ESTRO ACROP and SIOPE recommendations for myeloablative Total Body Irradiation in children.
Access full-text PDFOpen Access
Check access options
Check access options
AuthorHoeben, Bianca A W
Bosman, Mirjam E
Albert, Michael H
Mico Milla, Soraya
Demiroz Abakay, Candan
Bentzen, Søren M
Kobyzeva, Daria A
Loginova, Anna A
Janssens, Geert O
JournalRadiotherapy and Oncology
MetadataShow full item record
AbstractBackground and purpose: Myeloablative Total Body Irradiation (TBI) is an important modality in conditioning for allogeneic hematopoietic stem cell transplantation (HSCT), especially in children with high-risk acute lymphoblastic leukemia (ALL). TBI practices are heterogeneous and institution-specific. Since TBI is associated with multiple late adverse effects, recommendations may help to standardize practices and improve the outcome versus toxicity ratio for children. Material and methods: The European Society for Paediatric Oncology (SIOPE) Radiotherapy TBI Working Group together with ESTRO experts conducted a literature search and evaluation regarding myeloablative TBI techniques and toxicities in children. Findings were discussed in bimonthly virtual meetings and consensus recommendations were established. Results: Myeloablative TBI in HSCT conditioning is mostly performed for high-risk ALL patients or patients with recurring hematologic malignancies. TBI is discouraged in children <3-4 years old because of increased toxicity risk. Publications regarding TBI are mostly retrospective studies with level III-IV evidence. Preferential TBI dose in children is 12-14.4 Gy in 1.6-2 Gy fractions b.i.d. Dose reduction should be considered for the lungs to <8 Gy, for the kidneys to ≤10 Gy, and for the lenses to <12 Gy, for dose rates ≥6 cGy/min. Highly conformal techniques i.e. TomoTherapy and VMAT TBI or Total Marrow (and/or Lymphoid) Irradiation as implemented in several centers, improve dose homogeneity and organ sparing, and should be evaluated in studies. Conclusions: These ESTRO ACROP SIOPE recommendations provide expert consensus for conventional and highly conformal myeloablative TBI in children, as well as a supporting literature overview of TBI techniques and toxicities.
Rights/TermsCopyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.
Hematopoietic stem cell transplantation
Total Body Irradiation
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/19215
- Factors Influencing Pulmonary Toxicity in Children Undergoing Allogeneic Hematopoietic Stem Cell Transplantation in the Setting of Total Body Irradiation-Based Myeloablative Conditioning.
- Authors: Abugideiri M, Nanda RH, Butker C, Zhang C, Kim S, Chiang KY, Butker E, Khan MK, Haight AE, Chen Z, Esiashvili N
- Issue date: 2016 Feb 1
- Towards homogenization of total body irradiation practices in pediatric patients across SIOPE affiliated centers. A survey by the SIOPE radiation oncology working group.
- Authors: Hoeben BAW, Pazos M, Albert MH, Seravalli E, Bosman ME, Losert C, Boterberg T, Manapov F, Ospovat I, Milla SM, Abakay CD, Engellau J, Kos G, Supiot S, Bierings M, Janssens GO
- Issue date: 2021 Feb
- Organ sparing total marrow irradiation compared to total body irradiation prior to allogeneic stem cell transplantation.
- Authors: Haraldsson A, Wichert S, Engström PE, Lenhoff S, Turkiewicz D, Warsi S, Engelholm S, Bäck S, Engellau J
- Issue date: 2021 Oct
- Extreme heterogeneity of myeloablative total body irradiation techniques in clinical practice: a survey of the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation.
- Authors: Giebel S, Miszczyk L, Slosarek K, Moukhtari L, Ciceri F, Esteve J, Gorin NC, Labopin M, Nagler A, Schmid C, Mohty M
- Issue date: 2014 Sep 1
- Ovarian function after allogeneic hematopoietic stem cell transplantation in children and young adults given 8-Gy total body irradiation-based reduced-toxicity myeloablative conditioning.
- Authors: Komori K, Hirabayashi K, Morita D, Hara Y, Kurata T, Saito S, Tanaka M, Yanagisawa R, Sakashita K, Koike K, Nakazawa Y
- Issue date: 2019 May