全身照射TBI.doc

全身照射（TBI）用于造血干细胞移植前预处理78例临床分析 李德志 周一兵 万久庆 陈正堂 （第三军医大学新桥医院肿瘤研究所 重庆 400037） 摘要： 目的 回顾性分析全身照射用于外周血干细胞移植治疗血液恶性肿瘤的作用、照射剂量和并发症。方法 2002年5月至2007年2月本院有78例造血干细胞移植病人使用了全身放疗作为预处理。采用直线加速器8MVX线，吸收剂量率为4.5-5.0cGy/min, 照射剂量为7-11Gy，连续两天完成。78例中，55例采用传统的先大剂量化疗再放疗的预处理方案，23例采用先TBI再大剂量化疗的顺序。 结果 78例使用了TBI为预处理病例移植全部成功，无严重的放射性肺炎等并发症发生。结论 全身照射预处理采用吸收剂量率小于5cGy/min、分两天照射、照射总剂量在成人为8-11Gy、在儿童为7-9Gy、肺受剂量小于7.5Gy的方案是安全，有效的。采用先TBI再大剂量化疗的顺序，可有效的减少TBI的即时反应，减少放疗科的准备工作量，又不影响预处理效果，值得临床进一步验证应用，采用直线加速器做TBI对设备有更高的要求需认真应对。 关键词： 全身照射； 干细胞移植； 血液肿瘤 The clinical analysis of total body irradiation for 78 examples of the peripheral blood stem cells transplantation Abstract Purpose Retrospective analysis of total body irradiation （TBI）for peripheral blood stem cell transplantation（PBSCT） in the treatment of malignant tumors, dose and complications. Methods May 2002 to February 2007 with 78 cases of hospital hematopoietic stem cell transplant patients using TBI as a pretreatment. Using linear accelerator 8 MVX line, absorbed dose rate of 4.5-5.0 cGy / min, 7-11 Gy irradiation dose for two days to complete. 78 cases, 55 cases of the traditional high-dose chemotherapy before radiotherapy in the conditioning regimen, 23 patients with TBI first to use large doses of chemotherapy order. Results 78 cases used for pretreatment TBI transplantation was successful in all cases, no serious complications such as pneumonia radioactive. Conclusion Pretreatment by TBI absorbed dose rate of less than 5 cGy / min, two-day radiation, the radiation dose in adults 8-11 Gy in 7-9 Gy children, lung by less than 7.5 Gy dose of the programme is safe and effective . TBI first to use large doses of the chemotherapy order to be effective even if the TBI reduction reaction, reducing the workload for the Department of Radiotherapy, without affecting the survival rate, it is worth further clinical validation applications, the linear accelerator of the equipment do TBI higher required