，无全身照射时为37%。副作用明显由分次剂量和剂量率决定。
