PDF(Pubmed)
Abstract：
Total marrow irradiation (TMI) has significantly improved radiation conditioning for hematopoietic cell transplantation in hematologic diseases by reducing conditioning-induced toxicities and improving survival outcomes in relapsed/refractory patients. Recently, preclinical three-dimensional image-guided TMI has been developed to enhance mechanistic understanding of the role of TMI and to support the development of experimental therapeutics. However, a dosimetric comparison between preclinical and clinical TMI reveals that the preclinical TMI treatment lacks the ability to reduce the dose to some of the vital organs that are very close to the skeletal system and thus limits the ability to evaluate radiobiological relevance. To overcome this limit, we introduce a novel Sparse Orthogonal Collimator (SOC)-based TMI and evaluate its ability to enhance dosimetric conformality. The SOC-TMI-based dose modulation technique significantly improves TMI treatment planning by reducing radiation exposures to critical organs that are close to the skeletal system that leads to reducing the gap between clinical and preclinical TMI.
摘要：
全骨髓照射（TMI）通过减少条件诱导的毒性并改善复发/难治性患者的生存结果，显着改善了血液病中造血细胞移植的辐射条件。最近,已经开发了临床前三维图像引导的TMI，以增强对TMI作用的机械理解，并支持实验疗法的发展。然而,临床前和临床TMI之间的剂量学比较表明,临床前TMI治疗缺乏减少非常接近骨骼系统的一些重要器官的剂量的能力,因此限制了评估放射生物学相关性的能力.为了克服这个限制，我们介绍了一种新颖的基于稀疏正交准直器（SOC）的TMI，并评估了其增强剂量测定保形性的能力。基于SOC-TMI的剂量调制技术通过减少对靠近骨骼系统的关键器官的辐射暴露，显着改善了TMI治疗计划，从而减少了临床和临床前TMI之间的差距。
