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Renal toxicity after total body irradiation
Martin Borg1, Timothy Hughes, Noemi Horvath
1Department of Radiation Oncology, Royal Adelaide Hospital, The University of Adelaide, North Terrace, Adelaide, SA 5000, Australia. mborg@mail.rah.sa.gov.au
International Journal of Radiation Oncology, Biology, Physics
|November 7, 2002
Summary
Total body irradiation (TBI) at 12 Gy showed a low incidence of renal dysfunction. Only one patient developed radiation nephritis 24 months after bone marrow transplantation (BMT), indicating TBI
Area of Science:
- Oncology
- Nephrology
- Radiation Oncology
Background:
- Total body irradiation (TBI) is a critical component of conditioning regimens for bone marrow transplantation (BMT).
- Assessing the long-term renal toxicity of TBI is crucial for patient outcomes.
- Renal dysfunction can be a significant complication following high-dose radiation therapy.
Purpose of the Study:
- To evaluate the incidence and risk factors of renal dysfunction after 12 Gy total body irradiation (TBI) in patients undergoing bone marrow transplantation (BMT).
Main Methods:
- A cohort of 59 patients receiving 12 Gy TBI before BMT between 1990 and 1997 were analyzed.
- Renal function was monitored via serum creatinine levels at baseline and up to 24 months post-BMT.
- Cox proportional hazard analysis was employed to identify factors associated with renal dysfunction.
Main Results:
- Only 4 patients (6.8%) had elevated creatinine at 12 months, with 2 (3.4%) showing persistent elevation at 24 months.
- One patient developed chronic renal failure secondary to radiation nephritis; another had possible radiation nephritis.
- Hypertension was correlated with TBI-related renal dysfunction on univariate, but not multivariate, analysis.
Conclusions:
- A 12 Gy TBI dose, delivered at 2 Gy/fraction, demonstrated a low incidence of radiation nephritis (1.7% at 24 months post-BMT).
- This TBI regimen appears to have acceptable renal toxicity in the context of BMT conditioning.
- Further investigation into the role of hypertension as a risk factor is warranted.