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dc.contributor.authorHoeben, Bianca A W
dc.contributor.authorPazos, Montserrat
dc.contributor.authorSeravalli, Enrica
dc.contributor.authorBosman, Mirjam E
dc.contributor.authorLosert, Christoph
dc.contributor.authorAlbert, Michael H
dc.contributor.authorBoterberg, Tom
dc.contributor.authorOspovat, Inna
dc.contributor.authorMico Milla, Soraya
dc.contributor.authorDemiroz Abakay, Candan
dc.contributor.authorEngellau, Jacob
dc.contributor.authorJóhannesson, Vilberg
dc.contributor.authorKos, Gregor
dc.contributor.authorSupiot, Stéphane
dc.contributor.authorLlagostera, Camille
dc.contributor.authorBierings, Marc
dc.contributor.authorScarzello, Giovanni
dc.contributor.authorSeiersen, Klaus
dc.contributor.authorSmith, Ed
dc.contributor.authorOcanto, Abrahams
dc.contributor.authorFerrer, Carlos
dc.contributor.authorBentzen, Søren M
dc.contributor.authorKobyzeva, Daria A
dc.contributor.authorLoginova, Anna A
dc.contributor.authorJanssens, Geert O
dc.date.accessioned2022-06-21T14:27:15Z
dc.date.available2022-06-21T14:27:15Z
dc.date.issued2022-05-31
dc.identifier.urihttp://hdl.handle.net/10713/19215
dc.description.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.en_US
dc.description.urihttps://doi.org/10.1016/j.radonc.2022.05.027en_US
dc.language.isoenen_US
dc.publisherElsevieren_US
dc.relation.ispartofRadiotherapy and Oncologyen_US
dc.rightsCopyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.en_US
dc.subjectConsensus recommendationsen_US
dc.subjectHematopoietic stem cell transplantationen_US
dc.subjectPediatricen_US
dc.subjectTotal Body Irradiationen_US
dc.titleESTRO ACROP and SIOPE recommendations for myeloablative Total Body Irradiation in children.en_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.radonc.2022.05.027
dc.identifier.pmid35661674
dc.source.journaltitleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
dc.source.volume173
dc.source.beginpage119
dc.source.endpage133
dc.source.countryIreland


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