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Sample records for body irradiation tbi

  1. Similar Survival for Patients Undergoing Reduced-Intensity Total Body Irradiation (TBI) Versus Myeloablative TBI as Conditioning for Allogeneic Transplant in Acute Leukemia

    International Nuclear Information System (INIS)

    Purpose: Hematopoietic stem cell transplantation (HSCT) is the mainstay of treatment for adults with acute leukemia. Total body irradiation (TBI) remains an important part of the conditioning regimen for HCST. For those patients unable to tolerate myeloablative TBI (mTBI), reduced intensity TBI (riTBI) is commonly used. In this study we compared outcomes of patients undergoing mTBI with those of patients undergoing riTBI in our institution. Methods and Materials: We performed a retrospective review of all patients with acute leukemia who underwent TBI-based conditioning, using a prospectively acquired database of HSCT patients treated at our institution. Patient data including details of the transplantation procedure, disease status, Karnofsky performance status (KPS), response rates, toxicity, survival time, and time to progression were extracted. Patient outcomes for various radiation therapy regimens were examined. Descriptive statistical analysis was performed. Results: Between June 1985 and July 2012, 226 patients with acute leukemia underwent TBI as conditioning for HSCT. Of those patients, 180 had full radiation therapy data available; 83 had acute lymphoblastic leukemia and 94 had acute myelogenous leukemia; 45 patients received riTBI, and 135 received mTBI. Median overall survival (OS) was 13.7 months. Median relapse-free survival (RFS) for all patients was 10.2 months. Controlling for age, sex, KPS, disease status, and diagnosis, there were no significant differences in OS or RFS between patients who underwent riTBI and those who underwent mTBI (P=.402, P=.499, respectively). Median length of hospital stay was shorter for patients who received riTBI than for those who received mTBI (16 days vs 23 days, respectively; P<.001), and intensive care unit admissions were less frequent following riTBI than mTBI (2.22% vs 12.69%, respectively, P=.043). Nonrelapse survival rates were also similar (P=.186). Conclusions: No differences in OS or RFS were seen between

  2. Similar Survival for Patients Undergoing Reduced-Intensity Total Body Irradiation (TBI) Versus Myeloablative TBI as Conditioning for Allogeneic Transplant in Acute Leukemia

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    Mikell, John L., E-mail: jmikell@emory.edu [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Waller, Edmund K. [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Switchenko, Jeffrey M. [Department of Biostatistics and Bioinformatics, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Rangaraju, Sravanti; Ali, Zahir; Graiser, Michael [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Hall, William A. [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Langston, Amelia A. [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Esiashvili, Natia [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Khoury, H. Jean [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Khan, Mohammad K. [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

    2014-06-01

    Purpose: Hematopoietic stem cell transplantation (HSCT) is the mainstay of treatment for adults with acute leukemia. Total body irradiation (TBI) remains an important part of the conditioning regimen for HCST. For those patients unable to tolerate myeloablative TBI (mTBI), reduced intensity TBI (riTBI) is commonly used. In this study we compared outcomes of patients undergoing mTBI with those of patients undergoing riTBI in our institution. Methods and Materials: We performed a retrospective review of all patients with acute leukemia who underwent TBI-based conditioning, using a prospectively acquired database of HSCT patients treated at our institution. Patient data including details of the transplantation procedure, disease status, Karnofsky performance status (KPS), response rates, toxicity, survival time, and time to progression were extracted. Patient outcomes for various radiation therapy regimens were examined. Descriptive statistical analysis was performed. Results: Between June 1985 and July 2012, 226 patients with acute leukemia underwent TBI as conditioning for HSCT. Of those patients, 180 had full radiation therapy data available; 83 had acute lymphoblastic leukemia and 94 had acute myelogenous leukemia; 45 patients received riTBI, and 135 received mTBI. Median overall survival (OS) was 13.7 months. Median relapse-free survival (RFS) for all patients was 10.2 months. Controlling for age, sex, KPS, disease status, and diagnosis, there were no significant differences in OS or RFS between patients who underwent riTBI and those who underwent mTBI (P=.402, P=.499, respectively). Median length of hospital stay was shorter for patients who received riTBI than for those who received mTBI (16 days vs 23 days, respectively; P<.001), and intensive care unit admissions were less frequent following riTBI than mTBI (2.22% vs 12.69%, respectively, P=.043). Nonrelapse survival rates were also similar (P=.186). Conclusions: No differences in OS or RFS were seen between

  3. Retrospective, monocentric analysis of late effects after total body irradiation (TBI) in adults

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    Boelling, Tobias [Universitaetsklinikum Muenster (Germany). Dept. of Radiotherapy; Paracelsus Clinic Osnabrueck (Germany). Dept. of Radiotherapy; Kreuziger, David Christoph; Ernst, Iris; Elsayed, Hassan; Willich, Normann [Universitaetsklinikum Muenster (Germany). Dept. of Radiotherapy

    2011-05-15

    Purpose: Total body irradiation (TBI) is a standard treatment modality within the multidisciplinary approach for allogeneous stem cell or bone marrow transplantation. However, surviving patients are at risk for developing a variety of late sequelae. This analysis aimed to retrospectively characterize late effects after TBI in adults treated in a single center. Patients and Methods: Patients {>=} 18 years treated with fractionated TBI (4-12 Gy) between 1996 and 2008 were included in this study. Treatment data were collected retrospectively from the treating departments. Late effects were evaluated using the clinic charts and/or were obtained from the general practitioners using a standardized questionnaire. Analyses were performed by calculation of the cumulative incidences using the Kaplan-Meier method and the log rank test. Results: A total of 308 patients {>=} 18 years were treated including a TBI of whom 78 patients were excluded from further analysis due to death within less than 1 year after TBI. Patients suffered from leukemia in most cases. Late toxicity follow-up was available in 120 patients (mean age 46.1 years; range, 18-70 years) after a mean follow-up of 23 months (range, 12-96 months). The cumulative incidences (CI) at 3 years were 28% for pulmonary event, 8% for pulmonary toxicity, 25% for kidney toxicity, 8% for cataract, 17% for bone toxicity, and 10% for secondary malignancy. The CI of bone toxicity was higher in female than in male patients (p = 0.019). Conclusion: Late effects after TBI in the context of allogeneous stem cell or bone marrow transplantation can frequently be observed. Regular follow-up examinations are advised for the early registration and treatment of adverse effects. (orig.)

  4. Retrospective, monocentric analysis of late effects after total body irradiation (TBI) in adults

    International Nuclear Information System (INIS)

    Purpose: Total body irradiation (TBI) is a standard treatment modality within the multidisciplinary approach for allogeneous stem cell or bone marrow transplantation. However, surviving patients are at risk for developing a variety of late sequelae. This analysis aimed to retrospectively characterize late effects after TBI in adults treated in a single center. Patients and Methods: Patients ≥ 18 years treated with fractionated TBI (4-12 Gy) between 1996 and 2008 were included in this study. Treatment data were collected retrospectively from the treating departments. Late effects were evaluated using the clinic charts and/or were obtained from the general practitioners using a standardized questionnaire. Analyses were performed by calculation of the cumulative incidences using the Kaplan-Meier method and the log rank test. Results: A total of 308 patients ≥ 18 years were treated including a TBI of whom 78 patients were excluded from further analysis due to death within less than 1 year after TBI. Patients suffered from leukemia in most cases. Late toxicity follow-up was available in 120 patients (mean age 46.1 years; range, 18-70 years) after a mean follow-up of 23 months (range, 12-96 months). The cumulative incidences (CI) at 3 years were 28% for pulmonary event, 8% for pulmonary toxicity, 25% for kidney toxicity, 8% for cataract, 17% for bone toxicity, and 10% for secondary malignancy. The CI of bone toxicity was higher in female than in male patients (p = 0.019). Conclusion: Late effects after TBI in the context of allogeneous stem cell or bone marrow transplantation can frequently be observed. Regular follow-up examinations are advised for the early registration and treatment of adverse effects. (orig.)

  5. Prospective evaluation of delayed central nervous system (CNS) toxicity of hyperfractionated total body irradiation (TBI)

    International Nuclear Information System (INIS)

    Purpose: Prospective evaluation of chronic radiation effects on the healthy adult brain using neuropsychological testing of intelligence, attention, and memory. Methods and Materials: 58 patients (43 ± 10 yr) undergoing hyperfractionated total body irradiation (TBI) (TBI, 14.4 Gy, 12 x 1.2 Gy in 4 days) before bone marrow or peripheral blood stem cell transplantation were prospectively included. Twenty-one recurrence-free long-term survivors were re-examined 6-36 months (median 27 months) after completion of TBI. Neuropsychological testing included assessment of general intelligence, attention, and memory using normative, standardized psychometric tests. Mood status was controlled, as well. Test results are given as IQ scores (population mean 100) or percentiles for attention and memory (population mean 50). Results: The 21 patients showed normal baseline test results of IQ (101 ± 13) and attention (53 ± 28), with memory test scores below average (35 ± 21). Test results of IQ (98 ± 17), attention (58 ± 27), and memory (43 ± 28) showed no signs of clinically measurable radiation damage to higher CNS (central nervous system) functions during the follow-up. The mood status was improved. Conclusion: The investigation of CNS toxicity after hyperfractionated TBI showed no deterioration of test results in adult recurrence-free patients with tumor-free CNS. The median follow-up of 27 months will be extended.

  6. Immunologic changes after loco-regional radiotherapy and fractionated total body irradiation (TBI) in mice

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    The immunologic effects of fractionated irradiation to both hind limbs and the tail of adult mice were investigated. A dose of 34 Gy given in 17 fractions of 2 Gy, 1 fraction per day, 5 days per week, was delivered with a 60Co source. A significant decrease of the total splenocyte count and of the PHA(phytohemagglutinin)-induced proliferation of T cells was found immediately after irradiation. Both parameters normalized within 30 days after irradiation. Immediately after irradiation, the MLC (mixed lymphocyte culture) was supranormal, dropped to 45% 1 week later, and normalized within 1 month after radiotherapy. The NK (natural killer) activity was significantly decreased only the first week after loco-regional irradiation, while the LAK (lymphokine activated killer) activity was not altered at all. The percentage of goat-anti-mouse+ cells (mainly B lymphocytes) was not changed immediately after loco-regional irradiation, but rose to supranormal values (175% of control level) 3 months after irradiation. A persistent decrease of the percentage and the absolute numbers of the Lyt2+ cells (= CD8+ cells, suppressor/cytotoxic phenotype) was observed up to 3 months after irradiation, while the percentage of L3T4+ cells (= CD4+ cells, helper phenotype) remained normal for the total follow-up. No differences in allogeneic skin graft survival could be demonstrated between irradiated and control animals. The observed immunological effects could not be explained by the scatter irradiation to the whole body as total body irradiation (TBI) administered in a dose and dose rate similar to the scatter dose did not result in persistent immunologic changes. No dose-rate effect could be demonstrated in a low dose fractionated total body irradiation schedule. A total body irradiation similar to the scatter dose in humans did not result in significant immunologic changes

  7. Biological dosimetry after total body irradiation (TBI) for hematologic malignancy patients

    International Nuclear Information System (INIS)

    Purpose: Biological dosimetry based on scoring chromosomal aberrations in peripheral lymphocytes was compared to physical dosimetry done for total body irradiation (TBI) before bone marrow transplantation (BMT) in patients with hematologic malignancies. Patients and Methods: Fifteen patients undergoing TBI were included in the study. A total dose of 12 Gy in 2.5 days was fractionated into 2 or 3 daily doses of 1.8 Gy delivered by a 18 MV linear accelerator (dose rate: 15.8 cGy · min-1). Blood samples were obtained from patients before irradiation and after the first fraction of 1.8 Gy. A standard dose-effect curve was established by in vitro irradiation of healthy volunteer lymphocytes. Chromosomal aberrations were scored by the conventional cytogenetics (CCG) method for unstable anomalies and by fluorescent in situ hybridization (FISH) for stable anomalies. Results: Healthy donor lymphocytes before irradiation yielded 0.1% dicentrics and 0.3% translocations of chromosome 4 (Chr. 4), that is 2.5% for the whole genome. Patients before irradiation had 2% of dicentrics and 1.1% of chromosome 4 translocations. The biologically estimated dose of the 15 patients after exposure to 1.8 Gy was 1.93 Gy (95% CI: 1.85-2.05) according to CCG, and 2.06 Gy (95% CI: 1.75-2.15) by FISH. Conclusion: The dose estimated by biological dosimetry, in this case of homogeneously distributed radiation of TBI, agrees well with the absorbed radiation dose calculated by physical dosimetry

  8. Total Body Irradiation (TBI) using Helical Tomotherapy in children and young adults undergoing stem cell transplantation

    International Nuclear Information System (INIS)

    Establishing Total Body Irradiation (TBI) using Helical Tomotherapy (HT) to gain better control over dose distribution and homogeneity and to individually spare organs at risk. Because of their limited body length the technique seems especially eligible in juvenile patients. The cohort consisted of 10 patients, 6 female and 4 male, aged 4 - 22 y with acute lymphoblastic- (ALL) or acute myeloic leukemia (AML). All patients presented with high risk disease features. Body length in treatment position ranged from 110–180 cm. Two Gy single dose was applied BID to a total dose of 12 Gy. Dose volume constraint for the PTV was 95% dose coverage for 95% of the volume. The lungs were spared to a mean dose of [less than or equal to] 10 Gy. Patients were positioned in a vac-loc bag in supine position with a 3-point head mask. Average D95 to the PTV was 11.7 Gy corresponding to a mean coverage of the PTV of 97.5%. Dmean for the lungs was 9.14 Gy. Grade 3–4 side effects were not observed. TBI using HT is feasible and well tolerated. A benefit could be demonstrated with regard to dose distribution and homogeneity and the selective dose-reduction to organs at risk

  9. Lung dose depending on exact patient positioning during total body irradiation (TBI) - isoeffective considerations to assess the risk of interstitial pneumonitis after TBI

    International Nuclear Information System (INIS)

    Purpose: In this case report, we studied the effect of patient's movements on total lung dose during total body irradiation (TBI). The dose-effect relationship regarding the development of interstitial pneumonitis and the problem of defining a threshold value are discussed. Based on considerations about the isoeffects we calculated the pneumonitis risk in dependence of increasing lung dose. Patient and Method: We calculated dose-volume histograms of the lung for defined lateral deviations (0-3 cm) from the isocenter. Total dose was 12 Gy, given in six fractions over 3 days. Lung shields were used after a total dose of 9 Gy. Lung shields were transferred into the Helax-TMS trademark planning system to quantify the influence of lateral deviation to lung dose. Results: The child's lateral deviation amounted up to 3 cm. Median dose of the whole lung amounted up to 11.64 Gy depending on lateral deviation. Discussion: In TBI, the lung limits the total dose. To estimate the risk of radiation pneumonitis, we calculated the isoeffective lung dose of our TBI regime for a fractionation scheme of 2 Gy daily using a formalism of van Dyk. The increase of median lung dose from 9.76 to 11.64 Gy would isoeffectively correspond to the increase from 19 Gy (no deviation) to 20.9 Gy (3 cm lateral deviation) with conventional fractionation. According to Burman, a pneumonitis risk of approximately 20% could be expected. Conclusion: With an estimated pneumonitis risk of approximately 20%, an indication for irradiation in general anesthesia seems to be reasonable. This is practicable in cooperation with radiation oncologists, anesthesists and pediatricians and should be included into therapeutic concepts. (orig.)

  10. Long-term renal toxicity in children following fractionated total-body irradiation (TBI) before allogeneic stem cell transplantation (SCT)

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    Gerstein, Johanna; Meyer, Andreas; Fruehauf, Joerg; Karstens, Johann H.; Bremer, Michael [Dept. of Radiation Oncology, Medical School Hannover (Germany); Sykora, Karl-Walter [Dept. of Pediatric Hematology and Oncology, Medical School Hannover (Germany)

    2009-11-15

    Purpose: to retrospectively assess the incidence and time course of renal dysfunction in children ({<=} 16 years) following total-body irradiation (TBI) before allogeneic stem cell transplantation (SCT). Patients and methods: between 1986 and 2003, 92 children (median age, 11 years; range, 3-16 years) underwent TBI before allogeneic SCT. 43 of them had a minimum follow-up of 12 months (median, 51 months; range, 12-186 months) and were included into this analysis. Conditioning regimen included chemotherapy and fractionated TBI with 12 Gy (n = 26) or 11.1 Gy (n = 17). In one patient, renal dose was limited to 10 Gy by customized renal shielding due to known nephropathy prior to SCt. Renal dysfunction was defined as an increase of serum creatinine > 1.25 times the upper limit of age-dependent normal. Results: twelve children (28%) experienced an episode of renal dysfunction after a median of 2 months (range, 1-10 months) following SCT. In all but one patient renal dysfunction was transient and resolved after a median of 8 months (range, 3-16 months). One single patient developed persistent renal dysfunction with onset at 10 months after SCT. None of these patients required dialysis. The actuarial 3-year freedom from persistent renal toxicity for children surviving > 12 months after SCt was 97.3%. Conclusion: the incidence of persistent renal dysfunction after fractionated TBI with total doses {<=} 12 Gy was very low in this analysis. (orig.)

  11. Acute central nervous system (CNS) toxicity of total body irradiation (TBI) measured using neuropsychological testing of attention functions

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to investigate acute normal tissue damage of low irradiation doses to the healthy, adult central nervous system (CNS) using neuropsychological testing of attention functions. Methods and Materials: Neuropsychological testing (IQ, attention [modified Trail-Making Test A, Digit Symbol Test, D2 Test, Wiener Determination Machine]) was used to examine 40 patients (43 ± 10 years) before and immediately after the first fraction (1.2 Gy) of hyperfractionated total body irradiation (TBI) at the University of Heidelberg. The patients received antiemetic premedication. Test results are given as mean percentiles ± standard deviation, with 50 ± 34 being normal. Thirty-eight control patients (53 ± 15 years) were studied to quantify the influence of hospitalization, stress, and repeated testing. Results: The patients showed normal baseline test results (IQ = 101 ± 14, attention = 54 ± 28) and no decrease in test results after 1.2 Gy TBI. Attention functions improved (66 ± 25) corresponding to a practice effect of repeated testing that was seen in the control group, although alternate versions of the tests were used (IQ = 104 ± 10, attention before = 42 ± 29, attention after = 52 ± 31). Conclusion: Our data show no deterioration of neuropsychologic test results acutely after 1.2 Gy whole body exposure in adult patients without CNS disease receiving antiemetic medication

  12. Factors modifying the toxicity of total body irradiation (TBI) with bone marrow transplant

    International Nuclear Information System (INIS)

    In defined-flora, barrier-maintained rats, radiation nephritis is the principle late toxicity seen after single dose, high dose rate TBI with bone marrow transplant. Shielding the kidneys eliminates this late toxicity. If rats are exposed to a conventional microbiological environment during and after TBI and bone marrow transplant, the principle late toxicity is pneumonitis. Low dose rate TBI gives similar renal toxicity but at doses twice as large. Clinically, TBI and bone marrow transplant is preceded by intensive drug treatment, typically with cyclophosphamide (Cytoxan) and cytosine arabinoside (ara-C). Pretreatment with a standard cytoxan/ara-C regimen, has no effect on the gastrointestinal toxicity of TBI, but results in a decrease in marrow toxicity. Late renal toxicity still occurs when bone marrow transplants are given, but it is to early to determine whether drug treatment has affected late renal tolerance. Experiments are also underway to determine the effects of fractionated TBI (3, 6 and 9 fractions in 60 hours) on acute tolerance and on late tolerance after bone marrow transplantation

  13. An explanation for the ability of cytotoxic drug pretreatment to reduce bone marrow related lethality of total body irradiation (TBI)

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    Mice given 9 to 10 Gy total body irradiation (TBI) die a hematological death 10 to 14 days after exposure. This lethality can be avoided by pretreatment with a cytotoxic drug two days before irradiation. The best example of this is seen when 200 mg/Kg cytosine arabinoside (ara-C) is given two days before TIB. Improved survival results from an earlier onset in the recovery of marrow stem cells (CFU-s) in animals given ara-C before irradiation as compared to controls. In animals given radiation alone there is a lag phase in the recovery of CFU-s; drug pretreatment before irradiation abolishes this delay. We postulate that the cells that repopulate the CFU-s compartment after irradiation are a sub-population of the DFU-s with higher self-renewal capability, lower proliferative activity and higher radiosensitivity (D0 = .8 Gy) than the overall population D0 = 1.1 Gy). Further, we suggest that drug pretreatment alters the radiosensitivity of the first population, increasing it temporarily to that of the overall population. This may come about by ara-C triggering these CFU-s into a relatively radioresistant phase of the cell cycle. In the Lewis lung tumor ara-C pretreatment does not affect the response to radiation, even at times when the drug promotes the early recovery of the CFU-s. It would therefore seem that a potentially useful gain in the therapeutic index may result from these findings

  14. Total body irradiation (TBI) in pediatric patients. A single-center experience after 30 years of low-dose rate irradiation

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    Linsenmeier, Claudia; Thoennessen, Daniel; Negretti, Laura; Streller, Tino; Luetolf, Urs Martin [University Hospital Zurich (Switzerland). Dept. of Radiation-Oncology; Bourquin, Jean-Pierre [University Children' s Hospital Zurich (Switzerland). Dept. of Hemato-Oncology; Oertel, Susanne [University Hospital Zurich (Switzerland). Dept. of Radiation-Oncology; Heidelberg Univ. (Germany). Dept. of Radiation Oncology

    2010-11-15

    To retrospectively analyze patient characteristics, treatment, and treatment outcome of pediatric patients with hematologic diseases treated with total body irradiation (TBI) between 1978 and 2006. 32 pediatric patients were referred to the Department of Radiation-Oncology at the University of Zurich for TBI. Records of regular follow-up of 28 patients were available for review. Patient characteristics as well as treatment outcome regarding local control and overall survival were assessed. A total of 18 patients suffered from acute lymphoblastic leukemia (ALL), 5 from acute and 2 from chronic myelogenous leukemia, 1 from non-Hodgkin lymphoma, and 2 from anaplastic anemia. The cohort consisted of 15 patients referred after first remission and 13 patients with relapsed leukemia. Mean follow-up was 34 months (2-196 months) with 15 patients alive at the time of last follow-up. Eight patients died of recurrent disease, 1 of graft vs. host reaction, 2 of sepsis, and 2 patients died of a secondary malignancy. The 5-year overall survival rate (OS) was 60%. Overall survival was significantly inferior in patients treated after relapse compared to those treated for newly diagnosed leukemia (24% versus 74%; p=0.004). At the time of last follow-up, 11 patients survived for more than 36 months following TBI. Late effects (RTOG {>=}3) were pneumonitis in 1 patient, chronic bronchitis in 1 patient, cardiomyopathy in 2 patients, severe cataractogenesis in 1 patient (48 months after TBI with 10 Gy in a single dose) and secondary malignancies in 2 patients (36 and 190 months after TBI). Growth disturbances were observed in all patients treated prepubertally. In 2 patients with identical twins treated at ages 2 and 7, a loss of 8% in final height of the treated twin was observed. As severe late sequelae after TBI, we observed 2 secondary malignancies in 11 patients who survived in excess of 36 months. However, long-term morbidity is moderate following treatment with the fractionated

  15. Total body irradiation (TBI) in pediatric patients. A single-center experience after 30 years of low-dose rate irradiation

    International Nuclear Information System (INIS)

    To retrospectively analyze patient characteristics, treatment, and treatment outcome of pediatric patients with hematologic diseases treated with total body irradiation (TBI) between 1978 and 2006. 32 pediatric patients were referred to the Department of Radiation-Oncology at the University of Zurich for TBI. Records of regular follow-up of 28 patients were available for review. Patient characteristics as well as treatment outcome regarding local control and overall survival were assessed. A total of 18 patients suffered from acute lymphoblastic leukemia (ALL), 5 from acute and 2 from chronic myelogenous leukemia, 1 from non-Hodgkin lymphoma, and 2 from anaplastic anemia. The cohort consisted of 15 patients referred after first remission and 13 patients with relapsed leukemia. Mean follow-up was 34 months (2-196 months) with 15 patients alive at the time of last follow-up. Eight patients died of recurrent disease, 1 of graft vs. host reaction, 2 of sepsis, and 2 patients died of a secondary malignancy. The 5-year overall survival rate (OS) was 60%. Overall survival was significantly inferior in patients treated after relapse compared to those treated for newly diagnosed leukemia (24% versus 74%; p=0.004). At the time of last follow-up, 11 patients survived for more than 36 months following TBI. Late effects (RTOG ≥3) were pneumonitis in 1 patient, chronic bronchitis in 1 patient, cardiomyopathy in 2 patients, severe cataractogenesis in 1 patient (48 months after TBI with 10 Gy in a single dose) and secondary malignancies in 2 patients (36 and 190 months after TBI). Growth disturbances were observed in all patients treated prepubertally. In 2 patients with identical twins treated at ages 2 and 7, a loss of 8% in final height of the treated twin was observed. As severe late sequelae after TBI, we observed 2 secondary malignancies in 11 patients who survived in excess of 36 months. However, long-term morbidity is moderate following treatment with the fractionated

  16. Value of SPIO for MRI of the bone marrow before and after total body irradiation (TBI) - initial investigations in an animal model

    International Nuclear Information System (INIS)

    Evaluation of the value of superparamagnetic iron oxides (SPIO; Endorem trademark) for MRI-derived quantifications of the permeability of the blood-bone marrow barrier and the phagocytic activity of reticuloendothelial system (RES) bone marrow cells before and after TBI. Methods: 12 New Zealand white rabbits underwent MRI of the lumbar spine and os sacrum using T1-weighted spinecho (SE) and T2-weighted Turbo-SE (TSE) sequences before and after injection of SPIO (Endorem trademark). Four animals each were examined without irradiation, after 4 Gy total body irradiation (TBI), and after 12 Gy TBI. Changes in bone marrow signal intensities (SI) after contrast agent injection were quantified as Δ SI(%) = vertical stroke ((SIpost-SIpre)/SIpre) x 100% vertical stroke and these data were correlated with bone marrow histopathology. Results: Histopathology of the bone marrow revealed a radiation-induced decline of all hematopoetic cell lines. SPIO were phagocytosed by bone marrow RES cells and caused a significant bone marrow signal decline on postcontrast T2-weighted images (p 2-weighted images were significantly higher for the irradiated bone marrow as compared to non-irradiated controls (p 1-weighted images directly after contrast medium injection were not able to characterize the permeability of the blood-bone marrow barrier. Conclusion: Hematopoetic bone marrow can be labelled with SPIO. Irradiation does not impair the phagocytic activity of bone marrow RES cells. However, the bone marrow enhancement with SPIO is smaller as compared to previous results obtained by our group with USPIO. (orig.)

  17. SU-E-T-515: Field-In-Field Compensation Technique Using Multi-Leaf Collimator to Deliver Total Body Irradiation (TBI) Dose

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    Lakeman, T [The State University of New York at Buffalo (United States); Wang, IZ [The State University of New York at Buffalo (United States); Roswell Park Cancer Institute, Buffalo, NY (United States)

    2014-06-01

    Purpose: Total body irradiation (TBI) uses large parallel-opposed radiation fields to suppress the patient's immune system and eradicate the residual cancer cells in preparation of recipient for bone marrow transplant. The manual placement of lead compensators has been used conventionally to compensate for the varying thickness through the entire body in large-field TBI. The goal of this study is to pursue utilizing the modern field-in-field (FIF) technique with the multi-leaf collimator (MLC) to more accurately and efficiently deliver dose to patients in need of TBI. Method: Treatment plans utilizing the FIF technique to deliver a total body dose were created retrospectively for patients for whom CT data had been previously acquired. Treatment fields include one pair of opposed open large fields (collimator=45°) with a specific weighting and a succession of smaller fields (collimator=90°) each with their own weighting. The smaller fields are shaped by moving MLC to block the sections of the patient which have already received close to 100% of the prescribed dose. The weighting factors for each of these fields were calculated using the attenuation coefficient of the initial lead compensators and the separation of the patient in different positions in the axial plane. Results: Dose-volume histograms (DVH) were calculated for evaluating the FIF compensation technique. The maximum body doses calculated from the DVH were reduced from the non-compensated 179.3% to 148.2% in the FIF plans, indicating a more uniform dose with the FIF compensation. All calculated monitor units were well within clinically acceptable limits and exceeded those of the original lead compensation plan by less than 50 MU (only ~1.1% increase). Conclusion: MLC FIF technique for TBI will not significantly increase the beam on time while it can substantially reduce the compensator setup time and the potential risk of errors in manually placing lead compensators.

  18. SU-E-T-515: Field-In-Field Compensation Technique Using Multi-Leaf Collimator to Deliver Total Body Irradiation (TBI) Dose

    International Nuclear Information System (INIS)

    Purpose: Total body irradiation (TBI) uses large parallel-opposed radiation fields to suppress the patient's immune system and eradicate the residual cancer cells in preparation of recipient for bone marrow transplant. The manual placement of lead compensators has been used conventionally to compensate for the varying thickness through the entire body in large-field TBI. The goal of this study is to pursue utilizing the modern field-in-field (FIF) technique with the multi-leaf collimator (MLC) to more accurately and efficiently deliver dose to patients in need of TBI. Method: Treatment plans utilizing the FIF technique to deliver a total body dose were created retrospectively for patients for whom CT data had been previously acquired. Treatment fields include one pair of opposed open large fields (collimator=45°) with a specific weighting and a succession of smaller fields (collimator=90°) each with their own weighting. The smaller fields are shaped by moving MLC to block the sections of the patient which have already received close to 100% of the prescribed dose. The weighting factors for each of these fields were calculated using the attenuation coefficient of the initial lead compensators and the separation of the patient in different positions in the axial plane. Results: Dose-volume histograms (DVH) were calculated for evaluating the FIF compensation technique. The maximum body doses calculated from the DVH were reduced from the non-compensated 179.3% to 148.2% in the FIF plans, indicating a more uniform dose with the FIF compensation. All calculated monitor units were well within clinically acceptable limits and exceeded those of the original lead compensation plan by less than 50 MU (only ~1.1% increase). Conclusion: MLC FIF technique for TBI will not significantly increase the beam on time while it can substantially reduce the compensator setup time and the potential risk of errors in manually placing lead compensators

  19. Anti-tumor effect of low dose total (or half) body irradiation and changes of the functional subset of peripheral blood lymphocytes in non-Hodgkin's lymphoma patients after TBI (HBI)

    International Nuclear Information System (INIS)

    Two-color analyses of peripheral blood lymphocytes using flow cytometry in 24 patients with non-Hodgkin's lymphoma, who received low dose total body irradiation (TBI) or half body irradiation (HBI), were performed to look at the influence of low dose irradiation on lymphocytes and its anti-tumor effects. The results of the present study were; significant increase in the proportion of the helper T, helper-inducer T and active helper/inducer T cells. Since low dose TBI or HBI preceded the other treatments such as primary site irradiation and multiple agent chemotherapy in 10 cases (group I), the antitumor effect of TBI or HBI were able to be investigated. Nine out of 10 patients showed at least partial responses, especially in cases 2 and 10 of group I where almost all tumors disappeared after only TBI or HBI. (author)

  20. SU-C-213-04: Application of Depth Sensing and 3D-Printing Technique for Total Body Irradiation (TBI) Patient Measurement and Treatment Planning

    International Nuclear Information System (INIS)

    Purpose: To develop and validate an innovative method of using depth sensing cameras and 3D printing techniques for Total Body Irradiation (TBI) treatment planning and compensator fabrication. Methods: A tablet with motion tracking cameras and integrated depth sensing was used to scan a RANDOTM phantom arranged in a TBI treatment booth to detect and store the 3D surface in a point cloud (PC) format. The accuracy of the detected surface was evaluated by comparison to extracted measurements from CT scan images. The thickness, source to surface distance and off-axis distance of the phantom at different body section was measured for TBI treatment planning. A 2D map containing a detailed compensator design was calculated to achieve uniform dose distribution throughout the phantom. The compensator was fabricated using a 3D printer, silicone molding and tungsten powder. In vivo dosimetry measurements were performed using optically stimulated luminescent detectors (OSLDs). Results: The whole scan of the anthropomorphic phantom took approximately 30 seconds. The mean error for thickness measurements at each section of phantom compare to CT was 0.44 ± 0.268 cm. These errors resulted in approximately 2% dose error calculation and 0.4 mm tungsten thickness deviation for the compensator design. The accuracy of 3D compensator printing was within 0.2 mm. In vivo measurements for an end-to-end test showed the overall dose difference was within 3%. Conclusion: Motion cameras and depth sensing techniques proved to be an accurate and efficient tool for TBI patient measurement and treatment planning. 3D printing technique improved the efficiency and accuracy of the compensator production and ensured a more accurate treatment delivery

  1. SU-C-213-04: Application of Depth Sensing and 3D-Printing Technique for Total Body Irradiation (TBI) Patient Measurement and Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Lee, M; Suh, T [Department of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Research Institute of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Han, B; Xing, L [Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA (United States); Jenkins, C [Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA (United States); Department of Mechanical Engineering, Stanford University, Palo Alto, CA (United States)

    2015-06-15

    Purpose: To develop and validate an innovative method of using depth sensing cameras and 3D printing techniques for Total Body Irradiation (TBI) treatment planning and compensator fabrication. Methods: A tablet with motion tracking cameras and integrated depth sensing was used to scan a RANDOTM phantom arranged in a TBI treatment booth to detect and store the 3D surface in a point cloud (PC) format. The accuracy of the detected surface was evaluated by comparison to extracted measurements from CT scan images. The thickness, source to surface distance and off-axis distance of the phantom at different body section was measured for TBI treatment planning. A 2D map containing a detailed compensator design was calculated to achieve uniform dose distribution throughout the phantom. The compensator was fabricated using a 3D printer, silicone molding and tungsten powder. In vivo dosimetry measurements were performed using optically stimulated luminescent detectors (OSLDs). Results: The whole scan of the anthropomorphic phantom took approximately 30 seconds. The mean error for thickness measurements at each section of phantom compare to CT was 0.44 ± 0.268 cm. These errors resulted in approximately 2% dose error calculation and 0.4 mm tungsten thickness deviation for the compensator design. The accuracy of 3D compensator printing was within 0.2 mm. In vivo measurements for an end-to-end test showed the overall dose difference was within 3%. Conclusion: Motion cameras and depth sensing techniques proved to be an accurate and efficient tool for TBI patient measurement and treatment planning. 3D printing technique improved the efficiency and accuracy of the compensator production and ensured a more accurate treatment delivery.

  2. Toxicities of bone marrow transplantation (BMT) with or without total body irradiation (TBI) in children ≤ 3 years old

    International Nuclear Information System (INIS)

    Purpose: To describe the toxicities of BMT using conditioning regimens with or without TBI in patients ≤ 3 years old treated at a single institution over a 10 year period. Materials/Methods: We retrospectively reviewed the medical records of 125 pediatric patients treated with BMT at a single institution from February, 1986 through February, 1996. Of these, 23 patients were ≤ 3 years old and are included in this study. A variety of chemotherapeutic preparative regimens were used. Fractionated TBI to a total dose of 12 Gy at 1.5 - 2.0 Gy/fraction over 3-4 days was used in 10 patients. Both acute and late toxicities were recorded based on interviews and the medical record. Survival and disease status were determined for all patients. Results: Patient diagnoses include acute lymphoblastic leukemia (n=3), acute myelogenous leukemia (n=7), neuroblastoma (n=4), rhabdomyosarcoma (n=1), severe aplastic anemia (n=3), and 5 patients with other inherited disorders. Thirteen patients (52%) were male. The mean age at diagnosis was 14.4 months (1-30 months). The mean age at transplant was 23.6 months (6-26 months). Median followup of surviving patients was 8 months (2-89 months). There were 10 autologuous, 11 allogeneic, and 2 haploidentical transplants. Four patients were retransplanted for relapsed neoplastic disease and 3 are alive. Thirteen of 23 patients (52%) are known to be alive. All 8 patients with non-malignant diagnoses (NM group) are alive. Of the 15 patients with malignancy (M group), 5 (33%) are alive. Of the NM group, 2 (25%) had interstitial pneumonitis post transplant, 3 (38%) were diagnosed with short stature, and 1 (7%) had diagnosed cataracts. One patient with 3 transplants had bronchiolitis obliterans and mild restrictive lung disease. Two patients had graft versus host disease (GVHD) post transplant. Of the M group, 1 (7%) patient died of transplant related toxicity (pulmonary mucormycosis and graft failure after second transplant). One (7%) patient had

  3. Lung dose depending on exact patient positioning during total body irradiation (TBI) - isoeffective considerations to assess the risk of interstitial pneumonitis after TBI; Lungendosis in Abhaengigkeit von der Lagerungsgenauigkeit bei Ganzkoerperbestrahlungen (TBI). Isoeffektivitaetsueberlegungen zur Einschaetzung des Risikos einer interstitiellen Pneumonitis nach Ganzkoerperbestrahlung

    Energy Technology Data Exchange (ETDEWEB)

    Piroth, M.D.; Zierhut, D.; Sroka-Perez, G.; Wannenmacher, M. [Radiologische Klinik der Univ. Heidelberg (Germany). Abt. fuer Klinische Radiologie; Kampen, M. van [Krankenhaus Nord-West, Frankfurt am Main (Germany). Radioonkologische Klinik

    2002-01-01

    Purpose: In this case report, we studied the effect of patient's movements on total lung dose during total body irradiation (TBI). The dose-effect relationship regarding the development of interstitial pneumonitis and the problem of defining a threshold value are discussed. Based on considerations about the isoeffects we calculated the pneumonitis risk in dependence of increasing lung dose. Patient and Method: We calculated dose-volume histograms of the lung for defined lateral deviations (0-3 cm) from the isocenter. Total dose was 12 Gy, given in six fractions over 3 days. Lung shields were used after a total dose of 9 Gy. Lung shields were transferred into the Helax-TMS trademark planning system to quantify the influence of lateral deviation to lung dose. Results: The child's lateral deviation amounted up to 3 cm. Median dose of the whole lung amounted up to 11.64 Gy depending on lateral deviation. Discussion: In TBI, the lung limits the total dose. To estimate the risk of radiation pneumonitis, we calculated the isoeffective lung dose of our TBI regime for a fractionation scheme of 2 Gy daily using a formalism of van Dyk. The increase of median lung dose from 9.76 to 11.64 Gy would isoeffectively correspond to the increase from 19 Gy (no deviation) to 20.9 Gy (3 cm lateral deviation) with conventional fractionation. According to Burman, a pneumonitis risk of approximately 20% could be expected. Conclusion: With an estimated pneumonitis risk of approximately 20%, an indication for irradiation in general anesthesia seems to be reasonable. This is practicable in cooperation with radiation oncologists, anesthesists and pediatricians and should be included into therapeutic concepts. (orig.) [German] Hintergrund: An einem Fallbeispiel werden die Auswirkungen von Lagerungsungenauigkeiten auf die Gesamtlungendosis bei Ganzkoerperbestrahlung eines Kindes erlaeutert. Die Dosis-Wirkungs-Beziehung bezueglich der Entstehung einer interstitiellen Pneumonitis nach

  4. Radiological protection in a patient during a total body irradiation procedure; Proteccion radiologica en un paciente durante un procedimiento de TBI (irradiacion de cuerpo entero)

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez O, J. O.; Hinojosa G, J.; Gomez M, E.; Balam de la Vega, J. A. [The American British Cowdray Medical Center, I. A. P., Sur 128 No. 143, Col. Americas, 01120 Mexico D. F. (Mexico); Deheza V, J. C., E-mail: johernandezo@abchospital.co [IPN, Escuela Superior de Fisica y Matematicas, Av. Luis Enrique Erro s/n, Edificio No. 9, Unidad Profesional Adolfo Lopez Mateos, Col. Lindavista, 07738 Mexico D. F. (Mexico)

    2010-09-15

    A technique used in the Service of Radiotherapy of the Cancer Center of the American British Cowdray Medical Center (ABC) for the bone marrow transplantation, is the total body irradiation. It is known that the dose calculation, for this irradiation type, is old, since the dosimetric calculation is carried out by hand and they exist infinity of techniques for the patients irradiation and different forms of protecting organs of risk, as well as a great uncertainty in the given dose. In the Cancer Center of the ABC Medical Center, was carried out an irradiation procedure to total body with the following methodology: Computerized tomography of the patient total body (two vacuum mattresses in the following positions: dorsal and lateral decubitus), where is combined the two treatment techniques anterior-posterior and bilateral, skin delineate and reference volumes, dose calculation with the planning system Xi O of CMS, dose determination using an ionization chamber and a lung phantom IMRT Thorax Phantom of the mark CIRS and dosimetry in vivo. In this work is presented the used treatment technique, the results, statistics and the actualization of the patient clinical state. (Author)

  5. Dosimetry of total body irradiation

    International Nuclear Information System (INIS)

    In the treatment of disseminated malignancies an improvement in the curability and reduction of complication rates require high precision total body irradiation (TBI) and correct reporting of relevant treatment parameters. Optimal TBI dosimetry is the basis. Radiooncological and radiobiological requirements as well as the special physical situation have to be considered. To review the efforts of medical physicists, highlights from TBI workshops and publications are summarized. Additionally, dosimetric data from 34 European radiooncological centres contributing to the recent ESTRO inquiry on TBI are analysed. The topics are: absorbed dose and dose monitor calibration, determination of absolute and relative doses, dose ratios, attenuation data and heterogeneity corrections; TBI dose calculation methods regarding patient position, beam incidence, body shape and thickness, lung size and density; methods of TBI treatment planning including calculated dose modification and of TBI quality assurance. In conclusion, the following recommendations can be given: TBI dosimetry shall be performed under TBI conditions, close to the real treatment situation. The absorbed dose to water must be determined. The dose monitor should be calibrated against dose measurements at the centre of a water equivalent phantom of TBI equivalent size and typical thickness. Photon fluence profiles have to be measured with small phantoms. Influences on the local dose must be investigated systematically. A reproducible AP/PA TBI technique should be used. The TBI dose shall be specified to mid-abdomen and reported in units of gray. The single and total dose and the dose rate to the lungs, the number of fractions and the treatment time schedule must be stated. In vivo dosimetry is required if non-reliable TBI techniques are used. An international TBI dosimetry intercomparison could assist these efforts to improve the treatment of acute leukaemia. (author). 89 refs, 3 figs, 13 tabs

  6. Value of SPIO for MRI of the bone marrow before and after total body irradiation (TBI) - initial investigations in an animal model; Experimentelle Untersuchungen zur Wertigkeit von SPIO fuer die MRT des Knochenmarkes vor und nach Ganzkoerperbestrahlung

    Energy Technology Data Exchange (ETDEWEB)

    Daldrup-Link, H.E.; Link, T.M.; Rummeny, E.J. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany); Inst. fuer Roentgendiagnostik, Klinikum rechts der Isar der Technischen Univ. Muenchen (Germany); Reinlaender, C. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany); Richter, K.J. [Zentrale Tierexperimentelle Einrichtung der Westfaelischen Wilhelms-Univ. Muenster (Germany); Koenemann, S. [Klinik und Poliklinik fuer Strahlentherapie, Univ. Muenster (Germany)

    2001-06-01

    Evaluation of the value of superparamagnetic iron oxides (SPIO; Endorem {sup trademark}) for MRI-derived quantifications of the permeability of the blood-bone marrow barrier and the phagocytic activity of reticuloendothelial system (RES) bone marrow cells before and after TBI. Methods: 12 New Zealand white rabbits underwent MRI of the lumbar spine and os sacrum using T{sub 1}-weighted spinecho (SE) and T{sub 2}-weighted Turbo-SE (TSE) sequences before and after injection of SPIO (Endorem {sup trademark}). Four animals each were examined without irradiation, after 4 Gy total body irradiation (TBI), and after 12 Gy TBI. Changes in bone marrow signal intensities (SI) after contrast agent injection were quantified as {delta} SI(%) = vertical stroke ((SIpost-SIpre)/SIpre) x 100% vertical stroke and these data were correlated with bone marrow histopathology. Results: Histopathology of the bone marrow revealed a radiation-induced decline of all hematopoetic cell lines. SPIO were phagocytosed by bone marrow RES cells and caused a significant bone marrow signal decline on postcontrast T{sub 2}-weighted images (p < 0.05). {delta} SI(%) data for T{sub 2}-weighted images were significantly higher for the irradiated bone marrow as compared to non-irradiated controls (p < 0.05). Dynamic T{sub 1}-weighted images directly after contrast medium injection were not able to characterize the permeability of the blood-bone marrow barrier. Conclusion: Hematopoetic bone marrow can be labelled with SPIO. Irradiation does not impair the phagocytic activity of bone marrow RES cells. However, the bone marrow enhancement with SPIO is smaller as compared to previous results obtained by our group with USPIO. (orig.) [German] Evaluierung der Wertigkeit von superparamagnetischen Eisenoxidpartikeln (SPIO) fuer die MR-tomographische Beurteilung der Permeabilitaet der Knochenmarkssinus und der RES-Phagozytoseaktivitaet des Knochenmarkes vor und nach fraktionierter Ganzkoerperbestrahlung. Methoden

  7. A review of total body irradiation

    International Nuclear Information System (INIS)

    This review of total body irradiation discusses the optimization of the prescription, relevant radiobiological research, cytotoxic drugs and TBI, and the delivery of TBI and its complications, with particular reference to acute effects, neurological sequelae, endocrine effects, cataracts, and secondary malignancies. (U.K.)

  8. Total body irradiation for bone marrow transplantation

    International Nuclear Information System (INIS)

    Purpose/Objective: The primary goal of this course is to develop an understanding of the rationale for the use of total body irradiation (TBI) as a component of cytoreduction for bone marrow transplantation, the techniques used, and the results of changing important parameters, such as dose, dose rate, and fractionation. Materials and Methods: Basic radiobiological principles relevant to TBI are reviewed; in particular, emphasis is placed on cell and animal studies which suggest means of optimizing TBI delivery to achieve maximum tumor cell kill and immunosuppression along with minimal normal tissue damage. Techniques utilized at various centers are described, with some discussion of achieving homogeneity, as well as inhomogeneity when desired with partial shielding or 'boosting'. A review of clinical studies, both randomized and non-randomized, is done; these are then interpreted in terms of potential optimization of the TBI parameters. Finally, comparison of TBI-containing regimens with chemotherapy-only regimens is done. Results: Radiobiological studies suggest a potential advantage for fractionated TBI over single dose TBI. Clinical studies support this view: highly fractionated regimens have allowed higher total doses to be used to increase malignant cell kill and immunosuppression without increasing toxicity. Randomized studies of TBI combined with VP-16 or cyclophosphamide versus busulfan combined with cyclophosphamide have either shown an advantage with TBI (in acute myelocytic leukemia in first remission) or no difference (in chronic myelogenous leukemia, chronic phase). Conclusion: TBI has been an effective component of cytoreductive regimens for marrow transplantation in patients with malignant disease, especially leukemias, which constitute 73% of all marrow transplants worldwide. Evidence supports fractionated TBI, to doses ≥ 13 Gy, when compared with single dose TBI. Randomized studies support the continued use of TBI in AML, and suggest that

  9. Radiobiological speculations on therapeutic total body irradiation

    International Nuclear Information System (INIS)

    Unexpected total body irradiation (TBI) of human beings, involved in nuclear warfare or in accidents in nuclear reactors can be lethal. In the 1950s, bone marrow transplantation was discovered as a potentially life saving procedure after TBI in the dose range of 5.0 to 12.0 Gy. Since that time, deliberate or therapeutic TBI has been used to condition patients with a lethal bone marrow disorder for bone marrow replacement. The therapeutic ratio of TBI followed by bone marrow transplantation is small. Many potentially lethal complications can occur, such as acute TBI side effects, late TBI side effects or immunological complications of bone marrow transplantation such as graft versus host disease or graft rejection. The benefits of TBI and bone marrow transplantation are that they offer a chance for cure of previously lethal bone marrow disorders. The optimal parameters for TBI remain to be defined. The review discusses the current clinical and experimental animal data, as they relate to the future definition of less toxic TBI procedures with a better therapeutic ratio. Different TBI procedures are required for patients with malignant vs. non-malignant disorders or for patients with histoincompatible vs. histocompatible bone marrow donors.77 references

  10. Total body irradiation - review of treatment techniques in Europe

    International Nuclear Information System (INIS)

    In treatment of acute leukaemia and other disseminated diseases, high dose total body irradiation (TBI) combined with intensive chemotherapy and bone marrow transplantation (BMT) is use more and more successfully. Reflecting the complex clinical, biological, physical and technical situation of TBI, a large variety of TBI treatment techniques has been developed. In order to review the techniques applied in Europe and to report about common methods as well as about new ideas in TBI, a questionnaire was prepared and mailed to medical physicists in Europe responsible for TBI. The topics of this questionnaire are general information: TBI technique (beams, fields, treatment conditions); basic TBI dosimetry; physical treatment planning (patient dosimetry, heterogeneity correction, dose modification, dose homogeneity, dose precision, confirmation measurements); TBI treatment planning (dose prescription, localization, documentation, verification, in vivo dosimetry); requirements (additional staff, time, equipment) and recommendations for improvement of TBI. Most questionnaires (34/45) were returned in time with detailed information from TBI centres in 15 European countries. These data as well as results of the 'Meeting of Leiden, 1982' of the 'Meeting of Essen, 1985' and of the 'Meeting of Toulouse, 1986' are summarized and discussed. There are many interesting methods to plan and perform exact TBI. However, anterior-posterior TBI is preferred to achieve sufficient homogeneity of dose and effective lung shielding. While the development of TBI has reached a high level of exactness, further improvement will require a better knowledge of the dose-effect relationships. (Auth.)

  11. Cataract incidence after total-body irradiation

    International Nuclear Information System (INIS)

    Purpose: The aim of this retrospective study was to evaluate cataract incidence in a homogeneously-treated group of patients after total-body irradiation (TBI) followed by autologous bone marrow transplantation or peripheral blood stem cell transplantation. Methods and Materials: Between 1982 and 1994, a total of 260 patients received either autologous bone marrow or blood stem cell transplantation for hematological malignancy at the University of Heidelberg. Two hundred nine of these patients received TBI in our hospital. Radiotherapy was applied as hyperfractionated TBI, with a median dose of 14.4 Gy in 12 fractions over 4 days. Minimum time between fractions was 4 h. Photons with an energy of 23 MeV were used with a dose rate of 7-18 cGy/min. Ninety-six of the 209 irradiated patients were still alive in 1996; 86 of these patients (52 men, 33 women) answered a questionnaire and could be examined ophthalmologically. The median age at time of TBI was 38.5 years, with a range of 15-59 years. Results: The median follow-up is now 5.8 years, with a range of 1.7-13 years. Cataract occurred in 28/85 patients (32.9%) after a median of 47 months (1-104 months). In 6 of 28 patients who developed a cataract, surgery of the cataract was performed. Whole-brain irradiation prior to TBI had been performed more often in the group of patients developing cataract (14.3%) versus 10.7% in the group of patients without cataract. However, there was no statistical difference (Chi-square, p > 0.05). Conclusion: Cataract is a common side effect of TBI. Cataract incidence found in our patients is comparable to results of other centers using a fractionated regimen for TBI. To assess the incidence of cataract after TBI, a long-term follow-up is required

  12. Biological basis of total body irradiation

    International Nuclear Information System (INIS)

    A comprehensive understanding of the radiobiological bases of total body irradiation (TBI) is made difficult by the large number of normal and malignant tissues that must be taken into account. In addition, tissue responses to irradiation are also sensitive to associated treatments, type of graft and a number of patient characteristics. Experimental studies have yielded a large body of data, the clinical relevance of which still requires definite validation through randomized trials. Fractionated TBI schemes are able to reduce late normal tissue toxicity, but the ultimate consequences of the fractional dose reduction do not appear to be equivocal. Thus, leukemia and lymphoma cells are probably more radio-biologically heterogeneous than previously thought, with several cell lines displaying relatively high radioresistance and repair capability patterns. The most primitive host-type hematopoietic stem cells are likely to be at least partly protected by TBI fractionation and may hamper late engraftment. Similarly, but with possibly conflicting consequences on the probability of engraftment, the persistence of a functional marrow stroma may also be fractionation-sensitive, while higher rejection rates have been reported after T-depletion grafts and fractionated TBI. in clinical practice (as for performance of relevant clinical trials), the influence of these results are rather limited by the heavy logistic constraints created by a sophisticated and time-consuming procedure. Lastly, clinicians are now facing an increasing incidence of second cancers, at least partly induced by irradiation, which jeopardize the long-term prospects of otherwise cured patients. (authors)

  13. Tissue air ratio in total body irradiation

    International Nuclear Information System (INIS)

    On the basis of dose readings in 102 patients treated with total body irradiation (TBI), a 'tissue air ratio (TAR) curve' has been produced. It could be useful to precalculate treatment time in TBI, for dose prescription to a specific point, provided the same source (60Co) and treatment setting (lateral irradiation; 3 m source-axis distance; reference point at thighs bifurcation, neat the perineum) is used. The TAR curve produced, and the formula relating tissue depth to TAR value, are presented, and compared to preexisting data for 'magna fields' treatments. This curve is exponential, and in semilog representation becomes straight, as every classic TAR curve; it is lower than others, reflecting non full-scatter situation in patient irradiation. (orig.)

  14. Total body irradiation: technical and clinical aspects

    International Nuclear Information System (INIS)

    Total-body irradiation (TBI) has an established role in many preparative regimens used before marrow transplantation (BMT) in the treatment of hematological malignancies in children and adults. Better choice in TBI techniques and dosimetry have permitted better homogeneity of dose, and therefore a significant sparing of critical tissues. Advances in treatments over the past 20 years have greatly improved survival; therefore, the evaluation of early and late complications with a sufficient follow-up, according to different conditioning regimens is important. In this article, we review and compare different TBI techniques and dosimetry, and their influence on the distribution and homogeneity of dose, and the possible relationship to the risk of complications. We also describe the acute and late effects of TBI in children and adults appearing in the first month post-BMT as veno-occlusive disease, interstitial pneumonitis, or after 3 months, i.e., endocrinal late effects and growth in children, cataracts, neurological and bone or other complications, secondary tumors and alteration in the quality of life. The responsibility of TBI in the increased rate of certain complications is difficult to assess from chemotherapy or allograft side effects (chronic graft vs. host disease) or from other associated medical treatments, such as long term steroid therapy. (authors)

  15. Patient dose analysis in total body irradiation through in vivo dosimetry

    OpenAIRE

    Ganapathy, K.; Kurup, P. G. G.; Murali, V.; M. Muthukumaran; Bhuvaneshwari, N.; Velmurugan, J.

    2012-01-01

    Total body irradiation (TBI) is a special radiotherapy technique, administered prior to bone marrow transplantation. Due to the complex nature of the treatment setup, in vivo dosimetry for TBI is mandatory to ensure proper delivery of the intended radiation dose throughout the body. Lithium fluoride (LiF) TLD-100 chips are used for the TBI in vivo dosimetry. Results obtained from the in vivo dosimetry of 20 patients are analyzed. Results obtained from forehead, abdomen, pelvis, and mediastinu...

  16. Cataracts following bone marrow transplantation (BMT) conditioned with total body irradiation (TBI) for acute leukemia (AL) in complete remission (CR): a study of the European group for blood and marrow transplantation

    International Nuclear Information System (INIS)

    Purpose: The advances in BMT over the past twenty years have greatly improved long term survival of patients (pts), therefore the evaluation of late complications such as cataract is of paramount importance. In order to assess the influence of several parameters on cataract formation and the risk for requiring surgery for sever opacification after BMT, we analyzed the collected data of 2149 pts from 48 EBMT centers. Patients and Methods: As of June 1996 among the 2149 questionnaires, data from 1760 pts were evaluable for survival with a median follow-up of 76 months (12-165). One thousand and ninty four pts have survived more than one year after BMT, including 5 pts who developed cataract during the first year. Thirty one pts with no ophthalmologic follow-up were excluded from the study, therefore the analyses concerned 1063 AL pts (Lymphoblastic: n = 567, 53%; Myeloblastic: n = 490, 46%; Undifferenciated: n = 6, 1%), allografted (n = 688, 65%) or autografted (n = 375, 35%) in first CR (n = 788, 74%) or in 2nd CR (n = 275, 26%). The median age was 23 years (1-57). Male to female ratio was 1.56 ((648(415))). The conditioning chemotherapy consisted of cyclophosphamide alone in 724 (68%) pts. Single dose TBI (STBI) was given a median dose of 10 Gy (6-11.82) to the mid-plane of abdomen in 495 (46%) pts, whereas fractionated regimens (FTBI; 2 to 12 fractions) were used in 568 (54%) pts, delivering a median dose of 12 Gy (8.5-12). Median dose rate (DR) was 0.06 Gy/min (0.018-0.3) in the STBI group, and 0.065 Gy/min (0.012-0.56) in the FTBI ≤ 6F group. Fifty two (5%) pts had prophylactic cranial radiotherapy delivering a median dose of 18 Gy (4-25). The administration of steroids for any reason was registered in 316 (30%) pts, and heparin as venocclusive disease (VOD) prevention in 195 (18%) pts. Results: After a median follow-up period of 76 months, (257(1063)) (24%) pts developed cataracts (unilateral in 18 and bilateral in 239 cases) with a 5 and 10-year estimated

  17. Total-body irradiation with 25-MV photons in advanced non-Hodgkin's lymphoma and chronic lymphocytic leukemia

    International Nuclear Information System (INIS)

    Patients with chronic lymphocytic leukemia (CLL) and non-Hodgkin's lymphoma were treated with total-body irradiation (TBI). One group was treated after chemotherapy failed, while the other group received TBI initially. TBI was ineffective against CLL after chemotherapy failed. All patients with lymphocytic lymphoma who initially responded to chemotherapy but later relapsed were helped by TBI, as were 88 percent of patients with previously untreated lymphocytic lymphomas

  18. Suppression of spontaneous and artificial metastasis by low dose total body irradiation in mice

    International Nuclear Information System (INIS)

    We investigated whether low dose total body irradiation (TBI) suppresses metastasis using both artificial and spontaneous lung metastasis in WHT/Ht mice. When mice were irradiated with 15-60 cGy immediately before tumor cell injection into a tail vein in artificial lung metastasis, lung colony formation was suppressed significantly by the TBI, and 20 cGy was the most effective dose. The suppressive effect of 20 cGy TBI lasted for 6 hours. TBI with 15-20 cGy suppressed spontaneous lung metastasis significantly, and 15 cGy was the most effective dose. (author)

  19. Multiple osteochondromata after total body irradiation. A case report

    International Nuclear Information System (INIS)

    We present a rare case of multiple osteochondromata after total body irradiation (TBI) in a bone marrow recipient. The patient was a 9-year-old boy. He had been given 13.2 Gy of TBI before allogeneic bone marrow transplantation (BMT) at the age of one because of acute lymphoblastic leukemia (ALL). He did not have a family history of hereditary multiple osteochondromatosis. Osteochondromata presented at the left clavicle, bilateral scapulae, right distal femur, and right proximal tibia. The lesions of the left clavicle and bilateral scapulae were excised. Histological features of resected specimens were those of osteochondroma, showing no evidence of malignant transformation. Although radiation is recognized to be a cause of osteochondroma, reports of TBI are rare. TBI should be considered as one of the causes of multiple osteochondromata. (author)

  20. Revisiting Biomarkers of Total-Body and Partial-Body Exposure in a Baboon Model of Irradiation.

    Directory of Open Access Journals (Sweden)

    Marco Valente

    Full Text Available In case of a mass casualty radiation event, there is a need to distinguish total-body irradiation (TBI and partial-body irradiation (PBI to concentrate overwhelmed medical resources to the individuals that would develop an acute radiation syndrome (ARS and need hematologic support (i.e., mostly TBI victims. To improve the identification and medical care of TBI versus PBI individuals, reliable biomarkers of exposure could be very useful. To investigate this issue, pairs of baboons (n = 18 were exposed to different situations of TBI and PBI corresponding to an equivalent of either 5 Gy 60Co gamma irradiation (5 Gy TBI; 7.5 Gy left hemibody/2.5 right hemibody TBI; 5.55 Gy 90% PBI; 6.25 Gy 80% PBI; 10 Gy 50% PBI, 15 Gy 30% PBI or 2.5 Gy (2.5 Gy TBI; 5 Gy 50% PBI. More than fifty parameters were evaluated before and after irradiation at several time points up to 200 days. A partial least square discriminant analysis showed a good distinction of TBI from PBI situations that were equivalent to 5 Gy. Furthermore, all the animals were pooled in two groups, TBI (n = 6 and PBI (n = 12, for comparison using a logistic regression and a non parametric statistical test. Nine plasmatic biochemical markers and most of hematological parameters turned out to discriminate between TBI and PBI animals during the prodromal phase and the manifest illness phase. The most significant biomarkers were aspartate aminotransferase, creatine kinase, lactico dehydrogenase, urea, Flt3-ligand, iron, C-reactive protein, absolute neutrophil count and neutrophil-to-lymphocyte ratio for the early period, and Flt3-ligand, iron, platelet count, hemoglobin, monocyte count, absolute neutrophil count and neutrophil-to-lymphocyte ratio for the ARS phase. These results suggest that heterogeneity could be distinguished within a range of 2.5 to 5 Gy TBI.

  1. Aspects of radioprotection in whole body irradiation treatments (TBI)

    International Nuclear Information System (INIS)

    Radiation protection occupationally exposed personnel and the public is considered in this study. It was done the experimental determination of the exposure rates at critical points in the area of radiotherapy and it was evaluated the staff dosimetry

  2. Total body irradiation for treatment of haematological diseases

    International Nuclear Information System (INIS)

    The present status of total body irradiation (TBI) as a part of the treatment of haematological diseases was discussed during a separate symposium at the 5th Annual ESTRO meeting at Baden-Baden. The experimental techniques applied in Europe, the dosimetry for TBI, the radiobiological aspects and the late effects after TBI have been reviewed. For specific geometries, precautions have to be taken to avoid increased dose contributions at the skin due to electrons scattered from the wall behind the patient. CT data can be useful for the individualisation of the exposure regimen of patients with extreme variations in lung anatomy or lung density. An appreciable number of centres apply in vivo dosimetry, however, special care is needed for the correct interpretation of the dosimeter readings. A number of late effects, including induction of cataract and secondary tumours has been observed after TBI. The techniques applied for TBI at the various centres and the temporal administration of the dose show wide variations. At present, the patient material is too heterogeneous to draw any conclusion about an optimum schedule for a TBI regimen. Further cooperation between clinicians, radiobiologists and radiation physicists has to be established to achieve consistency and further improvement of the results after TBI. (Auth.)

  3. Conditioning with total body irradiation for autologous bone marrow transplantation in patients with advanced neuroblastoma

    International Nuclear Information System (INIS)

    We administered a combination of chemotherapy, autologous bone marrow purged with magnet immunobeads and total body irradiation (TBI) for advanced neuroblastoma (NB). The effect of TBI was retrospectively studied with regard to hematological recovery and complications after autologous bone marrow transplantation (A-BMT). The bone marrow was engrafted in all patients, both recipients and non-recipients of TBI. In patients receiving TBI, the average number or days after A-BMT required for the white blood cell count to exceed 1,000/μl, the neutrophile count to exceed 500/μl and the platelet count to exceed 5.0 x 104/μl was 15.0±6.5, 16.0±6.4 and 59.7±24.4, respectively. In patients not receiving TBI, the corresponding figures were 12.2±6.2, 12.9±6.9 and 43.2±17.8 days, respectively. During hematological recovery after A-BMT, there was no statistical difference between patients having received TBI and those who did not receive TBI. Hemolytic uremic syndrome (HUS) was observed in four patients while receiving TBI, but no HUS developed after shielding the kidney from TBI. In terms or engraftment and complications, A-BMT can be performed on patients receiving TBI as safely as on those patients not receiving TBI. (author)

  4. Total body irradiation in bone marrow transplantation

    International Nuclear Information System (INIS)

    Total body irradiation was used in 22 patients as part of their conditioning regimen for bone marrow transplantation. Nine patients with acute leukemia received 1000 cGy TBI in addition with chemotherapy. None of them survived and the main cause of death was interstitial pneumonitis (50%). 4 patients received 1000 cGy with a lung shielding of 500 cGy. Two patients with acute leukemia died of leukemia and sepsis, two patients had aplastic anemia, one is surviving, the other died of severe GVHD and infectious complications. Nine patients with severe aplastic anemia strongly immunized by previous blood transfusions received 800 cGy TBI with a lung shielding of 400 cGy. No rejection was observed and 7 patients (63%) are currently alive. One patient died of interstitial pneumonitis probably related to CMV infection, one of subacute necrotizing hepatitis, two of severe acute GVHD. It is concluded from this study that TBI remains the best immunosuppressive conditioning regimen even in strongly immunized patients. It may be a contributing factor of the incidence and severity of interstitial pneumonitis. A reduction of the dose of the lung to 400-500 cGy seems to decrease the severity of this complication

  5. Thermoluminescent dosimetry in total body irradiation

    International Nuclear Information System (INIS)

    The aim of this paper was to develop a thermoluminescent dosimetry method for the absorbed dose determination of 6 MeV high-energy electron beams by thermoluminescent dosimetry. Total body irradiation (TBI) was performed using four dual fields angled at 252° and 285° in high-dose rate (HDR) mode. TBI measurements were investigated to estimate the absorbed dose in different anatomical parts of the patient. Experimental results were obtained using thermoluminescent detectors and solid water phantoms. The TL response of the dosimeters, as a function of the high-energy electron beam (HEEB) absorbed dose, was linear, from 0.1 to 500 cGy. The entrance skin dose (ESD) and isodose distribution on the surface of the treatment were investigated graphically. - Highlights: ► The total patient skin electron dose was determined. ► The patient skin dose distribution was measured by TL. ► TBID in treatment planning and QA for radiation therapy are suggested. ► TLD system is a good candidate for TBI dosimetry.

  6. Total body irradiation for myasthenia gravis with thymoma: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ki Mun; Choi, Ihl Bohng; Kim, In Ah [College of Medicine, Catholic Univ., Seoul (Korea, Republic of)

    1999-06-01

    Myasthenia Gravis (MG) is relatively rare occuring as one of important autoimmune disease to affect neuromuscular junction. This study was clinically to evaluate total body irradiation (TBI) against two patients including 33-year and 39-year females for chronic MG with thymoma who hospitalized in the St. Mary's Hospital, Catholic University since 1994 as well as who showed no response by thymectomy, immunotherapy and hormonal therapy. TBI designed by the dose of 150-180 cGy consisting of 10 cGy per fraction, three times a week, for 5-6 weeks using linear accelerator of 6 MV. During the treatment of TBI, they did complain acute side effect such as vomiting and also appear improved physical condition from 4-6 weeks after TBI. Through the follow-up period of 18 or 42 months after TBI, they did not have any symptomatic recurrence. Consequently, the results suggest that TBI can be used as an alternative tool for the patients concurrently for MG with thymoma who had been refractory to various conventional therapies like thymectomy, immunotherapy and hormonal therapy.

  7. Total body irradiation for myasthenia gravis with thymoma: case report

    International Nuclear Information System (INIS)

    Myasthenia Gravis (MG) is relatively rare occuring as one of important autoimmune disease to affect neuromuscular junction. This study was clinically to evaluate total body irradiation (TBI) against two patients including 33-year and 39-year females for chronic MG with thymoma who hospitalized in the St. Mary's Hospital, Catholic University since 1994 as well as who showed no response by thymectomy, immunotherapy and hormonal therapy. TBI designed by the dose of 150-180 cGy consisting of 10 cGy per fraction, three times a week, for 5-6 weeks using linear accelerator of 6 MV. During the treatment of TBI, they did complain acute side effect such as vomiting and also appear improved physical condition from 4-6 weeks after TBI. Through the follow-up period of 18 or 42 months after TBI, they did not have any symptomatic recurrence. Consequently, the results suggest that TBI can be used as an alternative tool for the patients concurrently for MG with thymoma who had been refractory to various conventional therapies like thymectomy, immunotherapy and hormonal therapy

  8. Total body irradiation in non-Hodgkin's lymphoma

    International Nuclear Information System (INIS)

    Between October 1972 and August 1977, low-dose fractionated total body irradiation (TBI), 150 to 300 rad,, was selected for 48 patients with previously untreated non-Hodgkin's lumphoma staged II, III, and IV. In 63% of the patients the disease had a nodular pattern; there were no patients with diffuse histiocytic lymphoma. All but 2 patients responded to TBI. The 4-year acutarial survival was 71% for the nodular group and 57% for the diffuse group. There were no acute symptoms during the course of treatment and no mortality associated with the treatment. Seventeen per cent of the patients developed transient platelet counts less than 30,000/mm3. Four required hospitilization for correction of thrombocytopenia and/or infection. The majority of patients who failed more than 3 months after initial complete remission were placed back in remission with either chemotherapy, TBI, or local irradiation. Patients with persistent disease after TBI showed a less favorable response with chemotherapy. A selected group of 15 patients in relapse after chemotherapy or localized radiotherapy were treated with TBI. Eleven responded to treatment, while 4 showed no useful response. The median survival for this group was slightly over 2 years. Twenty percent developed transient platelet counts less than 30,000/mm3

  9. Booster irradiation to the spleen following total body irradiation. A new immunosuppressive approach for allogeneic bone marrow transplantation

    International Nuclear Information System (INIS)

    Graft rejection presents a major obstacle for transplantation of T cell-depleted bone marrow in HLA-mismatched patients. In a primate model, after conditioning exactly as for leukemia patients, it was shown that over 99% of the residual host clonable T cells are concentrated in the spleen on day 5 after completion of cytoreduction. We have now corroborated these findings in a mouse model. After 9-Gy total body irradiation (TBI), the total number of Thy-1.2+ cells in the spleen reaches a peak between days 3 and 4 after TBI. The T cell population is composed of both L3T4 (helper) and Lyt-2 (suppressor) T cells, the former being the major subpopulation. Specific booster irradiation to the spleen (5 Gy twice) on days 2 and 4 after TBI greatly enhances production of donor-type chimera after transplantation of T cell-depleted allogeneic bone marrow. Similar enhancement can be achieved by splenectomy on day 3 or 4 after TBI but not if splenectomy is performed 1 day before TBI or 1 day after TBI, strengthening the hypothesis that, after lethal TBI in mice, the remaining host T cells migrate from the periphery to the spleen. These results suggest that a delayed booster irradiation to the spleen may be beneficial as an additional immunosuppressive agent in the conditioning of leukemia patients, in order to reduce the incidence of bone marrow allograft rejection

  10. Total body irradiation with a four-field technique using a 10 MV linear accelerator

    International Nuclear Information System (INIS)

    Recently, total body irradiation (TBI) is being used as a method of preparation for bone marrow transplantation (BMT). However, many variations exist in the TBI procedure, such as the irradiation technique, total dose, dose rate and dose fractionation. In TBI treatment, it is important to apply a homogeneous dose to the total body, and avoid interstitial pneumonitis and cataracta. Therefore, we applied a four-field technique using 10 MV X-rays with a shield for lungs and eyeballs, and employed tissue compensators and bolus to obtain a homogeneous dose distribution. The midpoint doses in 12 positions of the total body have been achieved within ±10% of that of the pelvis with the use of this technique. Also, this TBI technique is capable of accurately controlling absorbed doses to the lungs and eyes. (author)

  11. Total body irradiation: present and future; Irradiation corporelle totale: present et avenir

    Energy Technology Data Exchange (ETDEWEB)

    Zilli, T.; Miralbell, R.; Ozsahin, M. [Hopitaux Universitaires de Geneve, Service de Radio-Oncologie (Switzerland); Ozsahin, M. [Centre Hospitalier Universitaire Vaudois, Service de Radio-Oncologie, Lausanne (Switzerland)

    2009-09-15

    Total body irradiation (T.B.I.) has an established role as preparative regimen for bone-marrow transplantation in the treatment of hematological malignancies. Many randomized trials demonstrated that the clinical outcomes obtained from the association of T.B.I. and cyclophosphamide are equivalent, or, sometimes, better than those based on chemotherapeutic agents. Despite the therapeutic progress of the last years, and the consequent improvement in the overall survival, this preparative regimen remains always associated with a relatively high rate of acute and late toxicity. In this article, we review the actual indications of T.B.I. in clinical practice, and analyze the technological progress in this domain. We focus on the hypothesis that a selective irradiation of the hematopoietic or lymphoid organs is actually possible with intensity-modulated radiotherapy. Technical limits and preliminary results in terms of acute and late toxicities of intensity-modulated T.B.I. are analyzed. With these new technologies, treatment-related toxicity is not anymore a major limiting factor in the preparative regimens for bone-marrow transplantation, allowing for a larger spectrum of T.B.I. indications, a possible extension to patients older than 50 years, or a dose escalation. Preliminary results warrant, however, further evaluation in clinical trials to better assess the impact of this new approach on disease control and the long-term toxicity. (authors)

  12. An Acute Transverse Myelitis Attack after Total Body Irradiation: A Rare Case

    OpenAIRE

    Ali Unal; Bulent Eser; Mustafa Cetin; Cigdem Pala; Serife Cingoz; Celalettin Eroglu; Serdar Sivgin; Leylagul Kaynar; Afra Yildirim; Muzaffer Keklik

    2013-01-01

    Total body irradiation (TBI) combined with chemotherapy is widely used as a pretreatment regimen of bone marrow transplantation (BMT) in hematologic disorders. Late complications related to TBI as part of the conditioning regimen for hematopoietic stem cell transplantation have been revealed. Acute transverse myelitis (ATM) is a neurological syndrome characterized by disorder of motor, sensorial, and autonomic nerves, and tracts at medulla spinalis, which is resulted from involvement of spina...

  13. Cataractogenesis after total body irradiation

    International Nuclear Information System (INIS)

    Purpose: To evaluate the prognostic factors and the ophthalmologic follow-up on cataract formation following total body irradiation (TBI) prior to bone marrow transplantation (BMT). Methods and Materials: Between 1980 and 1992, 494 patients were referred to our department for TBI prior to BMT. The mean age was 32 ± 11 (median: 32, range: 2-63) years and the male to female ratio was 1.6 (304:190). The majority of patients were treated for acute leukemia (lymphoblastic, n = 177, 36%; or nonlymphoblastic, n = 139, 28%); 80 (16%) for chronic myeloid leukemia, 60 (12%) for non-Hodgkin's lymphoma, 23 (5%) for multiple myeloma, and 15 (3%) for other malignancies. Two hundred and fifty-four (51%) patients were grafted in the first complete remission (CR), 118 (24%) in second CR. Allogeneic BMT was performed in 210 (43%) patients, and autologous BMT in 284 (57%). Methotrexate combined to steroids (n = 47, 22%) or to cyclosporine (n = 163, 78%) was administered for graft-versus-host disease (GvHD) prophylaxis. In 188 patients (38%), heparin was used in the prevention of veno-occlusive disease (VOD) of the liver. Furthermore, steroid administration was registered in 223 patients (45%). The conditioning chemotherapy consisted of cyclophosphamide (Cy) alone in 332 (67%) patients. Total-body irradiation was administered either in single dose (STBI; 10 Gy in 1 day, n = 291) or in six fractions (FTBI; 12 Gy over 3 consecutive days, n = 203) before BMT. The mean instantaneous dose rate was 0.0574 ± 0.0289 Gy/min (0.024-0.1783). It was < 0.048 Gy/min in 157 patients (LOW group), ≥ 0.048 Gy/min and < 0.09 Gy/min in 301 patients (MEDIUM group), and ≥ 0.09 Gy/min in 36 patients (HIGH group). Results: When considering all patients, 42 (8.5%) patients developed cataracts after 13 to 72 months (median: 42 months) with a 5-year estimated cataract incidence (ECI) of 23%. Thirty-three (11.3%) out of 291 patients in the STBI group, and 9 (4.4%) out of 203 patients in the FTBI group

  14. An Acute Transverse Myelitis Attack after Total Body Irradiation: A Rare Case

    Directory of Open Access Journals (Sweden)

    Muzaffer Keklik

    2013-01-01

    Full Text Available Total body irradiation (TBI combined with chemotherapy is widely used as a pretreatment regimen of bone marrow transplantation (BMT in hematologic disorders. Late complications related to TBI as part of the conditioning regimen for hematopoietic stem cell transplantation have been revealed. Acute transverse myelitis (ATM is a neurological syndrome characterized by disorder of motor, sensorial, and autonomic nerves, and tracts at medulla spinalis, which is resulted from involvement of spinal cord. In this paper, we presented an ATM attack developed after TBI in a patient with acute lymphoblastic leukemia (ALL as it is a rarely seen case.

  15. Total body irradiation and allogeneic bone-marrow transplantation

    International Nuclear Information System (INIS)

    The aim of the present study is to present the first case in the Bulgarian oncological practice of total-body irradiation (TBI) followed by allogeneic transplantation of hemopoietic peripheral steam cells from a haploidentical family donor to a patient with acute lymphoblastic leukemia. The patient was a 10-year old boy with a verified non-Hodgkin lymphoma - IV clinical stage (leukemia-lymphoma syndrome) with initial mediastinal and bone-marrow engagement. After the disease recurrence the patient was hospitalized in the Transplantation Department of the Specialized Pediatric Hospital for Active Treatment of Oncological Diseases for realizing allogeneic transplantation. The application of the conditioning regime includes Melphalan, Fludarabine, ATG and TBI with 5x2 Gy. The patient was discharged on the 30th day in a good general condition with compensated haematological parameters and stable function of the transplant, and with instructions for the control check-ups and examinations each 14 days till the day + 100. The TBI method applied by the team was simple for realization and did not require special equipment. The patient received irradiation by a vertical radiation beam in a small procedure room in a comfortable spinal and prone position, which allowed the realization of sufficiently homogeneous dose in the body and effective lung protection. The irradiation time was acceptable, compared with the time for the application of horizontal radiation beams at large distances. (authors)

  16. Cataracts after total body irradiation and marrow transplantation: a sparing effect of dose fractionation

    International Nuclear Information System (INIS)

    Two hundred seventy-seven patients, who have been followed for 1 to 12 years after marrow transplantation, have been examined for cataract development. In preparation for transplantation, 96 patients with aplastic anemia were conditioned with chemotherapy only, while 181 patients (two with aplastic anemia and 179 with a hematologic malignancy) were conditioned with a regimen of total body irradiation (TBI) and chemotherapy. TBI was delivered from two opposing 60Co sources at an exposure rate of 4 to 8 cGy/min, either as a single dose of 10 Gy (105 patients) or in fractions (76 patients). To date, 86 patients have developed cataracts. Kaplan-Meier product limit estimates of the incidence of cataracts for patients given chemotherapy only and no TBI, single-dose TBI, and fractionated TBI are 19, 80, 18%, respectively. On the basis of proportional hazards regression analyses, patients given single-dose TBI had a relative risk of developing cataracts that was 4.7-fold higher than in patients given fractionated TBI or chemotherapy only, suggesting a significant sparing effect with use of TBI dose fractionation

  17. The distribution of mesenchymal stem cells after total-body irradiation in rats

    International Nuclear Information System (INIS)

    Objective: To detect the distribution of mesenchymal stem cells(MSCs) after total-body irradiation in rats. Methods: MSCs were cultured and labeled with green fluorescent protein(GFP). Rats were exposed to total-body irradiation(TBI) or TBI plus total brain irradiation, and then MSCs were injected through the tail vein. The Fluorescent MSCs were observed by fluorescence microscope. The MSCs numbers in different organs were determined by quantitative RT-PCR method. Results: GFP-labeled MSCs were obtained. After MSCs were infused to the rats, few of them were observed in the organs of nonirradiated group except for a very low number in the lungs ,bone marrow(BM) and spleen. TBI of 6 Gy increased the engraftment of MSCs in almost all the organs, especially in early response tissues such as the small intestine and BM. TBI of 7 Gy further increased the number of MSCs. The MSCs numbers in the brain and other organs were significantly increased after 20 Gy total brain irradiation in addition to 6 Gy TBI. Conclusions: Radiation injury can induce the aggregation of MSCs. With the increase of radiation dose and severity of radiation injury, a significant increase of MSCs in different organs were observed. Local irradiation can increase the MSCs distribution in the radiation field as well as other organs. (authors)

  18. Interaction of whole-body hyperthermia and irradiation in the treatment of AKR mouse leukemia

    International Nuclear Information System (INIS)

    Whole-body hyperthermia (WBH) to 41-420C combined with fractionated total-body irradiation (TBI) was studied in mice with transplanted AKR leukemia. Mice treated with both TBI and WBH survived longer than mice treated with either modality alone. From other groups of similarly treated mice the spleens were removed, weighed, and assayed for their content of leukemic colony-forming units (CFU) by injecting single-cell suspensions into normal syngeneic recipients. Using this methodology it was determined that the thermal enhancement ratio for WBH combined with TBI was 1.6, and that enhanced killing of leukemia cells occurred irrespective of the sequence of WBH and TBI. Data are presented which relate variables, such as duration of WBH or heating time to target temperature, to the response of neoplastic disease. The implications of these preclinical findings to clinical trials are discussed. (author)

  19. Cataracts after bone marrow transplantation: long-term follow-up of adults treated with fractionated total body irradiation

    International Nuclear Information System (INIS)

    Purpose: To determine the risk of, and risk factors for, developing cataracts after bone marrow transplantation.Methods and Materials: Four hundred and ninety-two adults who underwent bone marrow transplantation in Seattle were followed for 2 to 18 (median, 6) years. Before transplantation, patients received a preparative regimen of chemotherapy plus total body irradiation (TBI) (n = 407) or chemotherapy alone, without TBI (n = 85). TBI was administered in a single dose of 10 Gy (n = 74) or in fractionated doses totaling 12-15.75 Gy (n = 333). The risk of cataracts was determined for groups of patients with respect to the type of preparative regimen received and other pretransplant and posttransplant variables. Results: One hundred and fifty-nine patients (32%) developed cataracts between 0.5 to 11 (median, 2.3) years after transplantation. The probability of cataracts at 11 years after transplantation was 85%, 50%, 34%, and 19% for patients receiving 10 Gy of single-dose TBI, >12 Gy fractionated TBI, 12 Gy fractionated TBI, and no TBI, respectively (p 12 Gy fractionated TBI, 12 Gy fractionated TBI, or no TBI (33%, 22% and 23%, respectively). Patients given corticosteroids after transplant had a higher probability of cataracts (45%) than those without steroids (38%)(p <0.0001). In a proportional hazards regression model, the variables that were correlated with an increased probability of cataracts were single-dose TBI (relative risk (RR) = 2.46) and steroid therapy (RR = 2.34), while a decreased probability of cataracts was correlated with a nonTBI preparative regimen (RR = 0.41). The yearly hazard of developing cataracts in recipients of single-dose TBI was highest during the third year after transplantation, while in recipients of fractionated TBI, the hazard was distributed among years one through seven. The probability of cataracts in all groups reached a plateau at 7 years after transplantation, after which the development of cataracts was extremely unlikely

  20. Pulmonary complications of bone marrow transplantation: a comparison of total body irradiation and cyclophosphamide to busulfan and cyclophosphamide

    International Nuclear Information System (INIS)

    Purpose: To retrospectively compare the acute and long-term pulmonary toxicities of total body irradiation and busulfan in bone marrow transplantation. Methods and Materials: From March 1984 through February 1991, 144 patients received high-dose therapy with cyclophosphamide plus either total body irradiation (TBI-CY) or busulfan (BU-CY) followed by bone marrow rescue. Treatment protocols were based on disease type. Cyclophosphamide dose was 120-200 mg/kg, given in 2-4 days. Total body irradiation was given as 12 Gy in four fractions over 4 days, or 14.4 Gy in eight fractions over 4 days. Busulfan dose was 16 mg/kg given over 4 days. Results: Seventy-nine patients were treated with TBI-CY and 65 patients with BU-CY. More patients in the TBI group had allogeneic transplants (40 vs. 18). Pulmonary events occurred in 48 patients, 19 in BU-CY and 29 in TBI-CY. Of the 58 patients with allogeneic transplants, 21 (36%) developed chronic graft-vs.-host disease (GVHD), and 10 of those patients developed pulmonary complications (including 2 with obliterative bronchitis and 1 with asthma). Interstitial pneumonitis (IP) occurred in 14 patients, 12 in the TBI-CY group and 2 in the BU-CY group. Cytomegalovirus and pneumocystis infections were associated with IP in 11 of those patients. Fatal idiopathic IP occurred in one patient in each of the TBI-CY and BU-CY groups. Multivariate analysis showed that only chronic GVHD and prior bleomycin use were significant predictors of interstitial pneumonitis; no difference was seen between TBI-CY and BU-CY. Conclusions: Pulmonary complications were most commonly associated with GVHD and prior bleomycin use. The incidence of cytomegalovirus or pneumocystis carinii pneumonitis was greater in the patients receiving the TBI regimen; fatal pulmonary complications were not significantly different between TBI and nonTBI regimens

  1. Cyclic, low-dose total body irradiation for metastatic neuroblastoma

    International Nuclear Information System (INIS)

    Total body irradiation (TBI) can be thought of as a systemic anticancer agent. It therefore might best be given like an adjuvant drug, i.e., in tolerable doses, cyclically. The therapeutic ratio between normal bone marrow stem cells and suitably sensitive cancer cells should be widened by these means. Fourteen children with advanced (Stage IV) neuroblastomas were given 100-150 rad TBI in 50 rad daily fractions along with each three-week cycle of standard triple-agent chemotherapy (vincristine, DTIC, cyclophosphamide). Two patients died of toxicity and one is still undergoing therapy. Four of the remaining 12 survive free of disease for 12+ to 31+ months. The regimen is well tolerated, but prolonged, pronounced bone marrow depression, especially thrombocytopenia, commonly occurs after doses of 300-450 rad

  2. In vivo dosimetry with silicon diodes in total body irradiation

    International Nuclear Information System (INIS)

    The aim of this work is the characterization and application of silicon diode detectors for in vivo dosimetry in total body irradiation (TBI) treatments. It was evaluated the diode response with temperature, dose rate, gantry angulations and field size. A maximum response variation of 2.2% was obtained for temperature dependence. The response variation for dose rate and angular was within 1.2%. For field size dependence, the detector response increased with field until reach a saturation region, where no more primary radiation beam contributes for dose. The calibration was performed in a TBI setup. Different lateral thicknesses from one patient were simulated and then the calibration factors were determined by means of maximum depth dose readings. Subsequent to calibration, in vivo dosimetry measurements were performed. The response difference between diode readings and the prescribed dose for all treatments was below 4%. This difference is in agreement as recommended by the International Commission on Radiation Units and Measurements (ICRU), which is ±5%. The present work to test the applicability of a silicon diode dosimetry system for performing in vivo dose measurements in TBI techniques presented good results. These measurements demonstrated the value of diode dosimetry as a treatment verification method and its applicability as a part of a quality assurance program in TBI treatments. - Highlights: ► Characterization of a silicon diode dosimetry system. ► Application of the diodes for in vivo dosimetry in total body irradiation treatments. ► Implementation of in vivo dosimetry as a part of a quality assurance program in radiotherapy

  3. Total lymphoid irradiation and total body irradiation for allogeneic bone marrow transplantation in aplastic anemia

    International Nuclear Information System (INIS)

    Between April 1980 and June 1989, 15 patients with severe aplastic anemia (SAA) were treated at Hyogo College of Medicine with bone marrow transplantation (BMT) after preparation consisting of cyclophosphamide (CY) and total lymphoid irradiation (TLI) or total body irradiation (TBI) for the purpose of reducing the incidence of graft rejection. All patients had initial evidence of engraftment after the first transplantation except for one patient who died of heart failure due to CY on the third day after transplantation and could not be evaluated for engraftment. Rejection later occurred in four of these 14 patients, who then underwent successful regrafting. One of these four patients, who was conditioned with CY alone at the first grafting, underwent successful regrafting after a conditioning regimen of CY and TBI. In the other three patients, irradiation was performed twice as the conditioning regimen. Thus, 14 of 15 patients underwent successful BMT and are alive with restored hematopoietic function. From the above results, the combination of TLI or TBI and CY was considered to be very useful as a conditioning regimen for BMT in patients with SAA. (author)

  4. A SIMPLIFIED IN VIVO DOSLMETRY FOR TOTAL BODY IRRADIATION PRIOR TO BONE MARROW TRANSPLANTATION

    Institute of Scientific and Technical Information of China (English)

    肖泽久

    1994-01-01

    For TBI (total body irradiation) prior to BMT (bone marrow transplantation) and in order to guarantee exact treatment, it is necessary to perfect is vivo dosimetry to detect any deviation of the treatment and to verify the dose dis-tribution. A simplified and convenient transmission type in vivo dosimetry and problems are introduced and discussed.

  5. The role of total body irradiation in preparation for bone marrow transplantation in acute leukaemia. A review

    International Nuclear Information System (INIS)

    From extrapolation obtained from animal studies and radiation accidents, it is assumed that for man the LD 50 (30) will be between 300-500 rads total body irradiation (TBI) and the LD 100 at least 600 rads TBI. A dose of 1000 rads TBI is generally used in man for conditioning for bone marrow transplantation. In acute leukemia, total body irradiation is usually associated with cytoreductive chemotherapy. In Seattle 110 patients underwent bone marrow transplantation for acute leukemia in relapse. 15 patients became long term survivors. The main cause of failure were GVH, interstitial pneumonitis and leukemic relapse. New attempts are being made to improve the results: (1) better cytoreductive therapy preceding transplantation, (2) bone marrow transplantation during remission of the disease, (3) prevention of interstitial pneumonitis by modifications of the TBI technique

  6. Patterns of patient specific dosimetry in total body irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Akino, Yuichi [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana 46202 (United States); Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871 (Japan); McMullen, Kevin P.; Das, Indra J. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana 46202 (United States)

    2013-04-15

    Purpose: Total body irradiation (TBI) has been used for bone marrow transplant for hematologic and immune deficiency conditions. The goal of TBI is to deliver a homogeneous dose to the entire body, with a generally accepted range of dose uniformity being within {+-}10% of the prescribed dose. The moving table technique for TBI could make dose uniform in whole body by adjusting couch speed. However, it is difficult to accurately estimate the actual dose by calculation and hence in vivo dosimetry (IVD) is routinely performed. Here, the authors present patterns of patient-specific IVD in 161 TBI patients treated at our institution. Methods: Cobalt-60 teletherapy unit (Model C9 Cobalt-60 teletherapy unit, Picker X-ray Corporation) with customized moving bed (SITI Industrial Products, Inc., Fishers, IN) were used for TBI treatment. During treatment, OneDose{sup TM} (Sicel Technology, NC) Metal Oxide-silicon Semiconductor Field Effect Transistor detectors were placed at patient body surface; both entrance and exit side of the beam at patient head, neck, mediastinum, umbilicus, and knee to estimate midplane dose. When large differences (>10%) between the prescribed and measured dose were observed, dose delivery was corrected for subsequent fractions by the adjustment of couch speed and/or bolus placement. Under IRB exempt status, the authors retrospectively analyzed the treatment records of 161 patients who received TBI treatment between 2006 and 2011. Results: Across the entire cohort, the median {+-} SD (range) percent variance between calculated and measured dose for head, neck, mediastinum, umbilicus, and knee was -2.3 {+-} 10.2% (-66.2 to +35.3), 1.1 {+-} 11.5% (-62.2 to +40.3), -1.9 {+-} 9.5% (-66.4 to +46.6), -1.1 {+-} 7.2% (-35.2 to +42.9), and 3.4 {+-} 12.2% (-47.9 to +108.5), respectively. More than half of treatments were within {+-}10% of the prescribed dose for all anatomical regions. For 80% of treatments (10%-90%), dose at the umbilicus was within {+-}10

  7. Prospective neurodevelopmental studies of two children treated with total body irradiation and bone marrow transplantation for acute leukemia in infancy

    International Nuclear Information System (INIS)

    Five-year neurodevelopmental studies of two infants with acute leukemia are presented. Both patients underwent bone marrow transplantation (BMT) after conditioning with cyclophosphamide and total body irradiation (TBI). Neither patient was treated with intrathecal chemotherapy. Their outcome is remarkable for normal development of intelligence, language, perception, and motor coordination. These results suggest that TBI and BMT should be considered in future therapeutic studies of infants with acute leukemia, who are at great risk for failure of conventional therapy

  8. Short-term endocrine consequences of total body irradiation and bone marrow transplantation in children treated for leukemia

    International Nuclear Information System (INIS)

    We studied 24-h hormone profiles and hormonal responses to insulin-induced hypoglycaemia prospectively in 23 children of similar age and pubertal stage, nine of whom had received prior cranial irradiation and fourteen of whom had not before and 6-12 months after total body irradiation (TBI) for bone marrow transportation in leukaemia. (Author)

  9. Biochemical and hematological indicators in model of total body irradiation

    International Nuclear Information System (INIS)

    With the purpose of evaluating the applicability of several biological indicators in accidental overexposures a study was carried out in 20 patients undergoing therapeutical total body irradiation (TBI). The following parameters were evaluated: a) Oxidative stress indicators: erythrocyte superoxide dismutase (SOD) and catalase activity (CAT), lipo peroxyde levels (TBARS) and total plasma antioxidant activity (TAA). b) Haematological indicators: reticulocyte maturity index (RMI) and charges in lymphocyte subpopulations. Non significant changes in SOD and CAT activity were observed. Significant higher TBARS levels were found in patients with unfavorable post-BTM course without any significant correlation with TAA. RMI decreased early and dropped to zero in most of the patients and rose several days prior to reticulocyte, neutrophils and platelets counts. A significant decrease in absolute counts of all lymphocyte subpopulations was observed during TBI, particularly for B lymphocytes. A subpopulation of natural killer (NK) cells (CD16+/ CD 56 +) showed a relative higher radioresistance. Cytotoxic activity was significantly decreased after TBI. These data suggest that TBARS could provide an useful evolutive indicator in accidental over exposure d patients and RMI is an early indicator of bone marrow recovery after radioinduced aplasia. The implications of the different radiosensitivities within the NK subsets remains unanswered. (author)

  10. Left-half-body-irradiation induced mouse bone marrow hematopoietic cells DNA damage in non-irradiation area

    International Nuclear Information System (INIS)

    Objective: To investigate the DNA damage of mouse bone marrow hematopoietic cells in-non-irradiation area after being irradiated by way of left-half-body. Methods: 6-8 weeks male Kunming strain mice were randomly divided into 4 groups i.e. normal control (NC), total-body-irradiated (TBI), left-half-body-irradiated (LHBI), and total -body-shield-irradiated (TBSI). Half-body-irradiated model were made with two pieces of 5 cm x 8 cm x 16 cm over- lapped lead bricks shielding right-side body and irradiated with 8.0 Gy 60Co γ-ray. The TNF-α, SOD, MDA in mouse serum were measured and the DNA damages of bone marrow hematopoietic cells were observed by comet assay and the frequency of polychromatic erythrocytes micronucleated(fMPCE). Results: In the left-half-body-irradiated condition, The TNF-α and MDA were increased and the SOD was decreased in serum remarkably(compared with NC, P<0.01); In non-irradiation area, the fMPCE and the percentage of bone marrow hematopoietic cells with comet-like tail, were aggravated significantly. Conclusions: Our study suggest that the local irradiation result in the DNA damage of bone marrow hematopoietic cells in non- irradiation area, and the increasing of TNF-α and reactive oxygen or free radicals may play an important role in the damages. (authors)

  11. Anticarcinogenic effect of tetrachlorodecaoxide after total-body gamma irradiation in rats

    International Nuclear Information System (INIS)

    Tetrachlorodecaoxygen (TCDO) therapy of acute radiation syndrome was tested for a possible influence on the development of X-ray-induced malignancies. BD IX rats were exposed to total-body irradiation (TBI, γ rays, 9 or 11 Gy) and received daily intravenous injections of either TCDO or physiological saline solution from days 4 through 11 after TBI. The short-term TCDO therapy reduced the acute death rate markedly, but survival rates after 4 months were similar with and without TCDO. The first malignancy after TBI occurred on day 103, and over the lifetime of the animals the tumor incidence in the group given TBI (11 Gy) without TCDO treatment was 73% vs 20% in animals with short-term TCDO therapy after TBI. In particular, there was a highly significant prevention of radiation-induced leukemia [P (one-sided) < 0.001] by TCDO, and a significantly reduced incidence of malignant epithelial tumors [P (one-sided) < 0.05]. The development of sarcomas was not affected by TCDO. Long-term survival was not enhanced by TCDO due to the occurrence of bronchopneumonial infections about 1 year after TBI. In conclusion, TCDO is not only a potent therapeutic agent in acute radiation syndrome, but it also significantly reduced the carcinogenic risk in rats after exposure to ionizing radiation. 18 refs., 3 figs., 4 tabs

  12. Induction of systemic bone changes by preconditioning total body irradiation for bone marrow transplantation

    International Nuclear Information System (INIS)

    Preconditioning total body irradiation (TBI) prior to bone marrow transplantation (BMT) has been believed to be a safe procedure that does not cause late morbidity; yet, a recent report raises the suspicion that TBI-induced chondroosseous abnormalities do occur. To evaluate the radiological manifestations of TBI-induced skeletal alterations and their orthopaedic morbidity. Subjects included 11 children with TBI-induced skeletal changes, including 9 in our hospital and 2 in other hospitals. The former were selected from 53 children who had undergone TBI with BMT. Radiographic examinations (n=11), MRI (n=3), CT (n=2), and medical records in the 11 children were retrospectively reviewed. The skeletal alterations included abnormal epiphyseal ossification and metaphyseal fraying (8/11), longitudinal metaphyseal striations (8/11), irregular metaphyseal sclerosis (6/11), osteochondromas (4/11), slipped capital femoral epiphysis (2/10), genu valgum (3/10), and platyspondyly (2/3). MRI demonstrated immature primary spongiosa in the metaphysis. Of the 11 children, 9 had clinical symptoms. TBI can induce polyostotic and/or generalized bone changes, mainly affecting the epiphyseal/metaphyseal regions and occasionally the spine. The epi-/metaphyseal abnormalities represent impaired chondrogenesis in the epiphysis and growth plate and abnormal remodelling in the metaphysis. Generalized spine changes may lead to misdiagnosis of a skeletal dysplasia. (orig.)

  13. Total body irradiation therapy for thymectomized myasthenic patients and immunological evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Yamanaka, Nobukazu; Tanaka, Masayuki; Kurihara, Teruyuki (Miyazaki Medical College (Japan))

    1983-06-01

    Three patients with intractable myasthenia gravis (MG) were treated with total body irradiation (TBI). All the three patients had been unstable after extended thymectomy and poorly responding to prednisolone therapy. Radiation therapy consisted of 10 doses of 10 rads/day given over five weeks. After the radiation therapy the three patients improved clinically, and an objective parameter, area of M-waves also improved. No significant side effects were noted. TBI therapy can be considered as a safe method to induce selective reduction of circulating lymphocytes. This was indeed achieved, as evidenced by a drop of the lymphocyte counts to the levels of 20-40 % of the pretreatment level. The effects were persistent over twelve weeks. Early radiosensitivity of B lymphocytes were recognized. The levels of T..gamma.. cells were low before TBI therapy, increasing gradually during TBI therapy and returned to normal range after twelve weeks. Serum anti-AChR antibody titers decreased in all the cases, but it was impossible to determine whether the decrement was due to the therapy or natural course after thymectomy. Two of our three cases had a significant percentage decrement of the titers after TBI therapy. We suggest that TBI therapy is a safe method of immunosupperssive treatment for the myasthenic patients after thymectomy.

  14. Basal Cell Skin Cancer after Total-Body Irradiation and Hematopoietic Cell Transplantation

    OpenAIRE

    Schwartz, Jeffrey L.; Kopecky, Kenneth J.; Robert W. Mathes; Leisenring, Wendy M; Friedman, Debra L.; Deeg, H. Joachim

    2009-01-01

    Previous studies identified radiation therapy as a key modifier of basal cell carcinoma (BCC) risk in survivors of hematopoietic cell transplantation (HCT). In the present analysis, risk of BCC was analyzed in relation to age at transplant, attained age, race, total-body irradiation (TBI), and radiation fractionation in 6,306 patients who received HCT at ages 0–65 years after conditioning regimens with (n = 3870) or without (n = 2436) TBI, and who were followed from 100 days to 36.2 years aft...

  15. Total body irradiation in France in the past twenty years

    International Nuclear Information System (INIS)

    A review of the activity and techniques of total body irradiation (TBI) in France in the last 20 years is presented. In order to have on overall view of the activity and techniques of total body irradiation in France, the group of cancer centre radiation oncologists sent a questionnaire to all the cancer centres or public hospitals radiotherapy departments dealing with this treatment. Thirty-six questionnaires were sent and thirty-one departments answered. Three departments do not offer this treatment. Five departments did not answer. Results, therefore, concern the activity of the 28 departments that agreed to give detailed and clear answers. A total of 10 630 TBIs have been documented, 850 to 900 TBI have been done each year since 1995. Single fraction TBIs are used in only five centres and are being progressively abandoned. For Multiple-fraction TBIs, the techniques described here are the ones used in 1999, at the time the questionnaires were sent. A majority (98%) of the teams used linear accelerators. The collected data are synthesised in tables. Nowadays, single fraction TBIs are only indicated in exceptional cases, Most of the TBIs are fractionated in six twice-daily fractions with pulmonary shielding to limit the dose between 6 and 11 Gy depending on departments' protocols and pathologies. (author)

  16. Thrombopoietin promotes hematopoietic recovery and survival after high-dose whole body irradiation

    International Nuclear Information System (INIS)

    Purpose: The therapeutic potential of thrombopoietin (TPO), the major regulator of platelet production, was evaluated for hematopoietic recovery and survival in mice following lethal and supralethal total body irradiation (TBI). Methods and Materials: Hematopoietic recovery was studied in C57BL6/J mice after 8 Gy TBI (gamma-rays). Survival experiments were performed with C57BL6/J and BCBA F1 mice. Two protocols of TPO administration were evaluated: treatment for 7 consecutive days (7 x 0.3 μg/mice) beginning 2 h after exposure, or a single dose (0.3 μg/mice) administered 2 h after irradiation. Results: TPO improved the platelet nadir and accelerated the platelet reconstitution of irradiated mice in comparison to placebo-treated mice. Recovery of neutrophils and erythrocytes was stimulated as well. TPO induced an accelerated recovery of hematopoietic progenitors and immature multilineage progenitors in bone marrow and spleen. In addition, TPO administration induced approximately 90% survival of 8 Gy irradiated C57BL6/J mice, a TBI dose which resulted in 100% mortality within 30 days for placebo-treated mice. Single TPO administration was as effective as repeated injections for hematopoietic recovery and prevention of mortality. Dose-effect survival experiments were performed in BCBA F1 mice and demonstrated that TPO shifted the LD50/30 from approximately 9.5 Gy to 10.5 Gy TBI given as a single dose, and from 14 Gy to as high as 17 Gy when TBI was given in three equal doses, each separated by 24 h. Conclusion: These results demonstrate that the multilineage hematopoietic effects of TPO may be advantageously used to protect against lethal bone marrow failure following high dose TBI

  17. Total Body Irradiation using VMAT (RapidArc): A Planning Study of a novel treatment delivery method

    OpenAIRE

    Santam Chakraborty; Suja Cheruliyil; Resmi Bharathan; Geetha Muttath

    2015-01-01

    Purpose: To evaluate the feasibility of using volumetric modulated arc therapy (VMAT) using RapidArc to deliver total body irradiation (TBI) treatment. Methods: VMAT planning was performed a whole body computed tomography (CT) data set using Rapid Arc. The planning target volumes included entire body trimmed to 3 mm below the skin. The organs at risk included the lungs and kidneys. A dose of 12 Gy in 10 fractions was prescribed to the target volume. The VMAT-TBI technique consisted of three i...

  18. Disturbances in dental development after total body irradiation in bone marrow transplant recipients

    International Nuclear Information System (INIS)

    The dental status of 16 children who had been treated with bone marrow transplantation (BMT) for serious bone marrow diseases was followed for up to 6 years. Several types of disturbances in dental development were observed in children who had been conditioned with total body irradiation (TBI) at 10 Gy before BMT. Thus, impaired root development that caused short V-shaped roots was found in all patients, a complete failure of root development and premature apical closure were found in five patients, enamel hypoplasia was observed in four patients, and microdontia was observed in three patients conditioned with TBI. Patients younger than 6 years of age at BMT exhibited the most severe and extensive dental aberrations. The TBI at 10 Gy appeared to be the major cause of the disturbances found

  19. Total-body irradiation in the beginning of the 21 century

    International Nuclear Information System (INIS)

    Total-body irradiation (TBI), in combination with intensive chemotherapy, plays an important role in the preparation of patients with hematological diseases for bone-marrow transplantation (BMT). Depending of the total dose applied low- and high-dose TBI is distinguished. The present review is aimed at presenting the accumulated experience so far in the field of the high-dose total-body irradiation with an emphasis on the effect of total dose, dose rate and fractionation on the therapeutic results, the host versus graft reactions as well as some reactions and complications during TBI performance. The indications, aims and priorities of TBI over chemotherapy as a conditioning regime are discussed in detail. The radiobiological bases and the technical and dosimetric requirements for TBI realization are presented. An attempt is made for systematizing the accumulated knowledge so far with respect to effects of total dose, dose rate and fractionation on the therapeutic results, host versus graft reactions, post TBI reactions and complications. High-dose TBI, in combination with chemotherapy, has been acknowledged and widely applied conditioning regime prior to allogeneic BMT in a number of hematological diseases. During the last three decades the performance of TBI treatment varies with respect to the realized total dose (10-16 Gy) as well as to the used radiotherapeutic sources (telegamma therapeutic devices or linear accelerators), the applied techniques (latero-lateral), prone-supine or combinations of both patient positions), the radiation beam modifiers, the lung compensators used, dose rate (2.5-15 cGy/min). Heterogeneous and difficult for systematization data are available at the present stage, which concern the effect of some parameters as realized total dose, dose rate and fractionation on the prognosis for patients with serious hematological diseases subjected to BMT. There are numerous questions concerning their effect on the therapeutic results, host versus

  20. Secondary radiation dose during high-energy total body irradiation

    International Nuclear Information System (INIS)

    The goal of this work was to assess the additional dose from secondary neutrons and γ-rays generated during total body irradiation (TBI) using a medical linac X-ray beam. Nuclear reactions that occur in the accelerator construction during emission of high-energy beams in teleradiotherapy are the source of secondary radiation. Induced activity is dependent on the half-lives of the generated radionuclides, whereas neutron flux accompanies the treatment process only. The TBI procedure using a 18 MV beam (Clinac 2100) was considered. Lateral and anterior-posterior/posterior-anterior fractions were investigated during delivery of 2 Gy of therapeutic dose. Neutron and photon flux densities were measured using neutron activation analysis (NAA) and semiconductor spectrometry. The secondary dose was estimated applying the fluence-to-dose conversion coefficients. The main contribution to the secondary dose is associated with fast neutrons. The main sources of γ-radiation are the following: 56Mn in the stainless steel and 187W of the collimation system as well as positron emitters, activated via (n,γ) and (γ,n) processes, respectively. In addition to 12 Gy of therapeutic dose, the patient could receive 57.43 mSv in the studied conditions, including 4.63 μSv from activated radionuclides. Neutron dose is mainly influenced by the time of beam emission. However, it is moderated by long source-surface distances (SSD) and application of plexiglass plates covering the patient body during treatment. Secondary radiation gives the whole body a dose, which should be taken into consideration especially when one fraction of irradiation does not cover the whole body at once. (orig.)

  1. Paraphyseal changes on bone-age studies predict risk of delayed radiation-associated skeletal complications following total body irradiation

    International Nuclear Information System (INIS)

    Children undergoing total body irradiation (TBI) often develop delayed skeletal complications. Bone-age studies in these children often reveal subtle paraphyseal changes including physeal widening, metaphyseal irregularity and paraphyseal exostoses. To investigate whether paraphyseal changes on a bone-age study following TBI indicate a predisposition toward developing other radiation-associated skeletal complications. We retrospectively reviewed medical records and bone-age studies of 77 children receiving TBI at our institution between 1995 and 2008 who had at least 2 years of clinical follow-up and one bone-age study after TBI. We graded bone-age studies according to the severity of paraphyseal changes. All documented skeletal complications following TBI were tabulated. Kendall's tau-b was used to examine associations between degree of paraphyseal change and development of a skeletal complication. Kendall's tau analyses showed that physeal widening and metaphyseal irregularity/sclerosis (tau = 0.87, P < 0.001) and paraphyseal exostoses (tau = 0.68, P < 0.001) seen on bone-age studies were significantly positively associated with the development of delayed skeletal complications following TBI. Thirty percent of children with no or mild paraphyseal changes developed a delayed skeletal complication, compared with 58% of children with moderate paraphyseal changes and 90% of children with severe paraphyseal changes. Paraphyseal changes identified on a bone-age study correlate positively with the development of delayed skeletal complications elsewhere in the skeleton following TBI. (orig.)

  2. Tissue air ratio in total body irradiation. An in vivo evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Scarpati, D.; Mancini, G.; Corvo, R.; Franzone, P.

    1989-01-01

    On the basis of dose readings in 102 patients treated with total body irradiation (TBI), a 'tissue air ratio (TAR) curve' has been produced. It could be useful to precalculate treatment time in TBI, for dose prescription to a specific point, provided the same source (/sup 60/Co) and treatment setting (lateral irradiation; 3 m source-axis distance; reference point at thighs bifurcation, neat the perineum) is used. The TAR curve produced, and the formula relating tissue depth to TAR value, are presented, and compared to preexisting data for 'magna fields' treatments. This curve is exponential, and in semilog representation becomes straight, as every classic TAR curve; it is lower than others, reflecting non full-scatter situation in patient irradiation. (orig.).

  3. Patient dosimetry for total body irradiation using single-use MOSFET detectors.

    Science.gov (United States)

    Briere, Tina Marie; Tailor, Ramesh; Tolani, Naresh; Prado, Karl; Lane, Richard; Woo, Shiao; Ha, Chul; Gillin, Michael T; Beddar, A Sam

    2008-01-01

    We studied the usefulness of a new type of solid-state detector, the OneDose single-use MOSFET (metal oxide semiconductor field effect transistor) dosimeter, for entrance dose measurements for total body irradiation (TBI). The factory calibration factors supplied by the manufacturer are applicable to conventional radiotherapy beam arrangements and therefore may not be expected to be valid for TBI dosimetry because of the large field sizes and extended source-to-axis distances used. OneDose detectors were placed under a 1-cm thick bolus at the head, neck, and umbilicus of 9 patients undergoing TBI procedures. Thermoluminescent dosimeters (TLDs) were placed beside the detectors. We found that the OneDose readings differed from the TLD readings by 4.6% at the head, 1.7% at the neck, and 3.9% at the umbilicus, with corresponding standard deviations of 3.9%, 2.2%, and 2.7%. For all patient measurements, 95% of the OneDose readings fell within 3.3% +/- 6.0% of the TLD readings. Anthropomorphic phantom measurements showed differences of -0.1% at the neck and -1.2% midway between the phantom's carina and umbilicus. Our results suggest that these detectors could be used for TBI quality assurance monitoring, although TLDs should remain the standard when critical dose measurements are performed. If OneDose detectors are to be used for TBI, the use of more than one at each location is strongly recommended. Because the detectors are designed for single use, they cannot be individually calibrated. However, to obtain institution-specific correction factors for better applicability to TBI dosimetry, measurements of several detectors taken from a particular lot could also be obtained in phantom with the TBI geometry configurations used for patient treatment. PMID:19020482

  4. Mitochondrial DNA alterations of peripheral lymphocytes in acute lymphoblastic leukemia patients undergoing total body irradiation therapy

    OpenAIRE

    2011-01-01

    Background Mitochondrial DNA (mtDNA) alterations, including mtDNA copy number and mtDNA 4977 bp common deletion (CD), are key indicators of irradiation-induced damage. The relationship between total body irradiation (TBI) treatment and mtDNA alterations in vivo, however, has not been postulated yet. The aim of this study is to analyze mtDNA alterations in irradiated human peripheral lymphocytes from acute lymphoblastic leukemia (ALL) patients as well as to take them as predictors for radiatio...

  5. Neurobehavioral toxicity of total body irradiation: a follow-up in long-term survivors

    International Nuclear Information System (INIS)

    Purpose: Total body irradiation (TBI) in preparation for bone marrow transplantation (BMT) is a routine treatment of hematological malignancy. A retrospective and a prospective group study of long-term cerebral side effects was performed, with a special emphasis on neurobehavioral toxicity effects. Methods and Materials: Twenty disease-free patients treated with hyperfractionated TBI (14.4 Gy, 12 x 1.2 Gy, 4 days), 50 mg/kg cyclophosphamide, and autologous BMT (mean age 38 years, range 17-52 years; age at TBI 35 years, 16-50 years; follow-up time 32 months, 9-65 months) participated in a neuropsychological, neuroradiological, and neurological examination. Data were compared to 14 patients who were investigated prior to TBI. Eleven patients with renal insufficiencies matched for sex and age (38 years, 20-52 years) served as controls. In a longitudinal approach, neuropsychological follow-up data were assessed in 12 long-term survivors (45 years, 23-59 years; follow-up time 8.8 years, 7-10.8 years; time since diagnosis 10.1 years, 7.5-14.2 years). Results: No evidence of neurological deficits was found in post-TBI patients except one case of peripheral movement disorder of unknown origin. Some patients showed moderate brain atrophy. Neuropsychological assessment showed a subtle reduction of memory performance of about one standard deviation. Cognitive decline in individual patients appeared to be associated with pretreatment (brain irradiation, intrathecal methotrexate). Ten-years post disease onset, survivors without pretreatment showed behavioral improvement up to the premorbid level. Conclusion: The incidence of long-term neurobehavioral toxicity was very low for the present TBI/BMT regimen

  6. Patient dose analysis in total body irradiation through in vivo dosimetry

    Directory of Open Access Journals (Sweden)

    K Ganapathy

    2012-01-01

    Full Text Available Total body irradiation (TBI is a special radiotherapy technique, administered prior to bone marrow transplantation. Due to the complex nature of the treatment setup, in vivo dosimetry for TBI is mandatory to ensure proper delivery of the intended radiation dose throughout the body. Lithium fluoride (LiF TLD-100 chips are used for the TBI in vivo dosimetry. Results obtained from the in vivo dosimetry of 20 patients are analyzed. Results obtained from forehead, abdomen, pelvis, and mediastinum showed a similar pattern with the average measured dose from 96 to 97% of the prescription dose. Extremities and chest received a dose greater than the prescription dose in many instances (more than 20% of measurements. Homogeneous dose delivery to the whole body is checked by calculating the mean dose with standard deviation for each fraction. Reasons for the difference between prescription dose and measured dose for each site are discussed. Dose homogeneity within ±10% is achieved using our in-house TBI protocol.

  7. High-dose total-body irradiation and autologous marrow reconstitution in dogs: dose-rate-related acute toxicity and fractionation-dependent long-term survival

    International Nuclear Information System (INIS)

    Beagle dogs treated by total-body irradiation (TBI) were given autologous marrow grafts in order to avoid death from marrow toxicity. Acute and delayed non-marrow toxicities of high single-dose (27 dogs) and fractionated TBI (20 dogs) delivered at 0.05 or 0.1 Gy/min were compared. Fractionated TBI was given in increments of 2 Gy every 6 hr for three increments per day. Acute toxicity and early mortality (<1 month) at identical total irradiation doses were comparable for dogs given fractionated or single-dose TBI. With single-dose TBI, 14, 16, and 18 Gy, respectively, given at 0.05 Gy/min, 0/5, 5/5, and 2/2 dogs died from acute toxicity; with 10, 12, and 14 Gy, respectively, given at 0.1 Gy/min, 1/5, 4/5, and 5/5 dogs died acutely. With fractionated TBI, 14 and 16 Gy, respectively, given at 0.1 Gy/min, 1/5, 4/5, and 2/2 dogs died auctely. Early deaths were due to radiation enteritis with or without associated septicemia (29 dogs; less than or equal to Day 10). Three dogs given 10 Gy of TBI at 0.1 Gy/min died from bacterial pneumonia; one (Day 18) had been given fractionated and two (Days 14, 22) single-dose TBI. Fifteen dogs survived beyond 1 month; eight of these had single-dose TBI (10-14 Gy) and all died within 7 months of irradiation from a syndrome consisting of hepatic damage, pancreatic fibrosis, malnutrition, wasting, and anemia. Seven of the 15 had fractionated TBI, and only one (14 Gy) died on Day 33 from hepatic failure, whereas 6 (10-14 Gy) are alive and well 250 to 500 days after irradiation. In conclusion, fractionated TBI did not offer advantages over single-dose TBI with regard to acute toxicity and early mortality; rather, these were dependent upon the total dose of TBI. The total acutely tolerated dose was dependent upon the exposure rate; however, only dogs given fractionated TBI became healthy long-term survivors

  8. MASM, a Matrine Derivative, Offers Radioprotection by Modulating Lethal Total-Body Irradiation-Induced Multiple Signaling Pathways in Wistar Rats

    Directory of Open Access Journals (Sweden)

    Jianzhong Li

    2016-05-01

    Full Text Available Matrine is an alkaloid extracted from Sophora flavescens Ait and has many biological activities, such as anti-inflammatory, antitumor, anti-fibrosis, and immunosuppressive properties. In our previous studies, the matrine derivative MASM was synthesized and exhibited potent inhibitory activity against liver fibrosis. In this study, we mainly investigated its protection against lethal total-body irradiation (TBI in rats. Administration of MASM reduced the radiation sickness characteristics and increased the 30-day survival of rats before or after lethal TBI. Ultrastructural observation illustrated that pretreatment of rats with MASM significantly attenuated the TBI-induced morphological changes in the different organs of irradiated rats. Gene expression profiles revealed that pretreatment with MASM had a dramatic effect on gene expression changes caused by TBI. Pretreatment with MASM prevented differential expression of 53% (765 genes of 1445 differentially expressed genes induced by TBI. Pathway enrichment analysis indicated that these genes were mainly involved in a total of 21 pathways, such as metabolic pathways, pathways in cancer, and mitogen-activated protein kinase (MAPK pathways. Our data indicated that pretreatment of rats with MASM modulated these pathways induced by TBI, suggesting that the pretreatment with MASM might provide the protective effects on lethal TBI mainly or partially through the modulation of these pathways, such as multiple MAPK pathways. Therefore, MASM has the potential to be used as an effective therapeutic or radioprotective agent to minimize irradiation damages and in combination with radiotherapy to improve the efficacy of cancer therapy.

  9. MASM, a Matrine Derivative, Offers Radioprotection by Modulating Lethal Total-Body Irradiation-Induced Multiple Signaling Pathways in Wistar Rats.

    Science.gov (United States)

    Li, Jianzhong; Xu, Jing; Lu, Yiming; Qiu, Lei; Xu, Weiheng; Lu, Bin; Hu, Zhenlin; Chu, Zhiyong; Chai, Yifeng; Zhang, Junping

    2016-01-01

    Matrine is an alkaloid extracted from Sophora flavescens Ait and has many biological activities, such as anti-inflammatory, antitumor, anti-fibrosis, and immunosuppressive properties. In our previous studies, the matrine derivative MASM was synthesized and exhibited potent inhibitory activity against liver fibrosis. In this study, we mainly investigated its protection against lethal total-body irradiation (TBI) in rats. Administration of MASM reduced the radiation sickness characteristics and increased the 30-day survival of rats before or after lethal TBI. Ultrastructural observation illustrated that pretreatment of rats with MASM significantly attenuated the TBI-induced morphological changes in the different organs of irradiated rats. Gene expression profiles revealed that pretreatment with MASM had a dramatic effect on gene expression changes caused by TBI. Pretreatment with MASM prevented differential expression of 53% (765 genes) of 1445 differentially expressed genes induced by TBI. Pathway enrichment analysis indicated that these genes were mainly involved in a total of 21 pathways, such as metabolic pathways, pathways in cancer, and mitogen-activated protein kinase (MAPK) pathways. Our data indicated that pretreatment of rats with MASM modulated these pathways induced by TBI, suggesting that the pretreatment with MASM might provide the protective effects on lethal TBI mainly or partially through the modulation of these pathways, such as multiple MAPK pathways. Therefore, MASM has the potential to be used as an effective therapeutic or radioprotective agent to minimize irradiation damages and in combination with radiotherapy to improve the efficacy of cancer therapy. PMID:27196884

  10. Craniomandibular dysfunction in children treated with total-body irradiation and bone marrow transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Dahlloef, G.; Krekmanova, L.; Kopp, S.; Borgstroem, B.; Forsberg, C.M.; Ringden, O. (Huddinge Univ. Hospital (Sweden))

    1994-01-01

    The prevalence of pain and dysfunction in the stomatognathic system was studied in a group of 19 long-term survivors after pediatric bone marrow transplantation (BMT), conditioned with total-body irradiation (TBI). Compared with the control group, the children and adolescents in the BMT group had a significantly reduced mouth opening capacity. A reduced translation movement of the condyles was diagnosed in 53% of children treated with TBI, compared with 5% in the control group. Signs of craniomandibular dysfunction were found in 84% of children in the BMT group, compared with 58% in the control group. Both irradiation and chemotherapy induce long-term alterations in connective and muscle tissues resulting in inflammation and eventually fibrosis. These changes in tissue homeostasis and concomitant growth retardation may lead to the observed malocclusion and reduced mobility of the temporomandibular joint, with subsequent muscle pain and headaches, which were found in this study. 29 refs., 3 tabs., 2 figs.

  11. Mitochondrial DNA alterations of peripheral lymphocytes in acute lymphoblastic leukemia patients undergoing total body irradiation therapy

    International Nuclear Information System (INIS)

    Mitochondrial DNA (mtDNA) alterations, including mtDNA copy number and mtDNA 4977 bp common deletion (CD), are key indicators of irradiation-induced damage. The relationship between total body irradiation (TBI) treatment and mtDNA alterations in vivo, however, has not been postulated yet. The aim of this study is to analyze mtDNA alterations in irradiated human peripheral lymphocytes from acute lymphoblastic leukemia (ALL) patients as well as to take them as predictors for radiation toxicity. Peripheral blood lymphocytes were isolated from 26 ALL patients 24 hours after TBI preconditioning (4.5 and 9 Gy, respectively). Extracted DNA was analyzed by real-time PCR method. Average 2.31 times mtDNA and 0.53 fold CD levels were observed after 4.5 Gy exposure compared to their basal levels. 9 Gy TBI produced a greater response of both mtDNA and CD levels than 4.5 Gy. Significant inverse correlation was found between mtDNA content and CD level at 4.5 and 9 Gy (P = 0.037 and 0.048). Moreover, mtDNA content of lymphocytes without irradiation was found to be correlated to age. mtDNA and CD content may be considered as predictive factors to radiation toxicity

  12. Mitochondrial DNA alterations of peripheral lymphocytes in acute lymphoblastic leukemia patients undergoing total body irradiation therapy

    Directory of Open Access Journals (Sweden)

    Ji Fuyun

    2011-10-01

    Full Text Available Abstract Background Mitochondrial DNA (mtDNA alterations, including mtDNA copy number and mtDNA 4977 bp common deletion (CD, are key indicators of irradiation-induced damage. The relationship between total body irradiation (TBI treatment and mtDNA alterations in vivo, however, has not been postulated yet. The aim of this study is to analyze mtDNA alterations in irradiated human peripheral lymphocytes from acute lymphoblastic leukemia (ALL patients as well as to take them as predictors for radiation toxicity. Methods Peripheral blood lymphocytes were isolated from 26 ALL patients 24 hours after TBI preconditioning (4.5 and 9 Gy, respectively. Extracted DNA was analyzed by real-time PCR method. Results Average 2.31 times mtDNA and 0.53 fold CD levels were observed after 4.5 Gy exposure compared to their basal levels. 9 Gy TBI produced a greater response of both mtDNA and CD levels than 4.5 Gy. Significant inverse correlation was found between mtDNA content and CD level at 4.5 and 9 Gy (P = 0.037 and 0.048. Moreover, mtDNA content of lymphocytes without irradiation was found to be correlated to age. Conclusions mtDNA and CD content may be considered as predictive factors to radiation toxicity.

  13. Total Body Irradiation using VMAT (RapidArc: A Planning Study of a novel treatment delivery method

    Directory of Open Access Journals (Sweden)

    Santam Chakraborty

    2015-01-01

    Full Text Available Purpose: To evaluate the feasibility of using volumetric modulated arc therapy (VMAT using RapidArc to deliver total body irradiation (TBI treatment. Methods: VMAT planning was performed a whole body computed tomography (CT data set using Rapid Arc. The planning target volumes included entire body trimmed to 3 mm below the skin. The organs at risk included the lungs and kidneys. A dose of 12 Gy in 10 fractions was prescribed to the target volume. The VMAT-TBI technique consisted of three isocentres and three overlapping arcs: the head and neck, the chest, and the pelvis. The plans were prescribed to ensure, at a minimum, 95% planning target volume dose coverage with the prescription dose (percentage of volume receiving dose of 12 Gy was 95% and maximum dose of 109.8%. Mean dose to lung was restricted at 8.6Gy. Results: The total body volume in the study was 15469cm3 and the PTV volume was 11322cm3. The mean dose to PTV was 104%. The homogeneity index was 0.09. Sparing of normal tissues with adequate coverage of skeletal bones was shown to be feasible with Rapid Arc. The study demonstrates that VMAT is feasible for TBI treatment. Unlike conventional TBI chest wall boost with electrons was not required. Conclusion: The technique for total body irradiation using RapidArc VMAT was found feasible and is undergoing further studies prior to clinical use.

  14. Treatment verification and in vivo dosimetry for total body irradiation using thermoluminescent and semiconductor detectors

    International Nuclear Information System (INIS)

    The objective of this work is the characterization of thermoluminescent and semiconductor detectors and their applications in treatment verification and in vivo dosimetry for total body irradiation (TBI) technique. Dose measurements of TBI treatment simulation performed with thermoluminescent detectors inserted in the holes of a “Rando anthropomorphic phantom” showed agreement with the prescribed dose. For regions of the upper and lower chest where thermoluminescent detectors received higher doses it was recommended the use of compensating dose in clinic. The results of in vivo entrance dose measurements for three patients are presented. The maximum percentual deviation between the measurements and the prescribed dose was 3.6%, which is consistent with the action level recommended by the International Commission on Radiation Units and Measurements (ICRU), i.e., ±5%. The present work to test the applicability of a thermoluminescent dosimetric system and of a semiconductor dosimetric system for performing treatment verification and in vivo dose measurements in TBI techniques demonstrated the value of these methods and the applicability as a part of a quality assurance program in TBI treatments. - Highlights: • Characterization of a semiconductor dosimetric system. • Characterization of a thermoluminescent dosimetric system. • Application of the TLDs for treatment verification in total body irradiation treatments. • Application of semiconductor detectors for in vivo dosimetry in total body irradiation treatments. • Implementation of in vivo dosimetry as a part of a quality assurance program in radiotherapy

  15. Effect of total body irradiation on skeletal growth and cataract formation in rhesus monkey

    International Nuclear Information System (INIS)

    The effect of total body irradiation in single doses of 400-950 rad on skeletal growth and the development of lens cataract was investigated in 21 rhesus monkeys. The results suggest that exposure to irradiation before or during adolescent growth in children may lead to bone shortening when doses of 750 rad or higher are concerned, and that treatment of children with TBI in excess of 750 rad - as is sometimes employed in conjunction with bone marrow transplantation for the treatment of leukemia - may carry a strong risk for the subsequent development of cataract formation. (C.F.)

  16. The carcinogenic risk of high dose total body irradiation in non-human primates

    International Nuclear Information System (INIS)

    High dose total body irradiation (TBI) in combination with chemotherapy, followed by rescue with bone marrow transplantation (BMT), is increasingly used for the treatment of haematological malignancies. With the increasing success of this treatment and its current introduction for treating refractory autoimmune diseases the risk of radiation carcinogenesis is of growing concern. Studies on turnout induction in non-human primates are of relevance in this context since the response of this species to radiation does not differ much from that in man. Since the early sixties, studies have been performed on acute effects in Rhesus monkeys and the protective action of bone marrow transplantation after irradiation with X-rays (average total body dose 6.8 Gy) and fission neutrons (average dose 3.4 Gy). Of those monkeys, which were irradiated and reconstituted with autologous bone marrow, 20 animals in the X-irradiated group and nine animals in the neutron group survived more than 3 years. A group of 21 non-irradiated Rhesus monkeys of a comparable age distribution served as controls. All animals were regularly screened for the occurrence of neoplasms. Complete necropsies were performed after natural death or euthanasia. At post-irradiation intervals of 4-21 years an appreciable number of tumours was observed. In the neutron irradiated group eight out of nine animals died with one or more malignant tumours. In the X-irradiated group this fraction was 10 out of 20. The tumours in the control group, in seven out of the 21 animals, appeared at much older a-e compared with those in the irradiated cohorts. The histogenesis of the tumours was diverse with a preponderance of renal carcinoma, sarcomas among which osteosarcormas, and malignant glomus tumours in the irradiated groups. When corrected for competing risks, the carcinogenic risk of TBI in the Rhesus monkeys is similar to that derived from the studies of the Japanese atomic bomb survivors. The increase of the risk by a

  17. Severe Pulmonary Toxicity After Myeloablative Conditioning Using Total Body Irradiation: An Assessment of Risk Factors

    International Nuclear Information System (INIS)

    Purpose: To assess factors associated with severe pulmonary toxicity after myeloablative conditioning using total body irradiation (TBI) followed by allogeneic stem cell transplantation. Methods and Materials: A total of 101 adult patients who underwent TBI-based myeloablative conditioning for hematologic malignancies at Duke University between 1998 and 2008 were reviewed. TBI was combined with high-dose cyclophosphamide, melphalan, fludarabine, or etoposide, depending on the underlying disease. Acute pulmonary toxicity, occurring within 90 days of transplantation, was scored using Common Terminology Criteria for Adverse Events version 3.0. Actuarial overall survival and the cumulative incidence of acute pulmonary toxicity were calculated via the Kaplan-Meier method and compared using a log-rank test. A binary logistic regression analysis was performed to assess factors independently associated with acute severe pulmonary toxicity. Results: The 90-day actuarial risk of developing severe (Grade 3-5) pulmonary toxicity was 33%. Actuarial survival at 90 days was 49% in patients with severe pulmonary toxicity vs. 94% in patients without (p < 0.001). On multivariate analysis, the number of prior chemotherapy regimens was the only factor independently associated with development of severe pulmonary toxicity (odds ratio, 2.7 per regimen). Conclusions: Severe acute pulmonary toxicity is prevalent after TBI-based myeloablative conditioning regimens, occurring in approximately 33% of patients. The number of prior chemotherapy regimens appears to be an important risk factor.

  18. Use of WR-2721 with total body irradiation in treatment of mouse lymphoma

    International Nuclear Information System (INIS)

    Efficacy of total body irradiation (TBI) in treatment of non-Hodgkin's lymphoma is limited by bone marrow radiosensitivity. WR-2721 has been shown to be an effective chemical protector of the hemotopoietic system. In this study, a spontaneous T-cell lymphoma implanted in BALB/c mice was used to determine the effect of WR-2721 on TBI of lymphoma. Mice were randomly assigned to 5 radiation dose groups (0-200 rad TBI) when the tumors reached the desired size. The experimental group received the half-maximum tolerated dose (365 mg/kg) of WR-2721/IP 30 min. before 150 rad TBI. Using tumor regrowth delay as an endpoint, WR-2721 was seen not to lessen the delay as would a tumor protector but rather to slightly increase the delay to 216 +- 9 hrs as compared with an expected value of 188 +- 20 hrs based on controls. In a subsequent experiment to determine the effect of WR-2721 alone, the experimental mice received 3 IP injections of WR-2721 (400 mg/kg/day) while the control group received saline. The geometric mean tumor regrowth delay times were 47 +- 3 hrs for the control group compared to 112 +- 10 hrs for the WR-2721 group ( p <.001). The authors conclude that WR-2721 does not give net radiation protection of this lymphoma at the doses studied and has an apparent cytotoxic effect on lymphoma that has not been previously reported

  19. Feasibility study of helical tomotherapy for total body or total marrow irradiation

    International Nuclear Information System (INIS)

    Total body radiation (TBI) has been used for many years as a preconditioning agent before bone marrow transplantation. Many side effects still plague its use. We investigated the planning and delivery of total body irradiation (TBI) and selective total marrow irradiation (TMI) and a reduced radiation dose to sensitive structures using image-guided helical tomotherapy. To assess the feasibility of using helical tomotherapy (A) we studied variations in pitch, field width, and modulation factor on total body and total marrow helical tomotherapy treatments. We varied these parameters to provide a uniform dose along with a treatment times similar to conventional TBI (15-30 min). (B) We also investigated limited (head, chest, and pelvis) megavoltage CT (MVCT) scanning for the dimensional pretreatment setup verification rather than total body MVCT scanning to shorten the overall treatment time per treatment fraction. (C) We placed thermoluminescent detectors (TLDs) inside a Rando phantom to measure the dose at seven anatomical sites, including the lungs. A simulated TBI treatment showed homogeneous dose coverage (±10%) to the whole body. Doses to the sensitive organs were reduced by 35%-70% of the target dose. TLD measurements on Rando showed an accurate dose delivery (±7%) to the target and critical organs. In the TMI study, the dose was delivered conformally to the bone marrow only. The TBI and TMI treatment delivery time was reduced (by 50%) by increasing the field width from 2.5 to 5.0 cm in the inferior-superior direction. A limited MVCT reduced the target localization time 60% compared to whole body MVCT. MVCT image-guided helical tomotherapy offers a novel method to deliver a precise, homogeneous radiation dose to the whole body target while reducing the dose significantly to all critical organs. A judicious selection of pitch, modulation factor, and field size is required to produce a homogeneous dose distribution along with an acceptable treatment time. In

  20. Interstitial pneumonitis after allogeneic bone marrow transplantation following total body irradiation

    International Nuclear Information System (INIS)

    The records of 40 patients who received allogeneic bone marrow transplantation (BMT) at Hyogo College of Medicine under the same conditioning regimen using cyclophosphamide and total body irradiation (TBI) from January 1984 to August 1989 were analyzed. The dose rate of TBI was 10 cGy per minute, and the total dose was 10 Gy (2.5 Gy daily for 4 days). Interstitial pneumonitis (IP) occurred in 13 of 40 patients, and was fatal in five patients. The probability of developing IP during the first year was 31%. We performed univariate analysis on the following factors but did not find any significant risk factors for IP: age and sex of patient, sex mismatch, ABO mismatch, grade of acute graft-versus-host disease, post immunosuppression regimen, and number of marrow cells transfused. (author)

  1. Cobalt-60 total body irradiation dosimetry at 220 cm source-axis distance

    International Nuclear Information System (INIS)

    Adults with acute leukemia are treated with cyclophosphamide and total body irradiation (TBI) followed by autologous marrow transplants. For TBI, patients seated in a stand angled 450 above the floor are treated for about 2 hours at 220 cm source-axis distance (SAD) with sequential right and left lateral 87 cm x 87 cm fields to a 900 rad mid-pelvic dose at about 8 rad/min using a 5000 Ci cobalt unit. Maximum (lateral) to minimum (mid-plane) dose ratios are: hips--1.15, shoulders--1.30, and head--1.05, which is shielded by a compensator filter. Organ doses are small intestine, liver and kidneys--1100 rad, lung--1100 to 1200 rad, and heart--1300 rad. Verification dosimetry reveals the prescribed dose is delivered to within +-5%. Details of the dosimetry of this treatment are presented

  2. TH-C-12A-04: Dosimetric Evaluation of a Modulated Arc Technique for Total Body Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Tsiamas, P; Czerminska, M; Makrigiorgos, G; Karen, M; Zygmanski, P [Brigham and Women' s Hospital/ Dana-Farber Institute/ Harvard Medical School, Boston, MA (United States)

    2014-06-15

    Purpose: A simplified Total Body Irradiation (TBI) was developed to work with minimal requirements in a compact linac room without custom motorized TBI couch. Results were compared to our existing fixed-gantry double 4 MV linac TBI system with prone patient and simultaneous AP/PA irradiation. Methods: Modulated arc irradiates patient positioned in prone/supine positions along the craniocaudal axis. A simplified inverse planning method developed to optimize dose rate as a function of gantry angle for various patient sizes without the need of graphical 3D treatment planning system. This method can be easily adapted and used with minimal resources. Fixed maximum field size (40×40 cm2) is used to decrease radiation delivery time. Dose rate as a function of gantry angle is optimized to result in uniform dose inside rectangular phantoms of various sizes and a custom VMAT DICOM plans were generated using a DICOM editor tool. Monte Carlo simulations, film and ionization chamber dosimetry for various setups were used to derive and test an extended SSD beam model based on PDD/OAR profiles for Varian 6EX/ TX. Measurements were obtained using solid water phantoms. Dose rate modulation function was determined for various size patients (100cm − 200cm). Depending on the size of the patient arc range varied from 100° to 120°. Results: A PDD/OAR based beam model for modulated arc TBI therapy was developed. Lateral dose profiles produced were similar to profiles of our existing TBI facility. Calculated delivery time and full arc depended on the size of the patient (∼8min/ 100° − 10min/ 120°, 100 cGy). Dose heterogeneity varied by about ±5% − ±10% depending on the patient size and distance to the surface (buildup region). Conclusion: TBI using simplified modulated arc along craniocaudal axis of different size patients positioned on the floor can be achieved without graphical / inverse 3D planning.

  3. Simvastatin mitigates increases in risk factors for and the occurrence of cardiac disease following 10 Gy total body irradiation

    OpenAIRE

    Lenarczyk, Marek; Su, Jidong; Haworth, Steven T.; Komorowski, Richard; Fish, Brian L; Migrino, Raymond Q.; Harmann, Leanne; Hopewell, John W.; Kronenberg, Amy; Patel, Shailendra; Moulder, John E.; Baker, John E

    2015-01-01

    The ability of simvastatin to mitigate the increases in risk factors for and the occurrence of cardiac disease after 10 Gy total body irradiation (TBI) was determined. This radiation dose is relevant to conditioning for stem cell transplantation and threats from radiological terrorism. Male rats received single dose TBI of 10 Gy. Age-matched, sham-irradiated rats served as controls. Lipid profile, heart and liver morphology and cardiac mechanical function were determined for up to 120 days af...

  4. Effect of radiation dose rate and cyclophosphamide on pulmonary toxicity after total body irradiation in a mouse model

    International Nuclear Information System (INIS)

    Purpose: Interstitial pneumonitis (IP) is still a major complication after total body irradiation (TBI) and bone marrow transplantation (BMT). It is difficult to determine the exact role of radiation in this multifactorial complication, especially because most of the experimental work on lung damage was done using localized lung irradiation and not TBI. We have thus tested the effect of radiation dose rate and combining cyclophosphamide (CTX) with single fraction TBI on lung damage in a mouse model for BMT. Methods and Materials: TBI was given as a single fraction at a high dose rate (HDR, 0.71 Gy/min) or a low dose rate (LDR, 0.08 Gy/min). CTX (250 mg/kg) was given 24 h before TBI. Bone marrow transplantation (BMT) was performed 4-6 h after the last treatment. Lung damage was assessed using ventilation rate (VR) and lethality between 28 and 180 days (LD(50(28))-180). Results: The LD50 for lung damage, ± standard error (SE), increased from 12.0 (± 0.2) Gy using single fraction HDR to 15.8 (± 0.6) Gy using LDR. Adding CTX shifted the dose-response curves towards lower doses. The LD50 values for the combined treatment were 5.3 (± 0.2) and 3.5 (± 0.2) Gy for HDR and LDR, respectively. This indicates that the combined effect of CTX and LDR was more toxic than that of combined CTX and HDR. Lung damage evaluated by VR demonstrated two waves of VR increase. The first wave of VR increase occurred after 6 weeks using TBI only and after 3 weeks in the combined CTX-TBI treatment, irrespective of total dose or dose rate. The second wave of VR elevation resembled the IP that follows localized thoracic irradiation in its time of occurrence. Conclusions: Lung damage following TBI could be spared using LDR. However, CTX markedly enhances TBI-induced lung damage. The combination of CTX and LDR is more toxic to the lungs than combining CTX and HDR

  5. Total-body irradiation and bone-marrow transplantation - first observations on clinical tolerance

    International Nuclear Information System (INIS)

    About 50 000 bone-marrow transplantations (BMT) are performed annually at the present stage in numerous clinical centers all over the world. The Bulgarian experience in total-body irradiation (TBI) with following BMT is rather scarce. The routine TBI procedures in the oncological practice in the country date back just to 2001. The aim of the present publication is to describe the Bulgarian experience and the first impressions from the clinical tolerance of the total-body irradiation (TBI) with subsequent allogeneic peripheral stem cell transplantation (PSCT). Patient characteristics are presented in detail, including their distribution with respect to sex, age, primary diagnose, recurrence number till BMT, patient status during BMT performance (clinical hematological remission or relapse), as well as the basic parameters of the conditioning regime including TBI with subsequent allogeneic PSCT. The position of the patient and the applied radiotherapeutic equipment are described as well as the TBI schemes, respectively 5 fractions of 2 Gy per day for two patients and 3-day irradiation with 6 fractions (two fractions with a 6-hour interval between them) for the rest of the patients. The total dose (TD) of 10 Gy is realized for all patients. The clinical tolerance of 7 patients subjected to TBI and allogeneic PSCT is discussed. All patients were tolerable to the TBI treatment and had no serious problems. The radiotherapy was interrupted only in the case of the first two patients due to slight gastro-intestinal reactions. The first days of radiation were accompanied with a light degree of headache, nausea and vomiting, which were successfully overcome by granisetron. Diarrhea syndrome and mucositis to the II-III degree were developed subsequently without parotitis development. On the days 0 and +1 of the clinical protocol transplantation was realized of non- T-cell-depleted grafts (in 5 patients) and T-cell-depleted grafts (in 2 patients), which had no serious

  6. Clinical tolerance of total body irradiation and allogeneic bone marrow transplantation

    International Nuclear Information System (INIS)

    Total body irradiation (TBI) followed by bone marrow transplantation (BMT) is well established as a part of the conditioning regimen in high dose therapy. The objective is to report the organ toxicity investigated prospectively in patients who had conditioning regimes including fractionated TBI (FTBI) and chemotherapy. From October 2002 to December 2007 18 patients received FTBI in our institution. There were 11 males and; 7 females with median age of 20 years (range 8-50). The present study includes 11 patients with initial diagnoses; acute lymphoid leukemia (ALL), 4 - acute myeloid leukemia (AML) and 3 - chronic myeloid leukemia (GML). At the time of BMT 11 patients were in complete response, 4 in progression and 3 in chronic phase. TBI was performed on a 60Co unit in alternate prone and supine position. Three patients received nonmyeloablative regimen including 'mini' TBI of 2 Gy followed by allogeneic BMT and 15 received myeloablative regimen of 10-12 Gy FTBI. The dose rate requirement was met for TBI 5-10 cGy/min. A standardized supportive therapy was administered. During the transplantation period on day 0 and +1 of the clinical protocol the realized transplantation of the donor cells pool passed without complications in 16 of the patients and was accompanied by allergic reactions in 2 patients. Induced bone-marrow aplasia was observed in all patients during the post-transplantation period. On day +14 to +24 'entgraftment' was established in 16 patients. In 2 patients till the 35th day after the transplantation no symptoms of the grafting were observed, which imposed reinfusion of donor cells pool. Seven patients developed acute GvHD, 2 patients developed idiopathic pneumonia syndrome, 1 patient developed liver toxicity, 1 - neurological and 1 - cardiovascular toxicity. FTBI is a well tolerated therapeutic regimen in high dose therapy. The observed organ toxicity in the 18 patients in similar to that cited in reference literature. (authors)

  7. Survival of mice and hematopoietic stem cells in bone marrow after intermittent total body irradiation

    International Nuclear Information System (INIS)

    As a preparative procedure for bone marrow transplantation, intermittent total body irradiation (TBI) has been used in our hospital. The biological significance of this method, in which the instantaneous dose rate is high but the average dose rate is low, has not been evaluated to date. The hematopoietic responses caused by both intermittent and continuous TBI were compared. In the intermittent irradiation, mice in a moving irradiation chamber were exposed under a small field (2 x 35 cm2), and the instantaneous and average dose rates were 1 Gy/min and 0.25 - 0.12 Gy/min, respectively. The average dose rate was adjusted to the same level in both irradiation methods. LD50/30 and survival of colony-forming units (CFU) in culture and survival of endogenuous CFU in the spleen from female BDF1 mice were the same with the two methods. These results show that the response of hematopoietic stem cells depends on the average dose rate, not on the instantaneous dose rate. Our findings suggest that intermittent irradiation, as well as the continuous method, would be useful for preparing patients before bone marrow transplantation. (author)

  8. Application of total body irradiation and real-time in vivo dosimetry with semiconductor dosimeter in hematogenous stem cell transplantation

    International Nuclear Information System (INIS)

    Objective: To investigate the safety and clinical outcome of total body irradiation (TBI) and the real-time in vivo dosimetry with semiconductor dosimeter in hematogenous stem cell transplantation (HSCT). Methods: Fifty-seven patients requiring HSCT were treated with TBI. The TBI was given with the semi-sitting or standing position or lateralcumbent posture, using 6 MV X-ray beams and opposed parallel fields technique (two or four fields, AP/PA fields) in a single fraction or multiple fractions. The real-time in vivo dosimetry was performed with six diodes positioned on the surface of patients to adjust the dose homogeneity of the midplane using the different thickness lead sheets. Results: Mild to moderate nausea, vomiting and swollen parotid occurred in 41 patients after TBI, which were relieved after allelopathy therapy. No radiation-induced interstitial pneumonia was observed. All patients fulfilled the HSCT. The homogeneity of relative dose (normalize to umbilicus dose) in the different positions accorded with the requirement of the prescription dose. Conclusions: The opposed parallel radiation, with the semi-sitting or standing positions or lateralcumbent posture, combined with the real-time in vivo dosimetry with semiconductor dosimeter is an effective and safe technique for TBI. (authors)

  9. Relationship between intestinal permeability and expression of intestinal trefoil factor mRNA in mice after total body irradiation

    International Nuclear Information System (INIS)

    Objective: To investigate the change of the intestinal permeability,the expression level of intestinal trefoil factor (ITF) mRNA and the relationship between them after total body irradiation (TBI), and explore the effect of TBI on the development of intestinal permeability and the expression level of ITF mRNA. Methods: Twenty two BALB/c mice were randomly divided into 4 equal groups: 3 groups at 4, 8 and 12 d after TBI with the total dose of 8.0 Gy and the dose rate of 1.0 Gy/min respectively,and a control group.Lactulose (L) and mannitol (M) were perfused into the esophagus before the experiment and urine samples were collected.Liquid chromatography was used to measure the L/M excretion ratio in the urine samples collected 4, 8, and 12 days after the TBI. And then the mice were killed with their intestine were taken out. The expression of ITF mRNA in the jejunum tissue was detected by real-time fluorescence quantitative PCR. Results: The urine L/M ratio levels of the groups 4, 8 and 12 days after TBI were (0.5092±0.0352),(0.7174±0.0116), and (0.7295 ± 0.0533) respectively, all significantly higher than that of the control group [(0.2908±0.0533), F=321.47, P<0.05]. The ITF mRNA expression levels of groups 4, 8 and 12 days after TBI were (0.78612 ±0.1428),(0.2521 ±0.1223), and (0.2306 + 0.0221 ) respectively, all significantly lower than that of the control group [( 1.3498 + 0.0476), F=235.71, P <0.05]. The urine L/M ratio was significantly negatively correlated with the expression of ITF mRNA in all TBI groups (r=-0.985, P<0.01). Conclusions: The intestinal permeability increases and the expression level of ITF mRNA decreases after TBI. The urine L/M ratio is negatively correlated with the expression level of ITF mRNA after TBI. ITF is involved in protection against intestinal permeability induced by TBI. (authors)

  10. Comparison between combination chemotherapy and total body irradiation plus combination chemotherapy in non-Hodgkin's lymphoma

    International Nuclear Information System (INIS)

    Thirty-nine untreated patients with either lymphocytic or nodular mixed/nodular histiocytic non-Hodgkin's lymphoma, stage II-IV, were randomized to treatment with total body irradiation (TBI), 100 rads in 10 fractions over 12 days, plus combination chemotherapy with either cyclophosphamide, vincristine and prednisone (CVP) or cyclophosphamide, vincristine, procarbazine and prednisone (C-MOPP) or to treatment with combination chemotherapy (CVP or C-MOPP) alone. Remission rate and duration were comparable for both treatment groups; thus the use of both treatment modalities ab initio provides no therapeutic advantage

  11. Cataract incidence after total-body irradiation

    International Nuclear Information System (INIS)

    Purpose: Aim of this retrospective study was to evaluate cataract incidence in a homogeneous group of patients after total-body irradiation followed by autologous bone marrow transplantation or peripheral blood stem cell transplantation. Method and Materials: Between 11/1982 and 6/1994 in total 260 patients received in our hospital total-body irradiation for treatment of haematological malignancy. In 1996-96 patients out of these 260 patients were still alive. 85 from these still living patients (52 men, 33 women) answered evaluable on a questionnaire and could be examined ophthalmologically. Median age of these patients was 38,5 years (15 - 59 years) at time of total-body irradiation. Radiotherapy was applied as hyperfractionated total-body irradiation with a median dose of 14,4 Gy in 12 fractions over 4 days. Minimum time between fractions was 4 hours, photons with a energy of 23 MeV were used, and the dose rate was 7 - 18 cGy/min. Results: Median follow-up is now 5,8 years (1,7 - 13 years). Cataract occurred in (28(85)) patients after a median time of 47 months (1 - 104 months). In 6 out of these 28 patients who developed a cataract, surgery of the cataract was performed. Whole-brain irradiation prior to total-body irradiation was more often in the group of patients developing a cataract (14,3%) vs. 10,7% in the group of patients without cataract. Conclusion: Cataract is a common side effect of total-body irradiation. Cataract incidence found in our patients is comparable to results of other centres using a fractionated regimen for total-body irradiation. The hyperfractionated regimen used in our hospital does obviously not result in a even lower cataract incidence. In contrast to acute and late toxicity in other organ/organsystems, hyperfractionation of total-body irradiation does not further reduce toxicity for the eye-lens. Dose rate may have more influence on cataract incidence

  12. Impact of TBI on late effects in children treated by megatherapy for Stage IV neuroblastoma. A study of the French Society of Pediatric oncology

    International Nuclear Information System (INIS)

    Purpose: To determine the contribution of total body irradiation (TBI) to late sequelae in children treated with high-dose chemotherapy and autologous bone marrow transplantation for Stage IV neuroblastoma. Patients and Methods: We compared two populations that were similar with regard to age, stage, pre-autologous bone marrow transplantation chemotherapy (CT) regimen, period of treatment, and follow-up (12 years). The TBI group (n = 32) received TBI as part of the megatherapy procedure (1982-1993), whereas the CT group (n 30) received conditioning without TBI (1985-1992). Analysis 12 years later focused on growth, weight and corpulence (body mass index) delay; hormonal deficiencies; liver, kidney, heart, ear, eye, and dental sequelae; school performance; and the incidence of secondary tumors. Results: Impact of TBI was most marked in relation to growth and weight delay, although the mean delay was not severe, probably because of treatment with growth hormones. Other consequences of TBI were thyroid insufficiency, cataracts, and a high incidence of secondary tumors. Hearing loss and dental agenesis were more prominent in the group treated with CT alone. No differences were observed in school performance. Conclusion: The most frequent side effects of TBI were cataracts, thyroid insufficiency, and growth delay, but more worrying is the risk of secondary tumors. Because of the young mean age of patients and the toxicity of TBI regimens without any survival advantage, regimens without TBI are preferable in the management of Stage IV neuroblastoma

  13. Utility of cranial boost in addition to total body irradiation in the treatment of high risk acute lymphoblastic leukemia

    International Nuclear Information System (INIS)

    Purpose: Total body irradiation (TBI) as part of a conditioning regimen before hematopoietic stem cell transplant (HSCT) is an important component in the management of acute lymphoblastic leukemia (ALL) that has relapsed or has other certain high-risk features. Controversy exists, however, as to whether a cranial boost in addition to TBI is necessary to prevent central nervous system (CNS) recurrences in these high-risk cases. Previous national trials have included a cranial boost in the absence of data to justify its use. Therefore, the aim of this study was to assess risk of CNS recurrence in ALL patients treated with TBI, to identify subsets of these high-risk patients at an increased or decreased risk of CNS recurrence after TBI, and to investigate whether regimens with higher doses of cranial irradiation further reduce the risk of CNS recurrence. Methods and Materials: Charts of 67 consecutively treated patients with ALL who received TBI before HSCT were reviewed. Data including patient demographics, clinical features at presentation, conditioning regimen, donor source, use of a cranial boost, remission stage at transplant, histologic subtype, cytogenetics, and extramedullary site of presentation were retrospectively collected and correlated with the risk of subsequent CNS recurrence. Results: At the time of analysis, 30 (45%) patients were alive with no evidence of disease, 8 (12%) were alive with recurrence of leukemia, 7 (10.5%) had recurrent ALL but with successful salvage, 7 (11%) died subsequent to recurrence, 14 (21%) died from complications related to HCST, and 1 patient was lost to follow-up (1.5%). Of the patients who recurred after HSCT, the relapses were hematologic in 13 (57%), CNS with or without simultaneous marrow involvement in 3 (13%), and other sites in 7 (30%). Forty-one (61%) patients did not receive an extracranial boost of irradiation with TBI. Two of these patients (4.9%) suffered CNS failures compared with 1 of 26 (3.8%) who received a

  14. Device for the irradiation of living bodies

    International Nuclear Information System (INIS)

    In attempting to protect as far as possible the surrounding healthy tissue in radiation exposure of living bodies, it is suggested to include part of an ellipsoid mirror in the casing of the irradiation device in which the exit opening of the radiation source is arranged under the focal point, and whose second focal point is on the outer side of the radiation penetration opening of the casing and fixes the irradiation spot. A locally sharply limited area is thus irradiated. Further advantageous improvements of the apparatus are described. (UWI)

  15. Treatment of chronic lymphocytic leukemia by total body irradiation alone and combined with chemotherapy

    International Nuclear Information System (INIS)

    Total body irradiation (TBI) offers a new dimension in the treatment of chronic lymphocytic leukemia (CLL), a disease heretofore refractory to effective management. Excellent responses were observed in 50/57 (88%) consecutive patients with active CLL treated since 1964, and complete remissions were achieved in 22/57 (39%). Toxicity was acceptable and was minimized by combining TBI and chemotherapy in attenuated doses of each modality. The responders had a modified natural history of disease as evidenced by prolonged survival, improved quality of life, and even restoration of immunologic competence in some cases. Benefit was particularly evident for patients with a poor prognosis, i.e., those with anemia and/or thrombocytopenia prior to treatment. A median survival of 55 months for the 40 Stage III-IV patients is 2-3 times longer than described for comparable patients in other series. This experience indicates TBI may be the most effective single agent available for the treatment of CLL and warrants consideration in primary therapy

  16. An experimental model of acute encephalopathy after total body irradiation in the rat: effect of Ginkgo biloba extract (EGb 761)

    International Nuclear Information System (INIS)

    To define the therapeutic effect of Ginkgo biloba extract (EGb 761) in an experimental model of acute encephalopathy following total body irradiation in rats. Ninety four-month-old rats received 4.5 Gy total body irradiation (TBI) at day 1 while 15 rats received sham irradiation. A behavioural study based on a conditioning test of negative reinforcement, the one-way avoidance test, was performed test, was performed after irradiation. Orally treatment was started one day (study A) or twenty two days (study B) after irradiation and repeated daily for twelve days. In the irradiated group, three subgroups were defined according to the treatment received: EGb 761 (50 mg/kg), EGb 761 (100 mg/kg), water. This work comprised two consecutive studies. In study A (45 rats) the one-way avoidance test was administered daily from day 7 to day 14. In study B (45 rats) the behavioural test was performed from day 28 to day 35. Study A (three groups of 15 rats): following TBI, irradiated rats treated with water demonstrated a significant delay in a learning the one-way avoidance test in comparison with sham-irradiated rats (P < 0.0002) or irradiated rats treated with EGb 761 (50 mg/kg; P < 0.007) or EGb 761 (100 mg/kg; P < 0.0002). The irradiated rats, treated with EGb 761 (50 or 100 mg/kg) did not differ from the sham-irradiated controls. Study B (three groups of 15 rats): the irradiated rats, treated with water of EGb 761 (50 or 100 mg/kg) did not differ from the sham-irradiated controls. (authors)

  17. Helical tomotherapy targeting total bone marrow after total body irradiation for patients with relapsed acute leukemia undergoing an allogeneic stem cell transplant

    International Nuclear Information System (INIS)

    Background and purpose: To report our clinical experience in planning and delivering total marrow irradiation (TMI) after total body irradiation (TBI) in patients with relapsed acute leukemia undergoing an allogeneic stem-cell transplant (SCT). Materials and Methods: Patients received conventional TBI as 2 Gy BID/day for 3 days boosted the next day by TMI (2 Gy in a single fraction) and followed by cyclophosphamide (Cy) 60 mg/kg for 2 days. While TBI was delivered with linear accelerator, TMI was performed with helical tomotherapy (HT). Results: Fifteen patients were treated from July 2009 till May 2010, ten with acute myeloid leukemia, and five with acute lymphoid leukemia. At the time of radiotherapy eight patients were in relapse and seven in second or third complete remission (CR) after relapse. The donor was a matched sibling in 7 cases and an unrelated donor in 8 cases. Median organ-at-risk dose reduction with TMI ranged from 30% to 65% with the largest reduction (-50%-65%) achieved for brain, larynx, liver, lungs and kidneys. Target areas (bone marrow sites and spleen in selected cases) were irradiated with an optimal conformity and an excellent homogeneity. Follow-up is short ranging from 180 to 510 days (median 310 days). However, tolerance was not different from a conventional TBI-Cy. All patients treated with TBI/TMI reached CR after SCT. Three patients have died (2 for severe GvHD, 1 for infection) and 2 patients showed relapsed leukemia. Twelve patients are alive with ten survivors in clinical remission of disease. Conclusions: This study confirms the clinical feasibility of using HT to deliver TMI as selective dose boost modality after TBI. For patients with advanced leukemia targeted TMI after TBI may be a novel approach to increase radiation dose with low risk of severe toxicity.

  18. Implantation of total body irradiation in radiotherapy

    International Nuclear Information System (INIS)

    Before implementing a treatment technique, the characteristics of the beam under irradiation conditions must be well acknowledged and studied. Each one of the parameters used to calculate the dose has to be measured and validated before its utilization in clinical practice. This is particularly necessary when dealing with special techniques. In this work, all necessary parameters and measurements are described for the total body irradiation implementation in facilities designed for conventional treatments that make use of unconventional geometries to generate desired enlarged field sizes. Furthermore, this work presents commissioning data of this modality at Hospital das Clinicas of Sao Paulo using comparison of three detectors types for measurements of entrance dose during total body irradiation treatment. (author)

  19. Physical aspects of total body irradiation as practised at Tuebingen

    International Nuclear Information System (INIS)

    From the outset it has been our overriding aim: administer the medically prescribed dose as correctly as possible to the patient. Both method and dosages we have taken over from the so-called Seattle technique. Only in the single fraction-irradiation (E) the dose rate of the linac (Philips SL 75/20 or SL 75/10) was reduced to 0.07 Gy/min. The report describes how the TBI was realized. (orig./HP)

  20. Whole-body irradiation technique: physical aspects

    International Nuclear Information System (INIS)

    The objective of this work has been to implement a Total body irradiation technique that fulfill the following conditions: simplicity, repeatability, fast and comfortable positioning for the patient, homogeneity of the dose between 10-15 %, short times of treatments and In vivo dosimetric verifications. (Author)

  1. Role of total body irradiation as based on the comparison of preparation regimens for allogeneic bone marrow transplantation for acute leukemia in first complete remission

    International Nuclear Information System (INIS)

    The role of total body irradiation (TBI) for allogeneic bone marrow transplantation (BMT) for acute leukemia in first complete remission was reevaluated in this study. From Japanese BMT Registry, data of 123 acute leukemia patients in first complete remission who underwent allogeneic bone marrow transplantation in 22 hospitals between 1988 and 1990 were available for the present comparative study of preparation regimens with or without total body irradiation. Two-year survivals were 77% and 51% in the TBI containing regimen group and in the non-TBI regimen group, respectively (p=0.0010). Corresponding two-year relapse rates were 16% and 37%, respectively (p=0.0197). Corresponding probabilities of developing interstitial pneumonitis were 21% and 24%, respectively (p=0.8127). The analysis of causes of death indicated that non-TBI regimen increased the incidence of septicemia and lethal organ failures, such as liver, heart, lung and other multiple sites. It was emphasized that an additional role of total body irradiation was to disperse the treatment-related toxicity in allogeneic bone marrow transplantation for acute leukemia. (orig.)

  2. Acute renal toxicity of 2 conditioning regimens in patients undergoing autologous peripheral blood stem-cell transplantation. Total body irradiation-cyclophosphamide versus ifosfamide, carboplatin, etoposide

    International Nuclear Information System (INIS)

    Objective was to compare renal toxicity of 2 conditioning regimens of total body irradiation/cyclophosphamide TBI-Cy and Ifosfamide, Carboplatin, Etoposide ICE. Between August 1996 and February 2004, patients treated with autologous peripheral stem cell transplantation in the Department of Medical and radiation Oncology, Gulhane Military Medical School, Ankara, Turkey with 2 different conditioning regimens was comparatively analyzed for acute renal toxicity in the early post-transplant period. Forty-even patients received ICE regimen with 12 g/m2; 1.2 g/m2 and 1.2 g/m2 divided to 6 consecutive days, whereas 21 patients received 12 Gy TBI 6 fractions twice daily in 3 consecutive days and 60 mg/m2/day cyclophosphamide for 2 days. Sixty-eight patients were evaluated in this study. There was no significant difference in baseline renal function between patients in the ICE and TBI-Cy groups. Eleven patients developed nephrotoxicity 23.4% in the ICE group while one patient 4.8% in the TBI-Cy group developed nephrotoxicity in ICEgroup required hemodialysis and subsequently 48.5% of them died. In contrast, one patient 4.8% died due to nephrotoxicity despite hemodialysis in the TBI-Cy arm. This study reveals that the TBI-Cy conditioning regimen seems no more nephrotoxic than an ICE regimen particularly in patients who had used cisplatin prior to transplantation. (author)

  3. Mood Disorders after TBI

    OpenAIRE

    Jorge, Ricardo E.; Arciniegas, David B

    2014-01-01

    In this article, we will examine the epidemiology and risk factors for the development of the most common mood disorders observed in the aftermath of TBI: depressive disorders and bipolar spectrum disorders. We will describe the classification approach and diagnostic criteria proposed in the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-V). We will also examine the differential diagnosis of post-TBI mood disorders and describe the mainstay of the evaluation ...

  4. Pharmacological Immunosuppression Reduces But Does Not Eliminate The Need For Total Body Irradiation In Nonmyeloablative Conditioning Regimens For Hematopoietic Cell Transplantation

    OpenAIRE

    Mielcarek, Marco; Torok-Storb, Beverly; Storb, Rainer

    2011-01-01

    In the dog leukocyte antigen (DLA)-identical hematopoietic cell transplantation (HCT) model, stable marrow engraftment can be achieved with total body irradiation (TBI) of 200 cGy when used in combination with postgrafting immunosuppression. The TBI dose can be reduced to 100 cGy without compromising engraftment rates if G-CSF-mobilized peripheral blood mononuclear cells (G-PBMC) are infused with the marrow. T-cell depleting the G-PBMC product abrogates this effect. These results were interpr...

  5. Interleukin 1 alpha stimulates hemopoiesis but not tumor cell proliferation and protects mice from lethal total body irradiation

    International Nuclear Information System (INIS)

    Interleukin 1 alpha (IL-1) is a polypeptide/glycoprotein growth factor with multiple functions including the modulation of hematopoietic cell proliferation and differentiation. In vivo studies were performed with C57BL/6J mice injected with 0, 0.2, or 2.0 micrograms of IL-1 24 hr before or after lethal total body irradiation (TBI) (9.5 Gy). More mice in the groups administered IL-1 before TBI survived (90% of the 2.0 micrograms group) than those treated 2 or 24 hr after TBI, which was still slightly superior to the uninjected group, which all died within 15 days (p = .0001). Proliferation of bone marrow granulocyte/macrophage colonies following split dose TBI was also greatest for mouse groups treated with IL-1 prior to TBI. These experiments support data from other investigators that IL-1 stimulation of BM is related to IL-1 timing with respect to TBI. Stimulation of hemopoiesis was also assessed in terms of changes in peripheral blood and BM cell numbers and cell cycle kinetics using an electronic particle counter and flow cytometric techniques. Mice injected with 2 micrograms of IL-1 showed an initial decline (at 3-6 hr) and then a selective proliferation (24-48 hr) of early and more committed progenitor cells to 125% and 200% of control values, respectively. Peripheral blood counts rose accordingly. Cells in S and G2/M phases increased over 10 hr and then declined in number. It thus appeared that some synchronization of cell cycling occurred, which might place cells in a more radioresistant phase of the cell cycle. The glutathione (GSH) content and synthesis in BM cells were measured by isocratic paired-ion high performance liquid chromatography and 35S-labelled cysteine incorporation into the GSH tripeptide. An increase in cellular GSH content and synthesis was demonstrated following IL-1 which lasted 24 hr

  6. Cataract after total body irradiation and bone marrow transplantation degree of visual impairment

    International Nuclear Information System (INIS)

    Purpose: To assess the degree of visual impairment as a result of cataract formation after total body irradiation (TBI) for bone marrow transplantation. Methods and Materials: The data from 93 patients who received TBI in 1 or 2 fractions as a part of their conditioning regimen for bone marrow transplantation were analyzed with respect to the degree of visual impairment as a result of cataract formation. The probability to develop severe visual impairment (SVI) was determined for all patients, and the degree of visual impairment was assessed for 56 patients with stabilized cataract, using three categories: no, mild, or severe. Results: For all 93 patients, the probability of developing a cataract causing SVI was 0.44. For allogeneic patients, it was 0.33 without and 0.71 with steroid treatment (p<0.001). All SVI-free probability curves reached a plateau distinct from the cataract-free curves. Apparently, cataracts developing late in the follow-up period rarely cause SVI. Of the patients with stabilized cataract, 32% had no visual impairment, 16% had mild, and 52% severe impairment. No or mild visual impairment was present in 61% of all patients with stable cataract and no steroid treatment compared with only 13% of the patients treated with steroids (p=0.035). Conclusion: SVI occurs in only some of the patients (52%) with stable cataract after TBI for bone marrow transplantation in 1 or 2 fractions. Steroid treatment markedly increases the probability of developing visual problems as result of a cataract after TBI

  7. Attenuator design for organs at risk in total body irradiation using a translation technique

    International Nuclear Information System (INIS)

    Total body irradiation (TBI) is an efficient part of the treatment for malignant hematological diseases. Dynamic TBI techniques provide great advantages (e.g., dose homogeneity, patient comfort) while overcoming treatment room space restrictions. However, with dynamic techniques come additional organs at risk (OAR) protection challenges. In most dynamic TBI techniques, lead attenuators are used to diminish the dose received by the OARs. The purpose of this study was to characterize the dose deposition under various shapes of attenuators in static and dynamic treatments. This characterization allows for the development of a correction method to improve attenuator design in dynamic treatments. The dose deposition under attenuators at different depths in dynamic treatment was compared with the static situation based on two definitions: the coverage areas and the penumbra regions. The coverage area decreases with depth in dynamic treatment while it is stable for the static situation. The penumbra increases with depth in both treatment modes, but the increasing rate is higher in the dynamic situation. Since the attenuator coverage is deficient in the dynamic treatment mode, a correction method was developed to modify the attenuator design in order to improve the OAR protection. The correction method is divided in two steps. The first step is based on the use of elongation charts, which provide appropriate attenuator coverage and acceptable penumbra for a specific depth. The second point is a correction method for the thoracic inclination, which can introduce an orientation problem in both static and dynamic treatments. This two steps correction method is simple to use and personalized to each patient's anatomy. It can easily be adapted to any dynamic TBI techniques

  8. Immunosuppression prior to marrow transplantation for sensitized aplastic anemia patients: comparison of TLI with TBI

    International Nuclear Information System (INIS)

    From May 1980 through July 1986, 26 patients with severe aplastic anemia, sensitized with multiple transfusions of blood products, were treated on either of two immunosuppressive regimens in preparation for bone marrow transplantation from a matched donor. There were 10 patients treated with total body irradiation (TBI), 200 cGy/fraction X 4 daily fractions (800 cGy total dose), followed by cyclophosphamide, 60 mg/kg/d X 2 d. An additional 16 patients were treated with total lymphoid irradiation (TLI) [or, if they were infants, a modified TLI or thoracoabdominal irradiation (TAI)], 100 cGy/fraction, 3 fractions/d X 2 d (600 cGy total dose), followed by cyclophosphamide, 40 mg/kg/d X 4 d. The extent of immunosuppression was similar in both groups as measured by peripheral blood lymphocyte depression at the completion of the course of irradiation (5% of initial concentration for TBI and 24% for TLI), neutrophil engraftment (10/10 for TBI and 15/16 for TLI), and time to neutrophil engraftment (median of 22 d for TBI and 17 d for TLI). Marrow and peripheral blood cytogenetic analysis for assessment of percent donor cells was also compared in those patients in whom it was available. 2/2 patients studied with TBI had 100% donor cells, whereas 6/11 with TLI had 100% donor cells. Of the five who did not, three were stable mixed chimeras with greater than or equal to 70% donor cells, one became a mixed chimera with about 50% donor cells, but became aplastic again after Cyclosporine A cessation 5 mo post-transplant, and the fifth reverted to all host cells by d. 18 post-transplant. Overall actuarial survival at 2 years was 56% in the TLI group compared with 30% in the TBI group although this was not statistically significant. No survival decrement has been seen after 2 years in either group

  9. Aspects of radioprotection in whole body irradiation treatments (TBI); Aspectos de proteccion radiologica en tratamientos de irradiacion de cuerpo total (TBI)

    Energy Technology Data Exchange (ETDEWEB)

    Pinella, Yuliana M. Ayala, E-mail: yayala@crlima.com [Centro de Radioterapia de Lima S.A., Lima (Peru); Chavez, Cesar Picon, E-mail: cesarpicon@yahoo.com [Universidad Nacional de Ingenieria (UNI), Lima (Peru)

    2013-11-01

    Radiation protection occupationally exposed personnel and the public is considered in this study. It was done the experimental determination of the exposure rates at critical points in the area of radiotherapy and it was evaluated the staff dosimetry.

  10. Total body irradiation and cyclophosphamide, vincristine, prednisone in the treatment of favorable prognosis non-Hodgkin's lymphomas

    International Nuclear Information System (INIS)

    A pilot study was undertaken to test the feasibility of administering total body irradiation (TBI) followed by chemotherapy with cyclophosphamide, vincristine and prednisone (CVP). Twelve patients with previously untreated Stages III to IV non-Hodgkin's lymphoma were studied. Nine patients had nodular poorly differentiated lymphocytic lymphoma and 3 had nodular mixed lymphoma. TBI was given to a total dose of 150 rad in biweekly 15 rad fractions. Reversible thrombocytopenia and neutropenia were observed and resulted in 3 attenuated courses (105 rad, 120 rad, 135 rad). No bleeding, infection or other important toxicity occurred from TBI. After a median of 45 days following TBI, all patients began CVP. Eleven patients completed 6 cycles; 1 patient refused further chemotherapy after the first cycle. Dosage adjustments made for neutropenia and thrombocytopenia were such that 83% of the planned cyclophosphamide dose was given. No bleeding, serious infections or fatalities were seen. Toxicities included parathesias, nausea and abdominal pain. At the end of chemotherapy, 6 of the 11 patients who completed 6 cycles of CVP were disease free with remissions of 3+, 4+, 7+, 11+, 14 and 20+ months. TRI + CVP delivered in the manner described is associated with acceptable toxicity

  11. Total body irradiation with volumetric modulated arc therapy: Dosimetric data and first clinical experience

    International Nuclear Information System (INIS)

    To implement total body irradiation (TBI) using volumetric modulated arc therapy (VMAT). We applied the Varian RapidArc™ software to calculate and optimize the dose distribution. Emphasis was placed on applying a homogenous dose to the PTV and on reducing the dose to the lungs. From July 2013 to July 2014 seven patients with leukaemia were planned and treated with a VMAT-based TBI-technique with photon energy of 6 MV. The overall planning target volume (PTV), comprising the whole body, had to be split into 8 segments with a subsequent multi-isocentric planning. In a first step a dose optimization of each single segment was performed. In a second step all these elements were calculated in one overall dose-plan, considering particular constraints and weighting factors, to achieve the final total body dose distribution. The quality assurance comprised the verification of the irradiation plans via ArcCheck™ (Sun Nuclear), followed by in vivo dosimetry via dosimeters (MOSFETs) on the patient. The time requirements for treatment planning were high: contouring took 5–6 h, optimization and dose calculation 25–30 h and quality assurance 6–8 h. The couch-time per fraction was 2 h on day one, decreasing to around 1.5 h for the following fractions, including patient information, time for arc positioning, patient positioning verification, mounting of the MOSFETs and irradiation. The mean lung dose was decreased to at least 80 % of the planned total body dose and in the central parts to 50 %. In two cases we additionally pursued a dose reduction of 30 to 50 % in a pre-irradiated brain and in renal insufficiency. All high dose areas were outside the lungs and other OARs. The planned dose was in line with the measured dose via MOSFETs: in the axilla the mean difference between calculated and measured dose was 3.6 % (range 1.1–6.8 %), and for the wrist/hip-inguinal region it was 4.3 % (range 1.1–8.1 %). TBI with VMAT provides the benefit of satisfactory dose

  12. Dosimetric Study and Verification of Total Body Irradiation Using Helical Tomotherapy and its Comparison to Extended SSD Technique

    International Nuclear Information System (INIS)

    The American College of Radiology practice guideline for total body irradiation (TBI) requires a back-up treatment delivery system. This study investigates the development of helical tomotherapy (HT) for delivering TBI and compares it with conventional extended source-to-surface distance (X-SSD) technique. Four patients' head-to-thigh computed tomographic images were used in this study, with the target defined as the body volume without the left and right lungs. HT treatment plans with the standard TBI prescription (1.2 Gy/fx, 10 fractions) were generated and verified on phantoms. To compare HT plans with X-SSD treatment, the dose distribution of X-SSD technique was simulated using the Eclipse software. The average dose received by 90% of the target volume was 12.3 Gy (range, 12.2-12.4 Gy) for HT plans and 10.3 Gy (range, 10.08-10.58 Gy) for X-SSD plans (p < 0.001). The left and right lung median doses were 5.44 Gy and 5.40 Gy, respectively, for HT plans and 8.34 Gy and 8.95 Gy, respectively, for X-SSD treatment. The treatment planning time was comparable between the two methods. The beam delivery time of HT treatment was longer than X-SSD treatment. In conclusion, HT-based TBI plans have better dose coverage to the target and better dose sparing to the lungs compared with X-SSD technique, which applies dose compensators, lung blocks, and electron boosts. This study demonstrates that HT is possible for delivering TBI. Clinical validation of the feasibility of this approach would be of interest in the future.

  13. Total body irradiation, busulfan and cyclophosphamide as a conditioning regimen for allogeneic bone marrow transplantation for patients with hematological malignancies

    International Nuclear Information System (INIS)

    Between May 1989 and October 1998, 44 patients with hematological malignancies received allogeneic bone marrow transplantation from HLA-matched related (n=25), unrelated (n=16) or 1 locus HLA-mismatched related donors (n=3). Busulfan (BU) (8 mg/kg) and cyclophosphamide (CY) (90 mg/kg) with fractionated total body irradiation (TBI) (12 Gy) (n=30) or BU (16 mg/kg) and CY (120 mg/kg) (n=14) were given as conditioning regimen. All patients receiving BU/CY were transplanted from related donors in first remission of acute leukemia or in first chronic phase of CML (standard risk group; S-group). For 30 patients receiving TBI/BU/CY, 13 were transplanted in standard risk and 17 were in advanced stage of hematological malignancies (high risk group; H-group); 7 in S-group and 9 in H-group transplanted from unrelated donor. Severe regimen-related toxicity was found in 10% of patients receiving TBI/BU/CY (one in standard risk group and 2 in high risk group), but not found in patients receiving BU/CY. Probability of disease free survival (DFS) at 5 years was 38% in patients receiving BU/CY, and 43% in patients receiving TBI/BU/CY (52% in S-group and 35% in H-group). For patients transplanted from related donor at standard risk, probability of DFS was higher in patients receiving TBI/BU/CY than in patients receiving BU/CY (83% vs 38%; p<0.05). For patients receiving TBI/BU/CY as preparatory regimen, probability of DFS was higher in patients transplanted from related donors than in patients transplanted from unrelated donors (63% vs 29%; p<0.05), that was due to lower rate of non-relapse mortality (8% vs 61%; p<0.001). Probability or relapse was 33% in patients receiving BU/CY, and 28% in patients receiving TBI/BU/CY (23%, in S-group and 31% even in H-group), and no significant difference was found between the three groups. We conclude that this TBI/BU/CY regimen is well tolerated and is very effective in reducing relapse and improving survival, especially in standard risk

  14. Total body irradiation, busulfan and cyclophosphamide as a conditioning regimen for allogeneic bone marrow transplantation for patients with hematological malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Kai, Shunro; Misawa, Mahito; Hara, Hiroshi [Hyogo Coll. of Medicine, Nishinomiya (Japan)

    1999-08-01

    Between May 1989 and October 1998, 44 patients with hematological malignancies received allogeneic bone marrow transplantation from HLA-matched related (n=25), unrelated (n=16) or 1 locus HLA-mismatched related donors (n=3). Busulfan (BU) (8 mg/kg) and cyclophosphamide (CY) (90 mg/kg) with fractionated total body irradiation (TBI) (12 Gy) (n=30) or BU (16 mg/kg) and CY (120 mg/kg) (n=14) were given as conditioning regimen. All patients receiving BU/CY were transplanted from related donors in first remission of acute leukemia or in first chronic phase of CML (standard risk group; S-group). For 30 patients receiving TBI/BU/CY, 13 were transplanted in standard risk and 17 were in advanced stage of hematological malignancies (high risk group; H-group); 7 in S-group and 9 in H-group transplanted from unrelated donor. Severe regimen-related toxicity was found in 10% of patients receiving TBI/BU/CY (one in standard risk group and 2 in high risk group), but not found in patients receiving BU/CY. Probability of disease free survival (DFS) at 5 years was 38% in patients receiving BU/CY, and 43% in patients receiving TBI/BU/CY (52% in S-group and 35% in H-group). For patients transplanted from related donor at standard risk, probability of DFS was higher in patients receiving TBI/BU/CY than in patients receiving BU/CY (83% vs 38%; p<0.05). For patients receiving TBI/BU/CY as preparatory regimen, probability of DFS was higher in patients transplanted from related donors than in patients transplanted from unrelated donors (63% vs 29%; p<0.05), that was due to lower rate of non-relapse mortality (8% vs 61%; p<0.001). Probability or relapse was 33% in patients receiving BU/CY, and 28% in patients receiving TBI/BU/CY (23%, in S-group and 31% even in H-group), and no significant difference was found between the three groups. We conclude that this TBI/BU/CY regimen is well tolerated and is very effective in reducing relapse and improving survival, especially in standard risk

  15. The evaluation of a modified technique of Total Body Irradiation in respect of treatment results and toxicity

    International Nuclear Information System (INIS)

    Total body irradiation (TBI) is a well established part of the conditioning regimen prior to bone marrow transplantation (BMT). Numerous different techniques are used and every center elaborates own solutions. The aim of our study to present the method of TBI developed in our department, and to discuss the results of treatment with respect of early and late toxicity. Between 11.2000 and 08.2004, 23 patients were with fractionated TBI at the Department of Radiotherapy of the M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in Warsaw (MSCMCC). Conditioning chemotherapy and BMT were performed in different hematological departments. All patients were irradiated with a total midline dose of 12 Gy in 6 fractions over 3 consecutive days. Doses to the lung did not exceed 11 Gy. The TBI method used in our department was evaluated over a few years. The following modifications have been introduced to the previously applied technique: change of photon energy 6 MV to 15 MV; increase of lung dose from 9 Gy to 11 Gy; the use of an individual bolus as a lung compensator in lateral fields; more frequent boost irradiation of the mediastinum and legs with small fields; calculations of Monitor Units based on dosimetric data. Boost irradiation of chest wall with electrons been abandoned. Median follow up was 12 months. Up till now, 17/23 patients are alive, of these 16 with no relapse. Immediate toxicity was low. Early complications were observed during the first 6 months after BMT in 11 patients. In the case of 4 patients these complications were fatal. Late complications were observed in 10 patients, including chronic GVHD and hormone disturbance. Only one patient had developed the first symptoms of cataract. In one case Lhermitte's syndrome was observed. One patient died due to liver insufficiency. The results of treatment and the complications rates in patients treated with TBI at our department are consistent with those published in literature. We conclude that

  16. A comparison of busulphan versus total body irradiation combined with cyclophosphamide as conditioning for autograft or allograft bone marrow transplantation in patients with acute leukaemia

    International Nuclear Information System (INIS)

    We retrospectively compared the outcome in patients in the EBMT database transplanted for acute leukaemia from January 1987 to January 1994 who received busulphan and cyclophosphamide (BU/CY) as a pretransplant regimen versus those who received cyclophosphamide and total-body irradiation (CY-TBI). The patients were matched for type of transplant (autologous bone marrow transplantation (ABMT) versus allogenic (BMT)), diagnosis (acute lymphoblast leukaemia (ALL) ora cute myeloid leukaemia (AML)), status (early first complete remission, CR-1) versus intermediate (second or later remission, first relapse)), age, FAB classification for AML, prevention of graft-versus-host disease and year of transplantation. BU/CY and CY/TBI as pretransplant regimens gave similar results in all situations, except ABMT for ALL intermediate stages with more than 2 years from diagnosis to transplantation, where a lower RI and a higher LFS were associated with CY/TBI. (author)

  17. Clinical evaluation of bone marrow transplantation using total body irradiation and induction chemotherapy. Treatment results during twelve years at our hospital and some problems on the therapy

    International Nuclear Information System (INIS)

    We performed sixty patients with hematological malignancies the total body irradiation prior to bone marrow transplantation (TBI-BMT) from 1988 to 2000. We delivered our each patient hyperfractionated TBI consisting of 2 fractions of 3 Gy per day for 2 consecutive days following induction chemotherapy. It proved that TBI-BMT was a valuable treatment method for hematological malignancies which have poor prognosis. About the cumulative survival rate, patients of first remission were better outcome than patients beyond second remission. However, the therapy remained some problems which were the prophylaxis of GVHD for HLA-matched unrelated recipients. And we have to consider a new maintenance procedure to prevent relapse from transplanted donor cell. (author)

  18. Clinical evaluation of bone marrow transplantation using total body irradiation and induction chemotherapy. Treatment results during twelve years at our hospital and some problems on the therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kawamura, Toshiki; Koga, Sukehiko; Kikukawa, Kaoru; Okamoto, Masataka; Miyazaki, Hitoshi; Kojima, Hiroshi; Esaki, Kohji [Fujita Health Univ., Toyoake, Aichi (Japan). School of Medicine

    2000-10-01

    We performed sixty patients with hematological malignancies the total body irradiation prior to bone marrow transplantation (TBI-BMT) from 1988 to 2000. We delivered our each patient hyperfractionated TBI consisting of 2 fractions of 3 Gy per day for 2 consecutive days following induction chemotherapy. It proved that TBI-BMT was a valuable treatment method for hematological malignancies which have poor prognosis. About the cumulative survival rate, patients of first remission were better outcome than patients beyond second remission. However, the therapy remained some problems which were the prophylaxis of GVHD for HLA-matched unrelated recipients. And we have to consider a new maintenance procedure to prevent relapse from transplanted donor cell. (author)

  19. Behavioural consequences of an 8 Gy total body irradiation in mice: Regulation by interleukin-4

    International Nuclear Information System (INIS)

    The effects of an 8 Gy γ total body irradiation (TBI) on exploration and locomotion activities as well as temperature were studied in C57BL6/J mice. Survival, body weight, and blood cell counts were also assessed in irradiated mice treated with placebo or interleukin (IL)-4. The efficacy of IL-4 treatment on improvement in exploration activity was evaluated. The study was carried out from 3 h to 30 days following exposure. Our results showed a biphasic response to irradiation concerning the exploration activity of mice. Irradiated mice had reduced activity as early as 3 h after exposure, with recovery of activity within 24 h. The exploration activity again decreased 4 days after irradiation and the recovery occurred slowly after day 17. IL-4 ameliorated the exploration status in mice in both phases. The locomotion activity was studied using a telemetry apparatus. A similar pattern to that of the exploration data was observed, with a minimal activity observed between days 13 and 17. A radiation-induced hypothermia was also noticed over the same time period. (author)

  20. Behavioural consequences of an 8 Gy total body irradiation in mice: Regulation by interleukin-4

    Energy Technology Data Exchange (ETDEWEB)

    Van der Meeren, A.; Lebaron-Jacobs, L. [Inst. de Protection et de Surete Nucleaire, Dept. de Protection de la sante de l' Homme et de Dosimetrie, Section Autonome de Radiobiologie Appliquee a la Medecine, IPSN, Fontenay-aux-Roses (France)

    2001-02-01

    The effects of an 8 Gy {gamma} total body irradiation (TBI) on exploration and locomotion activities as well as temperature were studied in C57BL6/J mice. Survival, body weight, and blood cell counts were also assessed in irradiated mice treated with placebo or interleukin (IL)-4. The efficacy of IL-4 treatment on improvement in exploration activity was evaluated. The study was carried out from 3 h to 30 days following exposure. Our results showed a biphasic response to irradiation concerning the exploration activity of mice. Irradiated mice had reduced activity as early as 3 h after exposure, with recovery of activity within 24 h. The exploration activity again decreased 4 days after irradiation and the recovery occurred slowly after day 17. IL-4 ameliorated the exploration status in mice in both phases. The locomotion activity was studied using a telemetry apparatus. A similar pattern to that of the exploration data was observed, with a minimal activity observed between days 13 and 17. A radiation-induced hypothermia was also noticed over the same time period. (author)

  1. Total Body Irradiation for Allogeneic Bone Marrow Transplantation in Chronic Myelogenous Leukemia

    International Nuclear Information System (INIS)

    Between July 1987 and December 1992, we treated 22 patients with chromic myelogenous leukemia; 14 in the chronic phase and 8 with more advanced disease. All were received with allogeneic bone marrow transplantation from HLA-identical sibling donors after a total body irradiation (TBI) cyclophosphamide conditioning regimen. Patients were non-randomly assigned to either 1200 cGy/6 fractions/3 days (6 patients) or 1320 cGy/8 fractions/4 days (16 patients) by dose of TBI. Of the 22 patients, 8 were prepared with cyclophosphamide alone, 14 were conditioned with additional adriamycin or daunorubicin. To prevent graft versus host disease, cyclosporine was given either alone or in conjunction with methotrexate. The actuarial survival and leukemic-free survival at four years were 58.5% and 41.2%, respectively, and the relapse rate was 36% among 22 patients. There was a statistically significant difference in survival between the patients in chronic phase and more advanced phase (76% vs 33%, p=0.05). The relapse rate of patients receiving splenectomy was higher than that of patients receiving splenic irradiation (50% vs 0%, p=0.04). We conclude that the probability of cure is highest if transplantation is performed while the patient remains in the chronic phase

  2. Total Body Irradiation for Allogeneic Bone Marrow Transplantation in Chronic Myelogenous Leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Su Mi; Choi, Ihl Bohng; Kang, Ki Mun; Kim, In Ah; Shinn, Kyung Sub; Kim, Choon Choo; Kim, Dong Jip [Catholic University College of Medicine, Seoul (Korea, Republic of)

    1994-06-15

    Between July 1987 and December 1992, we treated 22 patients with chromic myelogenous leukemia; 14 in the chronic phase and 8 with more advanced disease. All were received with allogeneic bone marrow transplantation from HLA-identical sibling donors after a total body irradiation (TBI) cyclophosphamide conditioning regimen. Patients were non-randomly assigned to either 1200 cGy/6 fractions/3 days (6 patients) or 1320 cGy/8 fractions/4 days (16 patients) by dose of TBI. Of the 22 patients, 8 were prepared with cyclophosphamide alone, 14 were conditioned with additional adriamycin or daunorubicin. To prevent graft versus host disease, cyclosporine was given either alone or in conjunction with methotrexate. The actuarial survival and leukemic-free survival at four years were 58.5% and 41.2%, respectively, and the relapse rate was 36% among 22 patients. There was a statistically significant difference in survival between the patients in chronic phase and more advanced phase (76% vs 33%, p=0.05). The relapse rate of patients receiving splenectomy was higher than that of patients receiving splenic irradiation (50% vs 0%, p=0.04). We conclude that the probability of cure is highest if transplantation is performed while the patient remains in the chronic phase.

  3. Study on Fractionated Total Body Irradiation before Hematopoietic Stem Cell Transplantation

    Institute of Scientific and Technical Information of China (English)

    Tong Fang; Bo Liu; Hong Gao

    2009-01-01

    OBJECTIVE To observe the dose and the complications from total body irradiation before hematopoietic stem cell transplantation.METHODS This study involved 312 patients with total body irradiation before hematopoietic stem cell transplantation. They were entered into the treated research from May 1999 to October 2005. All patients had Received the irradiation from 60Co of an absorbed dose rate of (5.2 ± 1.13) cGy/min. The total dose of TBI was 7~12 Gy, 1 f/d × 2 d. A high-dose rate group (≥ 10 Gy) included 139 cases and a low-dose rate group (< 10 Gy) included 173 cases.RESULTS The probability of acute gastrointestinal reactions in the high-dose rate group was more compared with that in the low-dose rate group. The differences for other reactions, such as hematopoietic reconstitution and graft survival rate, between the two groups were insignificant.CONCLUSION Using fractional total body irradiation at a dose rate of 5 cGy/min, with a total dose of 7~12 Gy, 1 f/d x 2 d, with the lung receiving under 7.5 Gy is a safe and effective pretreatment for hematopoietic stem cell transplantation.

  4. Improvement of lateral position total body irradiation with ovarian shielding. Shielding block for the lung of tungsten sheets

    International Nuclear Information System (INIS)

    Bone marrow transplantation requires the prior administration of a large amount of anticancer and total body irradiation (TBI) with 12 Gy, which brings about infertility in females as the dose exceed the threshold of the pregnant function (2.5-6 Gy). This paper reports the preparation of columnar shields for ovaries of low melting point lead (Pb), and of shields of the lung-formed Pb and tungsten (W) sheet for lungs at TBI. Reported cases are from the experience of 11 patients during the period of 2007-2012, Jan. Ordinary old TBI is conducted from right/left and left/right directions at the source-skin distance (SSD) 400 cm with 10 MV X-ray (10 cGy/min) at the supine position with the lung density correction; TBI with ovarian shielding (OS) from anteroposterior and posteroanterior directions, at the lateral position, with the lung shielding (Pb); and TBI-OS, with the lung shielding (W sheet). Ovarian block shield is a Pb column of 5 cm diameter X 8 cm thickness. The Pb lung block with 0.5 cm thickness is made fitted to individual patients' lung form, of which preparation has been time-consuming and has required much labor. The W sheet is a commercially available one with 1 mm thickness, and easily usable with several sheets for shielding after cutting with a scissor so as to be fitted to individual patients' lung form. In contrast to the ordinary supine TBI, lateral TBI with the lung Pb block shielding is found for the lung dose to be reduced from 12 Gy to 10 Gy; and with the W sheet (4 mm thick) shielding, for the transmission coefficient to be virtually similar to that of Pb block (82.6 and 83.4%, respectively). The ovarian shielding is found effective for the organ dose to be reduced to about 2 Gy at 12 Gy irradiation. Preparation of W sheet is easier and more convenient for its fitting to individual patients' lung form than previous Pb block. (T.T.)

  5. Translating bed total body irradiation lung shielding and dose optimization using asymmetric MLC apertures.

    Science.gov (United States)

    Ahmed, Shahbaz; Brown, Derek; Ahmed, Saad B S; Kakakhel, Muhammad B; Muhammad, Wazir; Hussain, Amjad

    2016-01-01

    A revised translating bed total body irradiation (TBI) technique is developed for shielding organs at risk (lungs) to tolerance dose limits, and optimizing dose distribution in three dimensions (3D) using an asymmetrically-adjusted, dynamic multileaf collimator. We present a dosimetric comparison of this technique with a previously developed symmetric MLC-based TBI technique. An anthropomor-phic RANDO phantom is CT scanned with 3 mm slice thickness. Radiological depths (RD) are calculated on individual CT slices along the divergent ray lines. Asymmetric MLC apertures are defined every 9 mm over the phantom length in the craniocaudal direction. Individual asymmetric MLC leaf positions are optimized based on RD values of all slices for uniform dose distributions. Dose calculations are performed in the Eclipse treatment planning system over these optimized MLC apertures. Dose uniformity along midline of the RANDO phantom is within the confidence limit (CL) of 2.1% (with a confidence probability p = 0.065). The issue of over- and underdose at the interfaces that is observed when symmetric MLC apertures are used is reduced from more than ± 4% to less than ± 1.5% with asymmetric MLC apertures. Lungs are shielded by 20%, 30%, and 40% of the prescribed dose by adjusting the MLC apertures. Dose-volume histogram analysis confirms that the revised technique provides effective lung shielding, as well as a homogeneous dose coverage to the whole body. The asymmetric technique also reduces hot and cold spots at lung-tissue interfaces compared to previous symmetric MLC-based TBI technique. MLC-based shielding of OARs eliminates the need to fabricate and setup cumbersome patient-specific physical blocks. PMID:27074477

  6. Total body irradiation in intensive treatment necessitating bone marrow graft, of malignant hematological diseases

    International Nuclear Information System (INIS)

    From 1980 to 1988, 65 consecutive patients were treated with a program of intensive chemotherapy and total body irradiation (TBI) for malignant hematological diseases at the Institut Jules-Bordet. Results were analyzed according to different prognostic factors as well as to the radiation technique; 3 different schedules were used: 3 fractions of 2.66 Gy given in one day at 3-h intervals, 6 daily fractions of 2 Gy in 6 days and 7 fractions of 2.25 Gy in 8 days. The second radiation schedule appears to give the best results as relapses were higher with the 1-day program and there was an increase in later effects and early deaths with 7 fractions of 2.25 Gy. Nevertheless, the results indicate that after administration of 5 or 6 times 2 Gy TBI, there might be possible benefit in treating certain parts of the body by radiation, those in particular that could be sanctuary sites for malignant cells from chemotherapy. The authors propose a simple and easy way of uniformizing the radiation schedule to carry out a multicentric trial

  7. Central axis dose verification in patients treated with total body irradiation of photons using a Computed Radiography system

    International Nuclear Information System (INIS)

    To propose and evaluate a method for the central axis dose verification in patients treated with total body irradiation (TBI) of photons using images obtained through a Computed Radiography (CR) system. It was used the Computed Radiography (Fuji) portal imaging cassette readings and correlate with measured of absorbed dose in water using 10 x 10 irradiation fields with ionization chamber in the 60Co equipment. The analytical and graphic expression is obtained through software 'Origin8', the TBI patient portal verification images were processed using software ImageJ, to obtain the patient dose. To validate the results, the absorbed dose in RW3 models was measured with ionization chamber with different thickness, simulating TBI real conditions. Finally it was performed a retrospective study over the last 4 years obtaining the patients absorbed dose based on the reading in the image and comparing with the planned dose. The analytical equation obtained permits estimate the absorbed dose using image pixel value and the dose measured with ionization chamber and correlated with patient clinical records. Those results are compared with reported evidence obtaining a difference less than 02%, the 3 methods were compared and the results are within 10%. (Author)

  8. Modeling, planning and XiO R CMS validation of TBI treatment (extended SSD 400 cm); Modelacion, planificacion y validacion del XiO CMS para tratamientos TBI (SSD extendida de 400 cm)

    Energy Technology Data Exchange (ETDEWEB)

    Teijeiro, A.; Pereira, L.; Moral, F. del; Vazquez, J.; Lopez Medina, A.; Meal, A.; Andrade Alvarez, B.; Salgado Fernandez, M.; Munoz, V.

    2011-07-01

    The whole body irradiation (TBI) is a radiotherapy technique previously used a bone marrow transplant and for certain blood diseases, in which a patient is irradiated to extended distance (SSD from 350 to 400). The aim of the TBI is to kill tumor cells in the receiver and prevent rejection of transplanted bone marrow. The dose is prescribed at the midpoint of the abdomen around the navel wing. The most planners not permit the treatment of patients with a much higher SSD to 100 cm, also using the table TBI with spoiler to increase skin dose should be taken into account This requires measurements and checks ad hoc if you use a planner, because modeling is not optimized a priori for an SSD of 400 cm.

  9. Establishment of Early Endpoints in Mouse Total-Body Irradiation Model.

    Science.gov (United States)

    Koch, Amory; Gulani, Jatinder; King, Gregory; Hieber, Kevin; Chappell, Mark; Ossetrova, Natalia

    2016-01-01

    Acute radiation sickness (ARS) following exposure to ionizing irradiation is characterized by radiation-induced multiorgan dysfunction/failure that refers to progressive dysfunction of two or more organ systems, the etiological agent being radiation damage to cells and tissues over time. Radiation sensitivity data on humans and animals has made it possible to describe the signs associated with ARS. A mouse model of total-body irradiation (TBI) has previously been developed that represents the likely scenario of exposure in the human population. Herein, we present the Mouse Intervention Scoring System (MISS) developed at the Veterinary Sciences Department (VSD) of the Armed Forces Radiobiology Research Institute (AFRRI) to identify moribund mice and decrease the numbers of mice found dead, which is therefore a more humane refinement to death as the endpoint. Survival rates were compared to changes in body weights and temperatures in the mouse (CD2F1 male) TBI model (6-14 Gy, 60Co γ-rays at 0.6 Gy min-1), which informed improvements to the Scoring System. Individual tracking of animals via implanted microchips allowed for assessment of criteria based on individuals rather than by group averages. From a total of 132 mice (92 irradiated), 51 mice were euthanized versus only four mice that were found dead (7% of non-survivors). In this case, all four mice were found dead after overnight periods between observations. Weight loss alone was indicative of imminent succumbing to radiation injury, however mice did not always become moribund within 24 hours while having weight loss >30%. Only one survivor had a weight loss of greater than 30%. Temperature significantly dropped only 2-4 days before death/euthanasia in 10 and 14 Gy animals. The score system demonstrates a significant refinement as compared to using subjective assessment of morbidity or death as the endpoint for these survival studies. PMID:27579862

  10. Late ophthalmological complications after total body irradiation in non-human primates

    Science.gov (United States)

    Niemer-Tucker, M. M.; Sterk, C. C.; de Wolff-Rouendaal, D.; Lee, A. C.; Lett, J. T.; Cox, A.; Emmanouilidis-van der Spek, K.; Davelaar, J.; Lambooy, A. C.; Mooy, C. M.; Broerse, J. J.

    1999-01-01

    PURPOSE: To investigate the long-term effects of total body irradiation (TBI) on the incidence and time course of ocular complications. MATERIALS AND METHODS: Rhesus monkeys treated with TBI photon doses up to 8.5 Gy and proton doses up to 7.5 Gy were studied at intervals up to 25 years post-irradiation. They were compared with control groups with a similar age distribution. Cataract formation and ocular fundus lesions were scored according to a standardized protocol. Fluorescein angiography and histopathology was performed in selected animals. RESULTS: Cataract formation occurred after a latent period of 3-5 years. Significant cataract induction was observed for photon-doses of 8 and 8.5 Gy and beyond 20 years after proton irradiation. The severity of the lesions represents significant impairment of vision and would require cataract surgery if similar results occurred in human bone marrow transplant patients. Fluorescein angiography demonstrated a normal pattern of retinal vessels in 13 out of 14 animals (93%) from the irradiated group and in eight out of nine animals (89%) from the control group. No additional lesions apart from age-related degenerative changes could be demonstrated. Histological evaluation revealed no radiation-associated vasculopathy. CONCLUSIONS: Radiation alone for doses up to 8.5 Gy of photons does not carry a potential risk for fundus pathology, whereas clinically important cataract induction should be anticipated within 5 years after photon doses of 8.0 and 8.5 Gy and proton doses in excess of 2.5 Gy.

  11. Effects of total body irradiation-based conditioning allogenic sem cell transplantation for pediatric acute leukemia: A single-institution study

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong Moo; Choi, Eun Kyung; Kim, Jong Hoon [Dept.of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); and others

    2014-09-15

    To evaluate the effects of total body irradiation (TBI), as a conditioning regimen prior to allogeneic stem cell transplantation (allo-SCT), in pediatric acute leukemia patients. From January 2001 to December 2011, 28 patients, aged less than 18 years, were treated with TBI-based conditioning for allo-SCT in our institution. Of the 28 patients, 21 patients were diagnosed with acute lymphoblastic leukemia (ALL, 75%) and 7 were diagnosed with acute myeloid leukemia (AML, 25%). TBI was completed 4 days or 1 day before stem cell infusion. Patients underwent radiation therapy with bilateral parallel opposing fields and 6-MV X-rays. The Kaplan-Meier method was used to calculate survival outcomes. The 2-year event-free survival and overall survival rates were 66% and 56%, respectively (71.4% and 60.0% in AML patients vs. 64.3% and 52.4% in ALL patients, respectively). Treatment related mortality rate were 25%. Acute and chronic graft-versus-host disease was a major complication; other complications included endocrine dysfunction and pulmonary complications. Common complications from TBI were nausea (89%) and cataracts (7.1%). The efficacy and toxicity data in this study of TBI-based conditioning to pediatric acute leukemia patients were comparable with previous studies. However, clinicians need to focus on the acute and chronic complications related to allo-SCT.

  12. Effects of total body irradiation-based conditioning allogenic sem cell transplantation for pediatric acute leukemia: A single-institution study

    International Nuclear Information System (INIS)

    To evaluate the effects of total body irradiation (TBI), as a conditioning regimen prior to allogeneic stem cell transplantation (allo-SCT), in pediatric acute leukemia patients. From January 2001 to December 2011, 28 patients, aged less than 18 years, were treated with TBI-based conditioning for allo-SCT in our institution. Of the 28 patients, 21 patients were diagnosed with acute lymphoblastic leukemia (ALL, 75%) and 7 were diagnosed with acute myeloid leukemia (AML, 25%). TBI was completed 4 days or 1 day before stem cell infusion. Patients underwent radiation therapy with bilateral parallel opposing fields and 6-MV X-rays. The Kaplan-Meier method was used to calculate survival outcomes. The 2-year event-free survival and overall survival rates were 66% and 56%, respectively (71.4% and 60.0% in AML patients vs. 64.3% and 52.4% in ALL patients, respectively). Treatment related mortality rate were 25%. Acute and chronic graft-versus-host disease was a major complication; other complications included endocrine dysfunction and pulmonary complications. Common complications from TBI were nausea (89%) and cataracts (7.1%). The efficacy and toxicity data in this study of TBI-based conditioning to pediatric acute leukemia patients were comparable with previous studies. However, clinicians need to focus on the acute and chronic complications related to allo-SCT.

  13. Total body irradiation and syngeneic marrow transplantation in an inbred rat model of acute myelogenous leukemia

    International Nuclear Information System (INIS)

    While acute myelogenous leukemia (AML) occurs rarely in laboratory animals, over 20 model systems have been reported. One of these, AML of the inbred Wistar/Furth rat, has been shown to be pathophysiologically similar to human AML. Ten days after intravenous inoculation of 1.0 x 106 cells of a tissue culture grown clonal line, rats demonstrated peripheral blood leukemia, replacement of greater than 90% of the bone marrow with distinctive malignant myeloblasts and a syndrome of hypermuramidase (lysozyme) emia and muramidasuria. Total body irradiation (TBI) at 10 days after leukemia cell passage with a marrow lethal dose (950 rad, 140 rad/min, 137Cs source, 663 kV) followed by intravenous inoculation of 5.0 x 108/kg viable syngeneic bone marrow cells produced transient complete remissions. Repopulation with transplanted marrow was detected along with increasing numbers of recognizable W/Fu AML cells in peripheral blood, marrow, and central nervous system. The delayed leukemia relapse in irradiated transplanted rats compared to irradiated non-transplanted controls suggests an interaction between surviving W/Fu AML cells and transplanted marrow. This model may be of value in studies designing a therapeutic interaction against AML by donor marrow in the chemotherapy, immunotherapy, and total body irradiated patient

  14. Biological problems of total body irradiation

    International Nuclear Information System (INIS)

    We have considered the dose required for meeting the aims of total body irradiation as well as its significance in terms of cell survival for bone marrow stem cells leukaemia, intestinal mucosa and lung. The necessity of a relative protection of the critical tissues with respect to the target populations the irradiation is aiming at, is emphasized. Localized shielding of the lung results in a reduction of the dose to a part of the target population; its biological consequence is discussed. Fractionation and protraction of the irradiation can achieve a significant protection of the critical tissues. Radiobiological data allow estimating the benefit of reducing the fraction size to 1.25 Gy or the dose rate to 0.05 Gy/mn. The benefit of smaller fraction size or dose rate is probably small. Fractionation or low dose rate appear equivalent for the protection of the critical tissues. A larger clinical experience is necessary for a definite comparison of their biological and practical advantages

  15. Clinical analysis of patients with acute radiation syndrome due to total body irradiation or total lymphatic irradiation

    International Nuclear Information System (INIS)

    Objective: To study the severity of iatrogenic acute radiation syndrome, treatment, hematopoietic recovery and related complications in patients subjected to total body irradiation (TBI) or total lymphatic irradiation (TLI) prior to hematopoietic stem cell transplantation. Methods: 100 tumor patients (91 with leukemia and 9 with other tumors), after receiving 500∼1000 cGy (in an average of 738.6 cGy) of TBI or TLI with super high dose chemotherapy as conditioning regimen during the process of hemopoietic stem cell transplantation, developed severe or even extremely severe, mainly bone marrow form acute radiation syndrome. Results: The patients' white blood cell count once dropped to (0∼0.15) x 109/L, platelet count fell to (1∼17) x 109/L, bone marrow was depleted with only a few non-hemopoietic cells and rare hemopoietic cells, and a high risk of complicating with infection and hemorrhage was observed. Treated with a variety of measures including protective isolation, supportive care, administration of growth factors such as GM-CSF or G-CSF, blood component transfusion and effective antibiotics, 92 cases restored their normal hemopoiesis, while 8 cases died of infection or hemorrhage. The clinical course of these patients indicated that a majority of the patients with severe and extremely severe, iatrogenic acute radiation syndrome involving bone marrow could restore their normal hemopoiesis, and hemopoietic stem cell transplantation played an important role in the treatment. Conclusion: Hemopoietic stem cell transplantation and administration of growth factors are very useful for the treatment of acute radiation syndrome

  16. Total body irradiation for children with malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Sanuki, Eiichi; Maeno, Toshio; Kamata, Rikisaburo; Tanaka, Yoshiaki; Mugishima, Hideo [Nihon Univ., Tokyo (Japan). School of Medicine

    1995-12-01

    Total body irradiation combined with high dose chemotherapy has been performed just before bone marrow transplantation in 35 children with advanced malignancies, with the object of achieving successful transplantation and improving the prognosis. Simulation was performed as follows: back scatter, flatness, dose accumulation using randophantom and dose distribution using a thermo-luminescence dosimeter and linac-graphy. The standard error of dose distribution was within 10%. In neuroblastoma, of which there were 14 cases in stage IV and one case in stage III, the 5-year survival rate was 55%. In leukemia, of which all cases were in the high-risk group (7 cases of acute lymphoblastic leukemia and 2 of acute myeloblastic leukemia) the 5-year survival rate was 55%. The 5 cases having first remission survived disease-free while the 4 cases having non-first remission died. In malignant lymphoma (6 cases in stage IV and one case in stage III, with bulky mass) the 5-year survival rate was 67%. Four cases with other diagnoses (severe aplastic anemia, and others) all survived. As yet no side effects resulting from total body irradiation have been recognized in our cases, but a longer follow-up period is necessary to observe possible late side effects. (author).

  17. Pretransplant pulmonary function tests predict risk of mortality following fractionated total body irradiation and allogeneic peripheral blood stem cell transplant

    International Nuclear Information System (INIS)

    Purpose: To determine the value of pulmonary function tests (PFTs) done before peripheral blood stem cell transplant (PBSCT) in predicting mortality after total body irradiation (TBI) performed with or without dose reduction to the lung. Methods and Materials: From 1997 to 2004, 146 consecutive patients with hematologic malignancies received fractionated TBI before PBSCT. With regimen A (n = 85), patients were treated without lung dose reduction to 13.6 gray (Gy). In regimen B (n = 35), total body dose was decreased to 12 Gy (1.5 Gy twice per day for 4 days) and lung dose was limited to 9 Gy by use of lung shielding. In regimen C (n = 26), lung dose was reduced to 6 Gy. All patients received PFTs before treatment, 90 days after treatment, and annually. Results: Median follow-up was 44 months (range, 12-90 months). Sixty-one patients had combined ventilation/diffusion capacity deficits defined as both a forced expiratory volume in the first second (FEV1) and a diffusion capacity of carbon dioxide (DLCO) <100% predicted. In this group, there was a 20% improvement in one-year overall survival with lung dose reduction (70 vs. 50%, log-rank test p = 0.042). Conclusion: Among those with combined ventilation/diffusion capacity deficits, lung dose reduction during TBI significantly improved survival

  18. Total body irradiation correlates with chronic graft versus host disease and affects prognosis of patients with acute lymphoblastic leukemia receiving an HLA identical allogeneic bone marrow transplant

    International Nuclear Information System (INIS)

    Purpose: To investigate whether different procedure variables involved in the delivery of fractionated total body irradiation (TBI) impact on prognosis of patients affected by acute lymphoblastic leukemia (ALL) receiving allogeneic bone marrow transplant (BMT). Methods and Materials: Ninety-three consecutive patients with ALL receiving a human leukocyte antigen (HLA) identical allogeneic BMT between 1 August 1983 and 30 September 1995 were conditioned with the same protocol consisting of cyclophosphamide and fractionated TBI. The planned total dose of TBI was 12 Gy (2 Gy, twice a day for 3 days). Along the 12-year period, variations in delivering TBI schedule occurred with regard to used radiation source, instantaneous dose rate, technical setting, and actual total dose received by the patient. We tested these different TBI variables as well as factors related to patient, state of disease, and transplant-induced disease to investigate their influence on transplant-related mortality, leukemia relapse, and survival. Results: At median follow-up of 7 years (range 3-15 years) the probabilities of leukemia-free survival (LFS) and overall survival (OS) for the 93 patients were 60% and 41%, respectively. At univariate analysis, chronic graft versus host disease (cGvHd) (p = 0.0005), age (p = 0.01), and state of disease (p 0.03) were factors affecting LFS whereas chronic GvHd (p = 0.0005), acute GvHd (p = 0.03), age (p = 0.0001), and GvHd prophylaxis (p = 0.01) were factors affecting overall survival. The occurrence of chronic GvHd was correlated with actually delivered TBI dose (p = 0.04). Combined stratification of prognostic factors showed that patients who received the planned total dose of TBI (12 Gy) and were affected by chronic GvHd had higher probabilities of LFS (p = 0.01) and OS (p = n.s.) than patients receiving less than 12 Gy and/or without occurrence of chronic GvHd. Moreover, TBI dose had a significant impact on LFS in patients transplanted in first

  19. Bone-marrow alterations after half-body irradiation

    International Nuclear Information System (INIS)

    The mouse bone marrow was investigated after upper half-body, upper and lower half-body and whole-body irradiation, resp., with regard to the development of an animal model for half-body treatment of tumor patients. As a result of the studies the practicability of bilateral half-body irradiation can be assumed as to the regeneration of the bone marrow and the survival of the whole organism based on a kind of 'endogeneous transplantation' of bone marrow cells from the unirradiated area into the irradiated one. Resulting from the single irradiations distinct reductive cellular effects followed by exceeding regeneration in the irradiated parts of the bone marrow as well as compensatory proliferations in the unirradiated parts could be revealed. The dynamics of the number of cells essentially turned out on account of leukopoiesis. The results presented are a guideline for the interpretation of clinical processes following upper and lower adjuvant half-body irradiation

  20. Marrow transplantation for leukemia following fractionated total body irradiation. A comparative trial of methotrexate and cyclosporine

    International Nuclear Information System (INIS)

    Fifty-six patients, 30-47 yr of age, with leukemia in relapse received allogeneic marrow transplants from HLA-identical siblings. All patients were treated with cyclophosphamide (120 mg/kg) and 7 daily fractions of 2.25 Gy of total body irradiation (TBI) for seven consecutive days. Nine patients (16%) are currently alive, free of disease, 324-845 days from transplantation. Actuarial relapse and survival rates at 2 yr were 56% and 9.5% respectively. These data were not remarkably different from those in previous studies using 10 Gy of TBI administered as a single dose. Thirty patients were randomized to receive methotrexate (MTX) and 26 to receive cyclosporine (CSP) as postgrafting prophylaxis for acute graft-versus-host disease (GVHD). Probability of developing significant acute GVHD by day 100 post-transplant was 71% for patients in the MTX group and 45% for patients in the CSP group (p<0.05). Probability of relapse was 37% for patients in the MTX group and 70% for patients in the CSP group (p<0.05). Transplant-related deaths were more frequent in the MTX group and leukemic deaths more frequent in the CSP group although this may have been related to an uneven distribution of high-risk patients. Long term disease-free survival was comparable. (author)

  1. Arc therapy for total body irradiation – A robust novel treatment technique for standard treatment rooms

    International Nuclear Information System (INIS)

    Background and purpose: We developed a simple and robust total body irradiation (TBI) method for standard treatment rooms that obviates the need for patient translation devices. Methods and materials: Two generic arcs with rectangular segments for a patient thickness of 16 and 20 cm (arc16/arc20) were generated. An analytical fit was performed to determine the weights of the arc segments depending on patient thickness and gantry angle. Stability and absolute dose for both arcs were measured using EBT3 films in a range of solid water slab phantom thicknesses. Additionally ionization chamber measurements were performed every 10 cm at a source surface distance (SSD) of ∼200 cm. Results: The measured standard deviation for arc16 is ±3% with a flatness ⩽9.0%. Arc20 had a standard deviation of ±3% with a flatness ⩽7.3% for all measured thicknesses. The theoretical curves proved to be accurate for the prediction of the segment weightings for the two arcs. In vivo measurements for the first 22 clinical patients showed a dose deviation of less than 3%. Conclusions: Arc therapy is a convenient and stable method for TBI. This cost-effective approach has been introduced clinically, obviating the need for field patches and to physically move the patient

  2. Simple technique for fabrication of shielding blocks for total body irradiation at extended treatment distances

    Directory of Open Access Journals (Sweden)

    Ravichandran R

    2009-01-01

    Full Text Available Techniques are being standardized in our department for total body irradiation (TBI with six MV photons in linear accelerator for preconditioning to bone marrow transplantation (BMT. Individualized shields with low melting point alloy are to be fabricated for shielding critical organs such as lungs, kidneys etc. A method to mount diminished dimension of shields in a tray at 3.75m is designed in the department for a teletreatment distance of four meters with magna field with A simulator image taken with the patient′s midplane (MP at one meter distance is used to mark the dimensions of lung, scaled down by a factor of 3.75/4.0. These lung dimensions are reprinted from the digital simulator image for making the shield. The methodology of the technique using digitized minification in radiography is the first of its kind to be used for shield cutting in magna field radiotherapy.

  3. Cytogenetic studies on recipients of allogeneic bone marrow transplants after fractionated total body irradiation

    International Nuclear Information System (INIS)

    Cytogenetic findings from the bone marrow (BM) and the peripheral blood (PB) of nine consecutive patients after allogeneic bone marrow transplantation (BMT) for acute or chronic myelogenous leukaemia are reported. After a conditioning regimen consisting of cyclophosphamide and fractionated total body irradiation (TBI) given in five or six fractions of 2 Gy, persistence of host cells was detected in four out of seven cases with permanent engraftment. While one of these patients relapsed 4 months after host cells had been found in BM and PB, the other patients stayed relapse-free 124, 257 and 347 d after grafting. Before transplantation, the leukaemic cells in all three cases carried unique cytogenetic abnormalities giving the opportunity to distinguish the leukaemic population from chromosomally non-aberrant cells thought to represent residual normal host cells. As the persisting host cells after BMT lacked any cytogenetic abnormalities, it is suggested that they were members of residual normal clones not involved in the leukaemic process. (author)

  4. Cell biological effects of total body irradiation on growth and differentiation of acute myelogenous leukemia cells compared to normal bone marrow

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    Greenberger, J.S.; Weichselbaum, R.R.; Botnick, L.E.; Sakakeeny, M.; Moloney, W.C.

    1979-01-01

    Radiation therapy is used as total body treatment in preparation of the acute myelogenous leukemia (AML) patient for bone marrow transplantation. Many AML patients will have residual leukemia cells at the time of total body irradiation (TBI). In the present study, the effect of TBI on leukemic myeloid cells was compared to the effect on normal marrow granulocytic stem cells (CFUc) in vitro. Little difference from that of normal CFUc was found in the radiosensitivity of two mouse myeloid leukemia cell lines. The effect of TBI on growth of WEHI-3 or J774 cells in millipore diffusion chambers was stimulatory. These AML cell lines as well as others derived from Friend or Abelson virus infected in vitro long term mouse marrow cultures showed some morphologic differentiation by 7 days growth in diffusion chambers in irradiated heterologous rat hosts, but immature cells predominated by day 21. Thus, evidence in murine models of AML indicates that residual AML cells surviving chemotherapy will show no greater susceptibility to radiation killing compared to normal stem cells and will rapidly repopulate the irradiated host.

  5. Technical modifications in hyperfractionated total body irradiation for T-lymphocyte deplete bone marrow transplant

    International Nuclear Information System (INIS)

    The Medical College of Wisconsin implemented a major bone marrow transplant (BMT) program in July 1985. The type of transplants to be focused on were allogeneic T-lymphocyte deplete. Total body irradiation (TBI) was initially patterned after the Memorial method. Patients received total body irradiation in a sitting position at a dose rate of 20-25 cGy/minute with 50% attenuation lung blocks used both anterior/posterior and posterior/anterior. Electron boosting was utilized for the ribs beneath the lung blocks. Occasionally, lower extremity boosting was required because of the sitting position. A dose of 14 Gy was chosen since T-lymphocyte deplete bone marrow transplant data suggest the need for higher total doses to consistently obtain engraftment. This dose was given in 3 equal daily fractions over 3 days following conditioning chemotherapy. Six of 11 patients treated in this manner developed lethal pulmonary events. In response to the pulmonary toxicity, partial lung shielding was increased to 60% attenuation. In the next 107 patients receiving this program of total body irradiation there was a reduced incidence of fatal pulmonary events (10 cases of fatal idiopathic interstitial pneumonitis and 12 cases of fatal pulmonary infections) after a median follow-up of 9 months. This was an obvious improvement over the initial group. A significant level of hepato-renal toxicity was also observed with 14 Gy total body irradiation when no liver or kidney blocking was used. Of the first 20 patients treated, three cases of fatal veno-occlusive disease resulted. Subsequently, a 10% attenuation right sided liver block was added. Five of 98 patients treated with this block have developed fatal hepatic dysfunction, (median follow-up of 7.2 months)

  6. Survival and Neurocognitive Outcomes After Cranial or Craniospinal Irradiation Plus Total-Body Irradiation Before Stem Cell Transplantation in Pediatric Leukemia Patients With Central Nervous System Involvement

    Energy Technology Data Exchange (ETDEWEB)

    Hiniker, Susan M. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Agarwal, Rajni [Section of Stem Cell Transplantation, Department of Pediatrics, Stanford University, Stanford, California (United States); Modlin, Leslie A. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Gray, Christine C. [Division of Child and Adolescent Psychiatry, Department of Psychiatry, Stanford University, Stanford, California (United States); Harris, Jeremy P.; Million, Lynn [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Kiamanesh, Eileen F. [Cancer Clinical Trials Office, Stanford Cancer Institute, Stanford University, Stanford, California (United States); Donaldson, Sarah S., E-mail: sarah2@stanford.edu [Department of Radiation Oncology, Stanford University, Stanford, California (United States)

    2014-05-01

    Purpose: To evaluate survival and neurocognitive outcomes in pediatric acute lymphoblastic leukemia (ALL) patients with central nervous system (CNS) involvement treated according to an institutional protocol with stem cell transplantation (SCT) and a component of craniospinal irradiation (CSI) in addition to total-body irradiation (TBI) as preparative regimen. Methods and Materials: Forty-one pediatric ALL patients underwent SCT with TBI and received additional cranial irradiation or CSI because of CNS leukemic involvement. Prospective neurocognitive testing was performed before and after SCT in a subset of patients. Cox regression models were used to determine associations of patient and disease characteristics and treatment methods with outcomes. Results: All patients received a cranial radiation boost; median total cranial dose was 24 Gy. Eighteen patients (44%) received a spinal boost; median total spinal dose for these patients was 18 Gy. Five-year disease-free survival (DFS) for all patients was 67%. Those receiving CSI had a trend toward superior DFS compared with those receiving a cranial boost alone (hazard ratio 3.23, P=.14). Patients with isolated CNS disease before SCT had a trend toward superior DFS (hazard ratio 3.64, P=.11, 5-year DFS 74%) compared with those with combined CNS and bone marrow disease (5-year DFS 59%). Neurocognitive testing revealed a mean post-SCT overall intelligence quotient of 103.7 at 4.4 years. Relative deficiencies in processing speed and/or working memory were noted in 6 of 16 tested patients (38%). Pre- and post-SCT neurocognitive testing revealed no significant change in intelligence quotient (mean increase +4.7 points). At a mean of 12.5 years after transplant, 11 of 13 long-term survivors (85%) had completed at least some coursework at a 2- or 4-year college. Conclusion: The addition of CSI to TBI before SCT in pediatric ALL with CNS involvement is effective and well-tolerated. Craniospinal irradiation plus TBI is worthy

  7. Survival and Neurocognitive Outcomes After Cranial or Craniospinal Irradiation Plus Total-Body Irradiation Before Stem Cell Transplantation in Pediatric Leukemia Patients With Central Nervous System Involvement

    International Nuclear Information System (INIS)

    Purpose: To evaluate survival and neurocognitive outcomes in pediatric acute lymphoblastic leukemia (ALL) patients with central nervous system (CNS) involvement treated according to an institutional protocol with stem cell transplantation (SCT) and a component of craniospinal irradiation (CSI) in addition to total-body irradiation (TBI) as preparative regimen. Methods and Materials: Forty-one pediatric ALL patients underwent SCT with TBI and received additional cranial irradiation or CSI because of CNS leukemic involvement. Prospective neurocognitive testing was performed before and after SCT in a subset of patients. Cox regression models were used to determine associations of patient and disease characteristics and treatment methods with outcomes. Results: All patients received a cranial radiation boost; median total cranial dose was 24 Gy. Eighteen patients (44%) received a spinal boost; median total spinal dose for these patients was 18 Gy. Five-year disease-free survival (DFS) for all patients was 67%. Those receiving CSI had a trend toward superior DFS compared with those receiving a cranial boost alone (hazard ratio 3.23, P=.14). Patients with isolated CNS disease before SCT had a trend toward superior DFS (hazard ratio 3.64, P=.11, 5-year DFS 74%) compared with those with combined CNS and bone marrow disease (5-year DFS 59%). Neurocognitive testing revealed a mean post-SCT overall intelligence quotient of 103.7 at 4.4 years. Relative deficiencies in processing speed and/or working memory were noted in 6 of 16 tested patients (38%). Pre- and post-SCT neurocognitive testing revealed no significant change in intelligence quotient (mean increase +4.7 points). At a mean of 12.5 years after transplant, 11 of 13 long-term survivors (85%) had completed at least some coursework at a 2- or 4-year college. Conclusion: The addition of CSI to TBI before SCT in pediatric ALL with CNS involvement is effective and well-tolerated. Craniospinal irradiation plus TBI is worthy

  8. Incidence of interstitial pneumonia after hyperfractionated total body irradiation before autologous bone marrow/stem cell transplantation

    International Nuclear Information System (INIS)

    Purpose/Objectives Interstitial pneumonia (IP) is a severe complication after allogenic bone marrow transplantation (BMT) with incidence rates between 10 % and 40 % in different series. It is a polyetiologic disease that occurs depending on age, graft vs. host disease (GvHD), CMV-status, total body irradiation (TBI) and immunosuppressive therapy after BMT. The effects of fractionation and dose rate are not entirely clear. This study evaluates the incidence of lethal IP after hyperfractionated TBI for autologous BMT or stem cell transplantation. Materials and Methods Between 1982 and 1992, 182 patients (60 % male, 40 % female) were treated with hyperfractionated total body irradiation (TBI) before autologous bone marrow transplantation. Main indications were leukemias and lymphomas (53 % AML, 21 % ALL, 22 % NHL, 4 % others) Median age was 30 ys (15 - 55 ys). A total dose of 14.4 Gy was applied using lung blocks (12 fractions of 1.2 Gy in 4 days, dose rate 7-18 cGy/min, lung dose 9 - 9.5 Gy). TBI was followed by cyclophosphamide (200 mg/kg). 72 % were treated with bone marrow transplantation, 28 % were treated with stem cell transplantation. Interstitial pneumonia was diagnosed clinically, radiologically and by autopsy. Results 4 patients died most likely of interstitial pneumonia. For another 12 patients interstitial pneumonia was not the most likely cause of death but could not be excluded. Thus, the incidence of lethal IP was at least 2.2 % but certainly below 8.8 %. Conclusion Lethal interstitial pneumonia is a rare complication after total body irradiation before autologous bone marrow transplantation in this large, homogeously treated series. In the autologous setting, total doses of 14.4 Gy can be applied with a low risk for developing interstitial pneumonia if hyperfractionation and lung blocks are used. This falls in line with data from series with identical twins or t-cell depleted marrow and smaller, less homogeneous autologous transplant studies. Thus

  9. CD154 blockade and donor-specific transfusions in DLA-identical marrow transplantation in dogs conditioned with 1-Gy total body irradiation.

    Science.gov (United States)

    Jochum, Christoph; Beste, Mechthild; Zellmer, Eustacia; Graves, Scott S; Storb, Rainer

    2007-02-01

    Stable mixed donor/host chimerism has been reliably established in dogs given a sublethal dose (2 Gy) of total body irradiation (TBI) before and immunosuppression with mycophenolate mofetil (MMF) or rapamycin combined with cyclosporine (CSP) after marrow transplantation from dog leukocyte antigen (DLA)-identical littermates (hematopoietic cell transplantation [HCT]). When TBI was reduced to 1 Gy, only transient engraftment was observed. Here we investigated whether stable engraftment after 1-Gy TBI could be accomplished by reducing host-versus-donor immune responsiveness through preceding CD154 blockade and infusion of donor peripheral blood mononuclear cells (PBMCs). We found that the anti-human CD154 antibody, 5c8, cross-reacted with canine lymphocytes and blocked alloimmune responses in vitro. Based on pharmacokinetic studies, 6 dogs received a single intravenous injection of 5 mg/kg anti-CD154 antibody (on day -5), followed 1 day later by donor PBMCs. On day 0, the dogs were given 1 Gy of TBI and underwent DLA-identical marrow grafts. Postgraft immunosuppression consisted of MMF and CSP. All 6 dogs demonstrated initial engraftment; 3 dogs sustained the engraftment for >26 weeks, whereas 3 dogs rejected their grafts, after 9, 22, and 24 weeks, and survived with autologous recovery. Graft survival was significantly improved over that in 11 historical controls conditioned with 1-Gy TBI and given either MMF or rapamycin with CSP after HCT, all of which rejected their grafts between 3 and 12 weeks (P = .03). Preceding donor PBMC infusion and CD154 blockade improved survival of DLA-identical marrow grafts after 1-Gy TBI. PMID:17241922

  10. Cataract-free interval and severity of cataract after total body irradiation and bone marrow transplantation: influence of treatment parameters

    International Nuclear Information System (INIS)

    Purpose: To determine prospectively the cataract-free interval (latency time) after total body irradiation (TBI) and bone marrow transplantation (BMT) and to assess accurately the final severity of the cataract. Methods and Materials: Ninety-three of the patients who received TBI as a part of their conditioning regimen for BMT between 1982 and 1995 were followed with respect to cataract formation. Included were only patients who had a follow-up period of at least 23 months. TBI was applied in one fraction of 8 Gy or two fractions of 5 or 6 Gy. Cataract-free period was assessed and in 56 patients, who could be followed until stabilization of the cataract had occurred, final severity of the cataract was determined using a classification system. With respect to final severity, two groups were analyzed: subclinical low-grade cataract and high-grade cataract. Cataract-free period and final severity were determined with respect to type of transplantation, TBI dose, and posttransplant variables such as graft versus host disease (GVHD) and steroid treatment. Results: Cataract incidence of the analyzed patients was 89%. Median time to develop a cataract was 58 months for autologous transplanted patients. For allogeneic transplanted patients treated or not treated with steroids, median times were 33 and 46 months, respectively. Final severity was not significantly different for autologous or allogeneic patients. In allogeneic patients, however, final severity was significantly different for patients who had or had not been treated with steroids for GVHD: 93% versus 35% high-grade cataract, respectively. Final severity was also different for patients receiving 1 x 8 or 2 x 5 Gy TBI, from patients receiving 2 x 6 Gy as conditioning therapy: 33% versus 79% high-grade cataract, respectively. The group of patients receiving 2 x 6 Gy comprised, however, more patients with steroid treatment for GVHD. So the high percentage of high-grade cataract in the 2 x 6 Gy group might also

  11. Enhancement of distribution of dermal multipotent stem cells to bone marrow in rats of total body irradiation by platelet-derived growth factor-AA treatment

    International Nuclear Information System (INIS)

    Objective: To observe whether dermal multipotent stem cells (dMSCs) treated with platelet-derived growth factor-AA (PDGF-AA) could distribute more frequently to the bone marrow in rats of total body irradiation (TBI). Methods: Male dMSCs were isolated and 10 μg/L PDGF-AA was added to the culture medium and further cultured for 2 h. Then the expression of tenascin-C were examined by Western blot, and the migration ability of dMSCs was assessed in transwell chamber. The pre-treated dMSCs were transplanted by tail vein injection into female rats administered with total body irradiation, and 2 weeks after transplantation, real-time PCR was employed to measure the amount of dMSCs in bone marrow. Non-treated dMSCs served as control.Results PDGF-AA treatment increased the expression of tenascin-C in dMSCs, made (1.79 ± 0.13) × 105 cells migrate to the lower chamber under the effect of bone marrow extract, and distributed to bone marrow in TBI rats, significantly more than (1.24 ± 0.09) ×105 in non-treated dMSCs (t=8.833, P<0.01). Conclusions: PDGF-AA treatment could enhance the migration ability of dMSCs and increase the amount of dMSCs in bone marrow of TBI rats after transplantation. (authors)

  12. The influence of x-ray energy on lung dose uniformity in total-body irradiation

    International Nuclear Information System (INIS)

    Purpose: In this study we examine the influence of x-ray energy on the uniformity of the dose within the lung in total-body irradiation treatments in which partial transmission blocks are used to control the lung dose. Methods and Materials: A solid water phantom with a cork insert to simulate a lung was irradiated by x-rays with energies of either 6, 10, or 18 MV. The source to phantom distance was 3.9 meters. The cork insert was either 10 cm wide or 6 cm wide. Partial transmission blocks with transmission factors of 50% were placed anterior to the cork insert. The blocks were either 8 or 4 cm in width. Kodak XV-2 film was placed in the midline of the phantom to record the dose. Midplane dose profiles were measured with a densitometer. Results: For the 10 cm wide cork insert the uniformity of the dose over 80% of the block width varied from 6.6% for the 6 MV x-rays to 12.2% for the 18 MV x-rays. For the 6 cm wide cork insert the uniformity was comparable for all three x-ray energies, but for 18 MV the central dose increased by 9.4% compared to the 10 cm wide insert. Conclusion: Many factors must be considered in optimizing the dose for total-body irradiation. This study suggests that for AP/PA techniques lung dose uniformity is superior with 6 MV irradiation. The blanket recommendation that the highest x-ray energy be used in TBI is not valid for all situations

  13. Total body irradiation: current indications; L`irradiation corporelle totale: les indications actuelles

    Energy Technology Data Exchange (ETDEWEB)

    Giraud, P.; Danhier, S.; Dubray, B.; Cosset, J.M. [Institut Curie, 75 - Paris (France)

    1998-05-01

    The choice of dose and fractionation for total body irradiation is made difficult by the large number of considerations to be taken into account. The outcome of bone marrow transplantation after total body irradiation can be understood in terms of tumor cell killing, engraftment, and normal tissue damage, each of these endpoints being influenced by irradiation-, disease-, transplant-, and patient- related factors. Interpretation of clinical data is further hampered by the overwhelming influence of logistic constraints, the small numbers of randomized studies, and the concomitant variations in total dose and fraction size or dose rate. So far, three cautious conclusions can be drawn in order to tentatively adapt the total body irradiation schedule to clinically-relevant situations. Firstly, the organs at risk for normal tissue damage (lung, liver, lens, kidney) are protected by delivering small doses per fraction at low dose rate. This suggests that, when toxicity is at stake (e.g. in children), fractionated irradiation should be preferred, provided that inter-fraction intervals are long enough. Secondly, fractionated irradiation should be avoided in case of T-cell depleted transplant, given the high risk of graft rejection in this setting. An alternative would be to increase total (or fractional) dose of fractionated total body irradiation, but this approach is likely to induce more normal tissue toxicity. Thirdly, clinical data have shown higher relapse rates in chronic myeloid leukemia after fractionated or low dose rate total body irradiation, suggesting that fractionated irradiation should not be recommended, unless total (or fractional) dose is increased. Total body irradiation-containing regimens, primarily cyclophosphamide / total body irradiation, are either equivalent to or better than the chemotherapy-only regimens, primarily busulfan / cyclophosphamide. Busulfan / cyclophosphamide certainly represents a reasonable alternative, especially in patients who

  14. Total body irradiation prior to bone marrow transplantation: efficacy and safety of granisetron in the prophylaxis and control of radiation-induced emesis

    International Nuclear Information System (INIS)

    Purpose: Radiation-induced emisis is one of the most disturbing side effects of total body irradiation (TBI). To evaluate the efficacy and to determine the best schedule of granisetron (a selective 5-hydroxytryptamine3 serotonin receptor antagonist) administration in the prevention of radiation-induced nausea and vomiting, we conducted a trial involving patients receiving single-dose TBI before bone marrow transplantation (BMT). Methods and Materials: Thirty-six patients with non-Hodgkin's lymphoma (n 12), multiple myeloma (n = 8), acute lymphoblastic leukemia (n = 7), acute nonlymphoblastic leukemia (n = 6), and chronic myeloid leukemia (n = 3) referred to our department between March 1992 and February 1994 were enrolled in this study to assess the efficacy of granisetron during single-dose TBI before autologous BMT (n = 26), allogeneic BMT (n = 8), or syngeneic BMT (n 2). The male-to-female ratio was 22:14 (1.57), and the mean age was 41 ± 11 years (range 16-58). Before TBI, conditioning chemotherapy consisted of cyclophosphamide (CY) alone (60 mg/kg per day on 2 successive days) in 24 patients, CY combined with other drugs in 6, and combinations without CY in 6. All patients received single-dose TBI (10 Gy administered to the midplane at L4, and 8 Gy to the lungs). The mean instantaneous and average dose rates were 0.039 ± 0.012 Gy/min (range 0.031-0.058), and 0.025-0.006 Gy/min (range 2.08-3.96), respectively. Granisetron was administered 30-45 min before TBI according to two different modalities: a total dose of 3 mg as a 5-min intravenous (i.v.) infusion (Treatment A, n = 15; 42%) or the same treatment plus 3 mg of granisetron as a 24-h continuous i.v. infusion (total dose: 6 mg, Treatment B, n = 21; 58%). Depending on the BMT teams, hyper diuresis was continued (n = 19, 53%) or suspended (n = 17, 47%) during TBI. Nausea and vomiting were assessed during the TBI session and the following 12 h, and were scored as follows: S1 = no nausea or vomiting; S2

  15. Investigation of immunological approaches to enhance engraftment in a 1 Gy TBI canine haematopoietic stem cell transplantation model

    Science.gov (United States)

    Lange, Sandra; Altmann, Simone; Brandt, Bettina; Adam, Carsten; Riebau, Franziska; Vogel, Heike; Weirich, Volker; Hilgendorf, Inken; Storb, Rainer; Freund, Mathias; Junghanss, Christian

    2010-01-01

    Objective Stable mixed haematopoietic chimerism can be established in a canine stem cell transplantation model using a conditioning consisting of total body irradiation (TBI, 2Gy) and postgrafting immunosuppression with mycophenolate mofetil (MMF) and cyclosporin (CSA). Reduction of TBI had resulted in graft rejection in this model previously. We investigated whether postgrafting stimulation of donor T-cells against recipient’s haematopoietic antigens or graft augmentation with donor monocyte-derived dendritic cells (MoDC) promote engraftment following 1Gy TBI. Methods All dogs received dog leukocyte-antigen-identical bone marrow transplantation. Dogs were conditioned with either 2Gy of TBI (group 1) or 1Gy of TBI followed by repetitive recipient haematopoietic cell lysate vaccinations (group 2) or graft augmentation with MoDC (group 3). Immunosuppression consisted of CSA and MMF. Results In group 1 four animals remained stable chimeras >wk110, and 3 rejected their grafts (wk10, wk14, wk16). All dogs in groups 2 and 3 rejected their graft (median: wk 10 and 11, respectively). Peak chimerism and engraftment duration was shorter in the 1Gy groups (p<0.05) compared to group 1. Conclusion Neither postgrafting vaccination nor graft augmentation with MoDC were effective in supporting durable engraftment. Additional modifications are neccessary to improve potential strategies aimed at establishment of early tissue specific graft-versus-host reactions. PMID:19100524

  16. In pediatric leukemia, dose evaluation according to the type of compensators in total body irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dong Yeon [Dongnam Inst. of Radiological and Medical science, Busan (Korea, Republic of); Kim, Chang Soo; Kim, Jung Hoon [Dept. of Radiological Science, College of Health Science, Catholic University of Busan, Busan (Korea, Republic of)

    2015-04-15

    Total body irradiation (TBI) and chemotherapy are the pre-treatment method of a stem cell transplantations of the childhood leukemia. in this study, we evaluate the Quantitative human body dose prior to the treatment. The MCNPX simulation program evaluated by changing the material of the tissue compensators with imitation material of pediatric exposure in a virtual space. As a result, first, the average skin dose with the material of the tissue compensators of Plexiglass tissue compensators is 74.60 mGy/min, Al is 73.96 mGy/min, Cu is 72.26 mGy/min and Pb 67.90 mGy/min respectively. Second, regardless of the tissue compensators material that organ dose were thyroid, gentile, digestive system, brain, lungs, kidneys higher in order. Finally, the ideal distance between body compensator and the patient were 50 cm aparting each other. In conclusion, tissue compensators Al, Cu, Pb are able to replace of the currently used in Plexiglass materials.

  17. Development of a new method of whole body irradiation

    International Nuclear Information System (INIS)

    A new method of whole body irradiation was developed using a linear accelerator linked to microprocessor. By this modified arc technique, a total body photon irradiation and a total skin electron irradiation were practical for narrow room. Approximative calculations were deviced for dose distribution. Dosimetric results were consistent with those previosly calculated. Local doses in lungs, neck and other areas were easily adjustable with arrangements of pre-set dose rate. In total skin electron irradation, six predeterminated postures and 'make up' irradiation were necessary to dose homogeneity over 'shady area' such as axillae. Clinically, a large arteriovenous malformation in an arm decreased with normalization of plethysmogram after treatment, and remarkable reductions of mycosis fungoides tumor were observed. This new method of total skin electron irradiation and total body photon therapy will clinically expand with the progress of bone marrow transplantation. (author)

  18. Comparative studies in the cellular immunostimulation by whole body irradiation

    International Nuclear Information System (INIS)

    The effect of the cellular immune response by total body irradiation was investigated. The transplant survival (skin grafts) was determined as immune parameter. Donors were colony bred Wistar rats and recipients were colony bred Sprague Dawley rats. The investigations were carried out with irradiated rats and with rats irradiated after thymectomy and/or adrenalectomy as well as with animals without irradiation. A single total-body irradiation (1 and 2 Gy) was administered. The skin graft survival in irradiated rats was significant shorter (radiogenic immunostimulation) than in unirradiated rats; there were no significant differences between the operated (thymectomy and/or adrenalectomy) and not operated animals. Including precedent examinations this radiogenic immunostimulation is caused by relativly selective inactivation of T-suppressor cells. (orig.)

  19. Total body irradiation and allogeneic bone marrow transplantation - Sofia University Hospital experience

    International Nuclear Information System (INIS)

    Aim of the study: To report the long-term outcome in patients with leukaemias, who had conditioning regimens including total body irradiation (TBI) prior to bone marrow transplantation (BMT), and to establish independent factors correlated with treatment outcome. Material and methods: Between January 2002 and December 2007, 18 patients, 11 males and 7 females with median age of 12 years (range 8-50), received TBI. Initial diagnoses were acute lymphoblastic leukaemia (ALL) 11 (61%), acute myeloid leukaemia (AML) 4 (22%), and chronic myeloid leukaemia (CML) 3 (17%). Pre-transplantation disease status was defined as remission 11 (61%), progression 4 (22%), and chronic phase 3 (17%). All the patients were conditioned with a high-dose chemoradiotherapy regimen including fractionated TBI delivering 10 to 12 Gy in 15 (73%) and a single fraction of 2 Gy in 3 (17%) of the cases. TBI was performed in alternate prone and supine positions with a 60 Co machine. In 13 (72%) patients transplantation was carried out from an HLA-identical related donor and in 5 (28%) from an unrelated donor. Seventeen allogeneic transplantations were of peripheral blood stem cells and 1 was of bone marrow stem cells. Post- transplantation clinical, biological, and functional evaluations were performed on days 30, 100, 180, at 1 year, and annually thereafter. Each evaluation included an assessment of the study end points: marrow chimerism, disease status (complete remission or relapse), survival status (alive or dead), treatment-related toxicity (TRT), treatment-related mortality (TRM) and graft-versus-host-disease (GvHD). Results: Median follow-up from BMT was 27 months (range 3-52). Sixteen patients achieved engraftment, 2 patients had primary graft failure. Seven of 18 (39%) evaluable patients developed acute GvHD, 6 (35%) patients developed chronic GvHD. At the time of reporting 9 of 18 patients remain alive and in remission. Nine patients died, 4 (22%) because of relapse and 5 (28%) because of

  20. Long-term results of total body irradiation in adults with acute lymphoblastic leukemia

    International Nuclear Information System (INIS)

    The aim of this chart review of adult patients treated for acute lymphoblastic leukemia (ALL) with total body irradiation (TBI) was to evaluate early and late toxicity and long-term outcome. A total of 110 adult patients (34 ± 12 years) with ALL underwent TBI (6 fractions of 2 Gy for a total of 12 Gy) as a part of the treatment regimen before transplantation. Treatment-related toxicity, mortality, and hematologic outcome are reported. Mean follow-up was 70 months. The 2- and 5-year leukemia-free survival rates were 78 and 72 %, respectively. In all, 29 % (32/110) patients suffered from medullary recurrence after a median time of 7 months. Gender was the only statistically significant prognostic factor in terms of overall survival in favor of female patients. Treatment-related mortality and overall survival after 2 and 5 years were 16 and 22 %, and 60 and 52.7 %, respectively. The most frequent late reaction wascGVHD of the skin (n = 33, 30 %). In addition, 15.5 % (17/110 patients) suffered pulmonary symptoms, and 6 patients developed lung fibrosis. Eyes were frequently affected by the radiation (31/110 = 28 %); 12 of 110 patients (11 %) presented with symptoms from osteoporosis, 5 of 110 patients (4.5 %) developed hypothyreosis and 2 patients diabetes mellitus. Of the male patients, 11 % reported erectile dysfunction or loss of libido, while 2 of 36 women reported menopausal syndrome at the mean time of 28 months after treatment with requirement for substitution. No women became pregnant after treatment. No acute or late cardiac toxicities were documented in our patients. No secondary malignancies were documented. Although hematologic outcome was in the upper range of that reported in the literature, treatment-related mortality (TRM) and medullary recurrences remain a challenge. Sophisticated radiation techniques allow for decreasing toxicity to certain organs and/or dose escalation to the bone marrow in highly selected patients in order to improve therapeutic

  1. Toxicities of total-body irradiation for pediatric bone marrow transplantation

    International Nuclear Information System (INIS)

    Purpose: To determine the acute and late effects, including cognitive function, of total body irradiation (TBI) and chemotherapy for bone marrow transplant (BMT) in children with immunodeficiency or hematologic disorders. Methods and Materials: At UCSF, 15 children with immunodeficiency disorders and 58 children with leukemia received chemoradiotherapy between July 1982 and November 1993 and were evaluated for toxicity. Patients with severe combined immunodeficiency disorder (SCID) received 7 Gy TBI while leukemia patients received 12 Gy TBI. Results: Eight immunodeficient patients (53%) are alive at 4 months to 11 years posttransplant. Acute toxicity was limited and treatment well tolerated. Most patients developed mild nausea and vomiting, skin rash, or erythema. Transient fever/chills, oral mucositis, and alopecia were noted in approximately 50% of patients. Seventy-three percent of patients demonstrated acute liver dysfunction, but only four (27%) developed veno-occlusive disease. All children had decreased growth velocity but normal growth hormone levels. Other endocrinologic evaluations including adrenocorticotropic hormone (ACTH), cortisol, and thyroid hormones were normal. Only one evaluable girl had delayed puberty with late onset of secondary sexual characteristics. Neuropsychological testing demonstrated an intelligence quotient (IQ) reduction between the baseline and 1 year post-BMT, with some recovery at 3 years. Only one patient developed a clinically significant cataract. Thirteen percent of patients had chronic interstitial lung disease. Four children developed exostosis. Only 1 of the 15 children developed a second malignancy (acute myelogenous leukemia) at age 5, 51 months posttransplant for SCID. For patients with leukemia, similar toxicities were observed. Twenty-nine percent disease-free survival was noted with a mean follow-up of 4.7 years. Twenty-two percent had chronic interstitial lung disease and two patients were diagnosed with cataracts

  2. TBI Symptoms, Diagnosis, Treatment, Prevention

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Cover Story: Traumatic Brain Injury TBI Symptoms, Diagnosis, Treatment, ... Prevention (CDC) urge people to always: Wear a seat belt when driving or riding in a car ...

  3. Traumatic Brain Injury Registry (TBI)

    Data.gov (United States)

    Department of Veterans Affairs — As the number of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Traumatic Brain Injury (TBI) patients has grown, so has the need to track and monitor...

  4. Autologous stem cell transplantation following high-dose whole-body irradiation of dogs - influence of cell number and fractionation regimes

    International Nuclear Information System (INIS)

    The acute radiation syndrome after a single dose of 1600 R (approx. 12-14 Gy in body midline) and after fractionated irradiation with 2400 R (approx. 18-20 Gy) was studied with regard to fractionation time and to the number of bone marrow cells infused. The acute radiation syndrome consisted of damage to the alimentary tract and of damage to the hemopoietic system. Damage of hemopoiesis was reversible in dogs which had been given a sufficient amount of hemopoietic cells. Furthermore changes in skin and in the mucous membranes occurred. Hemopoietic recovery following infusion of various amounts of bone marrow was investigated in dogs which were irradiated with 2400 R within 7 days. Repopulation of bone marrow as well as rise of leukocyte and platelet counts in the peripheral blood was taken as evidence of complete hemopoietic reconstitution. The results indicate that the acute radiation syndrom following 2400 R TBI and autologous BMT can be controlled by fractionation of this dose within 5 or 7 days. The acute gastrointestinal syndrome is aggravated by infusion of a lesser amount of hemopoietic cells. However, TBI with 2400 R does not require greater numbers of hemopoietic cells for restoration of hemopoiesis. Thus, the hemopoiesis supporting tissue can not be damage by this radiation dose to an essential degree. Longterm observations have not revealed serious late defects which could represent a contraindication to the treatment of malignent diseases with 2400 R of TBI. (orig./MG)

  5. Current status of total body irradiation in conditioning regimen for childhood acute lymphoblastic leukemia. Survey in the Japan Association of Childhood Leukemia Study (JACLS) Group

    International Nuclear Information System (INIS)

    We surveyed methods of total body irradiation (TB I) in conditioning regimens of stem cell transplantation (SCT) for children with acute lymphoblastic leukemia (ALL) at participating institutions of the Japan Association of Childhood Leukemia Study (JACLS) ALL-97 protocol. We obtained information about TBI from 25 institutions. Total dose of 12 Gy fractionated by four to six in two to three days for TBI was conducted in 22 of 25 institutions. High-risk patients, such as patients with Philadelphia positive ALL, received over 12 Gy in five institutions. Beam direction and patient's positioning were horizontal and lateral respectively in 15 institutions. Shielding of lung and/or eyes and boost irradiation to central nervous system and/or testis were done in 24 and 11 institutions respectively, but in various ways. We have to keep in mind that a great variety of TBI have been undergone in each institution when we intend to interpret multi-institutional trials of treatment including SCT for patients with ALL. (author)

  6. Addition of 10-Day Decitabine to Fludarabine/Total Body Irradiation Conditioning is Feasible and Induces Tumor-Associated Antigen-Specific T Cell Responses.

    Science.gov (United States)

    Cruijsen, Marjan; Hobo, Willemijn; van der Velden, Walter J F M; Bremmers, Manita E J; Woestenenk, Rob; Bär, Brigitte; Falkenburg, J H Frederik; Kester, Michel; Schaap, Nicolaas P M; Jansen, Joop; Blijlevens, Nicole N M; Dolstra, Harry; Huls, Gerwin

    2016-06-01

    Allogeneic hematopoietic cell transplantation (HCT) offers the possibility of curative therapy for patients with myelodysplastic syndromes (MDS), chronic myelomonocytic leukemia (CMML), and acute myelogenous leukemia (AML). However, post-HCT relapse remains a major problem, particularly in patients with high-risk cytogenetics and in patients who cannot tolerate consolidation chemotherapy (eg, due to previous toxicity). We assessed the toxicity and efficacy of 10-day decitabine (Dec), fludarabine (Flu), and 2 Gy total body irradiation (TBI) as a new conditioning regimen for allogeneic HCT in patients with MDS, CMML, or AML. Thirty patients were enrolled, including 11 with MDS, 2 with CMML, and 17 with AML. Patients received 20 mg/m(2)/day Dec on days -11 to -2, 30 mg/m(2)/day Flu on days -4 to -2, and 2 Gy TBI on day -1, followed by infusion of a donor stem cell graft on day 0. Postgrafting immunosuppression consisted of cyclosporin A and mycophenolate mofetil. At a median follow-up of 443 days, the overall survival was 53%, relapse incidence was 27%, and nonrelapse mortality was 27%. The incidence of severe acute (grade III/IV) graft-versus-host disease (GVHD) was 27%, and that of (predominantly mild) chronic GVHD was 60%. Immunomonitoring studies revealed that specific CD8(+) T cell responses against epigenetically silenced tumor-associated antigens (TAAs), including cancer-testis antigens (MAGE-A1/A2/A3 and PRAME) and RHAMM, occurred more frequently in patients who had received Dec/Flu/TBI conditioning (8 of 11 patients) compared with a control group of patients who had received only Flu/TBI conditioning (2 of 9 patients). In summary, Dec/Flu/TBI conditioning proved feasible and effective and enhanced the induction of TAA-reactive CD8(+) T cell responses in vivo, which may contribute to disease control post-transplantation. PMID:26860635

  7. Changes of pulmonary function in patients treated with bone marrow transplantation after total body irradiation

    International Nuclear Information System (INIS)

    Changes of pulmonary functions were studied with time in 10 patients who underwent bone marrow transplantation (BMT) after total body irradiation (TBI, total lung dose, 3 to 12 Gy; dose rate, 5.3 to 10.0 cGy/min). Regardless of the total lung dose and the dose rate of irradiation or the period after BMT, the percent vital capacity (%VC) and the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1.0%) were kept within normal limits, whereas the diffusion capacity of carbon monoxide (%DLco) tended to decrease within 100 days after BMT in all of our patients. From the possibility that respiratory insufficiency will rapidly occur due to infection, it seems unfavorable for the patients to return to routine life during this period after BMT, even if in states without any clinical manifestations. It was found that the %DLco began to decrease prior to the onset of interstitial pneumonia (IP) and that the degree was more marked in patients who progressed to IP than in those who did not. Therefore, it is possible to predict the occurrence of IP by frequently measuring pulmonary function. In patients with IP, the %DLco rapidly improved with steroid administration, and it tended to improve gradually even after discontinuing the administration of the drug. But regardless of the total lung dose and dose rate of irradiation, the %DLco in patients with chronic graft-versus-host disease (GVHD) did not recover completely when compared with that in patients without chronic GVHD. Thus, it is considered that this persistant pulmonary dysfunction is caused mainly by chronic GVHD rather than by irradiation. (author)

  8. Low-dose total body irradiation and G-CSF without hematopoietic stem cell support in the treatment of relapsed or refractory acute myelogenous leukemia (AML), or AML in second or subsequent remission

    International Nuclear Information System (INIS)

    Purpose: Patients with relapsed acute myelogenous leukemia (AML), who are not eligible for bone marrow transplantation, have a poor prognosis when treated with chemotherapy alone. Total body irradiation (TBI) is an effective modality against AML when used in doses of 1000-1400 cGy with hematopoietic stem cell support. We undertook a phase I study of TBI with granulocyte-colony-stimulating factor (G-CSF) support, without stem cell support in patients with AML either in relapse or second or subsequent remission. Methods and Materials: Patients with relapsed AML, or AML in second or subsequent remission were treated in a phase I study of TBI followed by G-CSF. The first dose level was 200 cGy. After the initial cohort of patients it was clear that patients with overt leukemia did not benefit from this treatment, and subsequent patients were required to be in remission at the time of TBI. Results: Eleven patients were treated, 4 in overt relapse, and 7 in remission. 200 cGy was used in all, and dose escalation was not possible due to prolonged thrombocytopenia in all patients but one. Neutrophil recovery was adequate in those patients who remained in remission after TBI. Patients with overt leukemia had transient reduction in blast counts, but rapid recurrence of their leukemia. Patients treated in remission had short remissions, with the exception of one patient who is in remission 32 months after treatment. Conclusion: There is some antileukemic effect of TBI even at 200 cGy, though this dose appears to be too low to help a significant number of patients. If TBI is to be escalated without stem cell support, then a thrombopoietic agent will need to be used

  9. The effects of single dose TBI on hepatic and renal function in non-human primates and patients

    International Nuclear Information System (INIS)

    Total body irradiation (TBI) and bone marrow transplantation (BMT) are common procedures in the treatment of severe combined immune deficiency syndromes, leukemia, non-Hodgkin lymphoma and other hematological disorders. Improved results following TBI and BMT have increased the number of patients in long term follow up. Late detrimental effects of TBI have been investigated in non-human primates and patients with emphasis on vital organs like liver and kidney. The response of monkeys to radiation is not significantly different from that in man. Long term effects of TBI could be studied by keeping 84 monkeys of different ages under continuous observation for a period up to 25 years. Effects on hepatic and renal function were demonstrated using serological and histological parameters. The values of the liver function parameters such as alkaline phosphatase and gamma glutamyl transferase in the irradiated group are significantly increased after TBI. Also the parameters of kidney dysfunction, e.g., Ht and urea show a significant change in the irradiated old aged cohort with respect to the controls. Between 1967 and 1993, 336 bone marrow transplantations were performed at the University Hospital Leiden. The present Study was restricted to those patients who survived at least 18 months after transplantation. This retrospective analysis consequently amounts to 120 patients. The monkey data indicated subclinical organ damage for postirradiation intervals exceeding 15 years. However, up to the present time, the human data do not support these findings since the follow up time is still restricted to a median survival of 4,5 years. Detrimental effects in liver and kidney function at a later stage can not be excluded yet, and careful examinations of the patients remain indicated

  10. Allogeneic marrow transplantation following cyclophosphamide and escalating doses of hyperfractionated total body irradiation in patients with advanced lymphoid malignancies: a phase I/II trial

    International Nuclear Information System (INIS)

    Purpose: To define the maximum tolerated dose (MTD) of unshielded total body irradiation (TBI) delivered from dual 60C sources at an exposure rate of 0.08 Gy/min and given in thrice daily fractions of 1.2 Gy in patients with advanced lymphoid malignancies. Methods and Materials: Forty-four patients with a median age of 28 (range 6-48) years were entered into a Phase I/II study. All patients received cyclophosphamide (CY), 120 mg/kg administered over 2 days before TBI. Marrow from human leukocyte antigen (HLA) identical siblings was infused following the last dose of TBI. An escalation-deescalation schema designed to not exceed an incidence of 25% of Grade 3-4 regimen-related toxicities (RRTs) was used. The first dose level tested was 13.2 Gy followed by 14.4 Gy. Results: None of the four patients at the dose level of 13.2 Gy developed Grade 3-4 RRT. Two of the first eight patients receiving 14.4 Gy developed Grade 3-4 RRT, establishing this as the MTD. An additional 32 patients were evaluated at the 14.4 Gy level to confirm these initial observations. Of 40 patients receiving 14.4 Gy, 13 (32.5%) developed Grade 3-4 RRTs; 46% in adults and 12% in children. The primary dose limiting toxicity was Grade 3-4 hepatic toxicity, which occurred in 12.5% of patients. Noninfectious Grade 3-4 interstitial pneumonia syndrome occurred in 5% of patients. The actuarial probabilities of event-free survival, relapse, and nonrelapse mortality at 2 years were 0.10, 0.81, and 0.47, respectively, for patients who received 14.4 Gy of TBI. Conclusions: The outcome for patients receiving 14.4 Gy of TBI was not different from previous studies of other CY and TBI regimens in patients with advanced lymphoid malignancies. These data showed that the incidence of Grade 3-4 RRTs in adults was greater than the 25% maximum set as the goal of this study, suggesting that 13.2 Gy is a more appropriate dose of TBI for adults, while 14.4 Gy is an appropriate dose for children

  11. Response of irradiated diet fed rats to whole body X irradiation

    International Nuclear Information System (INIS)

    The response to whole body X irradiation has been studied in the brain of rats fed both on a normal diet (consisting of equal parts of wheat and gram flour) and on a low protein irradiated diet (consisting of a part of normal diet and three parts of wheat). The activity of enzymes related to the glucose metabolism (glucose 6-phosphate dehydrogenase and fructose diphosphate aldolase) is reduced, while that of peroxidant enzymes (catalase and lipid peroxidase) increased in the brain of rats that received a diet poor in proteins and irradiated diets (normal or hypoproteic). DNA and RNA levels and protein content show a significant reduction in the brain of rats with hypoproteic and irradiated diets. The total body irradiation causes serious alterations in the brain in animals with a hypoproteic malnutritions due both to a low protein and an irradiated diet. The brain of rats fed on a low protein and irradiated diet exhibits after whole body irradiation damages more severe than those in rats fed on a normal irradiated diet

  12. Hyperfractionated high-dose total body irradiation in bone marrow transplantation for Ph{sup 1}-positive acute lymphoblastic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, Akira; Ebihara, Yasuhiro; Mitsui, Tetsuo [Tokyo Univ. (Japan). Hospital of the Institute of Medical Science] [and others

    1998-12-01

    In two cases of Philadelphia-positive childhood acute lymphoblastic leukemia (Ph{sup 1} ALL), we performed allogeneic bone marrow transplantation (AlloBMT) with preconditioning regimen, including hyperfractionated high-dose total body irradiation (TBI) (13.5 Gy, in 9 fractions). Their disease statuses at BMT were hematological relapse in case 1 and molecular relapse in case 2. Bone marrow donors were unrelated in case 1, and HLA was a partially mismatched mother in case 2. Regimen-related toxicity was tolerable in both cases. Hematological recovery was rapid, and engraftment was obtained on day 14 in case 1 and on day 12 in case 2. BCR/ABL message in bone marrow disappeared on day 89 in case 1 and on day 19 in case 2 and throughout their subsequent clinical courses. Although short-term MTX and Cy-A continuous infusion were used for GVHD prophylaxis, grade IV GVHD was observed in case 1 and grade III in case 2. Both cases experienced hemorrhagic cystitis because of adenovirus type 11 infection. Although case 1 died of interstitial pneumonitis on day 442, case 2 has been free of disease through day 231. AlloBMT for Ph{sup 1} ALL with preconditioning regimen including hyperfractionated high-dose TBI is considered to be worth further investigation. (author)

  13. Acute and delayed toxicities of total body irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Deeg, H.J.

    1983-12-01

    Total body irradiation is being used with increasing frequency for the treatment of lymphopoietic malignancies and in preparation for marrow transplantation. Acute toxicities include reversible gastroeneritis, mucositis, myelosuppression alopecia. As the success of treatment improves and more patients become long-term survivors, manifestations of delayed and chronic toxicity become evident. These include impairment of growth and development, gonadal failure and sterility, cataract formation and possibly secondary malignancies. The contribution of total body irradiation to the development of pneumonitis and pulmonary fibrosis is still poorly understood. Some of these changes are reversible or correctable, whereas others are permanent. Nevertheless, until equally effective but less toxic regimens become available, total body irradiation appears to be the treatment of choice to prepare patients with leukemia for marrow transplantation.

  14. Acute and delayed toxicities of total body irradiation

    International Nuclear Information System (INIS)

    Total body irradiation is being used with increasing frequency for the treatment of lymphopoietic malignancies and in preparation for marrow transplantation. Acute toxicities include reversible gastroeneritis, mucositis, myelosuppression alopecia. As the success of treatment improves and more patients become long-term survivors, manifestations of delayed and chronic toxicity become evident. These include impairment of growth and development, gonadal failure and sterility, cataract formation and possibly secondary malignancies. The contribution of total body irradiation to the development of pneumonitis and pulmonary fibrosis is still poorly understood. Some of these changes are reversible or correctable, whereas others are permanent. Nevertheless, until equally effective but less toxic regimens become available, total body irradiation appears to be the treatment of choice to prepare patients with leukemia for marrow transplantation

  15. Late complications following total-body irradiation and bone marrow rescue in mice: predominance of glomerular nephropathy and hemolytic anemia

    International Nuclear Information System (INIS)

    Late mortality and pathology were assessed in various mouse strains following total-body irradiation (TBI) and bone marrow transplantation. Long-term survival data revealed both radiation dose- and strain-dependent onset of mortality between 1 and 2 years post-treatment. Renal damage appeared to have contributed to the late mortality in most treatment groups as shown by glomerular lesions, elevated blood urea nitrogen and an accompanying fall in hematocrit. Hemolysis was deduced to be the major cause of anemia, as concluded from results of 51Cr-labeled erythrocyte survival. No decrease in erythropoiesis was evident as seen from spleen and bone marrow 59Fe uptake. These findings are together consistent with the manifestation of a hemolytic uremic syndrome (HUS) with kidney glomeruli representing the principal sites of injury responsible for both renal dysfunction and microangiopathic hemolysis. (author)

  16. Poster — Thur Eve — 38: Feasibility of a Table-Top Total Body Irradiation Technique using Robotic Couch Motion

    International Nuclear Information System (INIS)

    Purpose: To develop and test the feasibility of a table-top implementation for total body irradiation (TBI) via robotic couch motion and coordinated monitor unit modulation on a standard C-arm linac geometry. Methods: To allow for collision free delivery and to maximize the effective field size, the couch was rotated to 270° IEC and dropped to 150 cm from the vertical radiation source. The robotic delivery was programmed using the TrueBeam STx Developer Mode using custom XML scripting. To assess the dosimetry of a sliding 30×20 cm2 field, irradiation on a solid water phantom of varying thickness was analyzed using EDR2 radiographic film and OSLDs. Beam modulation was achieved by dividing the couch path into multiple segments of varying dose rates and couch speeds in order to deliver 120 cGy to the midline. Results: The programmed irradiation in conjunction with coordinated couch motion was successfully delivered on a TrueBeam linac. When no beam modulation was employed, the dose difference between two different phantom sections was 17.0%. With simple beam modulation via changing dose rates and couch speeds, the desired prescription dose can be achieved at the centre of each phantom section within 1.9%. However, dose deviation at the junction was 9.2% due to the nonphysical change in the phantom thickness. Conclusions: The feasibility of robotic table-top TBI on a C-arm linac geometry was experimentally demonstrated. To achieve a more uniform dose distribution, inverse-planning allowing for a combination of dose rate modulation, jaw tracking and MLC motion is under investigation

  17. Poster — Thur Eve — 38: Feasibility of a Table-Top Total Body Irradiation Technique using Robotic Couch Motion

    Energy Technology Data Exchange (ETDEWEB)

    Chin, Erika; Otto, Karl; Hoppe, Richard; Hsu, Annie; Loo, Billy; Million, Lynn; Xing, Lei; Fahimian, Benjamin [Department of Radiation Oncology, Stanford University (United States)

    2014-08-15

    Purpose: To develop and test the feasibility of a table-top implementation for total body irradiation (TBI) via robotic couch motion and coordinated monitor unit modulation on a standard C-arm linac geometry. Methods: To allow for collision free delivery and to maximize the effective field size, the couch was rotated to 270° IEC and dropped to 150 cm from the vertical radiation source. The robotic delivery was programmed using the TrueBeam STx Developer Mode using custom XML scripting. To assess the dosimetry of a sliding 30×20 cm{sup 2} field, irradiation on a solid water phantom of varying thickness was analyzed using EDR2 radiographic film and OSLDs. Beam modulation was achieved by dividing the couch path into multiple segments of varying dose rates and couch speeds in order to deliver 120 cGy to the midline. Results: The programmed irradiation in conjunction with coordinated couch motion was successfully delivered on a TrueBeam linac. When no beam modulation was employed, the dose difference between two different phantom sections was 17.0%. With simple beam modulation via changing dose rates and couch speeds, the desired prescription dose can be achieved at the centre of each phantom section within 1.9%. However, dose deviation at the junction was 9.2% due to the nonphysical change in the phantom thickness. Conclusions: The feasibility of robotic table-top TBI on a C-arm linac geometry was experimentally demonstrated. To achieve a more uniform dose distribution, inverse-planning allowing for a combination of dose rate modulation, jaw tracking and MLC motion is under investigation.

  18. Benefits of online in vivo dosimetry for single-fraction total body irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Eaton, David J., E-mail: davideaton@nhs.net [Department of Radiotherapy, Royal Free Hospital, London (United Kingdom); Warry, Alison J. [Department of Radiotherapy Physics, University College London Hospital, London (United Kingdom); Trimble, Rachel E.; Vilarino-Varela, Maria J.; Collis, Christopher H. [Department of Radiotherapy, Royal Free Hospital, London (United Kingdom)

    2014-01-01

    Use of a patient test dose before single-fraction total body irradiation (TBI) allows review of in vivo dosimetry and modification of the main treatment setup. However, use of computed tomography (CT) planning and online in vivo dosimetry may reduce the need for this additional step. Patients were treated using a supine CT-planned extended source-to-surface distance (SSD) technique with lead compensators and bolus. In vivo dosimetry was performed using thermoluminescent dosimeters (TLDs) and diodes at 10 representative anatomical locations, for both a 0.1-Gy test dose and the treatment dose. In total, 28 patients were treated between April 2007 and July 2013, with changes made in 10 cases (36%) following test dose results. Overall, 98.1% of measured in vivo treatment doses were within 10% of the prescribed dose, compared with 97.0% of test dose readings. Changes made following the test dose could have been applied during the single-fraction treatment itself, assuming that the dose was delivered in subportions and online in vivo dosimetry was available for all clinically important anatomical sites. This alleviates the need for a test dose, saving considerable time and resources.

  19. Radiation damage in patients treated by total-body irradiation, bone marrow grafting, and cyclosporin

    International Nuclear Information System (INIS)

    The bone marrow (BM) and peripheral blood (PB) from 63 patients were assessed for the presence of chromosomal aberrations after bone marrow transplantation (BMT) following total body irradiation (TBI) for leukemia. Forty-one patients showed no abnormalities in either BM or PB, and 22 had aberrations in either BM or PB or both. Only stable aberrations were found in the BM, but both stable and unstable abnormalities were present in the PB, the majority showing only unstable aberrations. Among the 25 patients who had a leukemic relapse, clonal chromosomal abnormalities were found in the BM of 12 out of the 16 cases for whom marrow was studied at the time of the relapse. A statistically significant negative correlation between leukemic relapse and graft versus host disease (GvHD) was found, but the relationships between chromosome damage and leukemic relapse, GvHD, and the pretransplant radiation dose and between the radiation dose and both leukemic relapse and GvHD were not significant

  20. Interstitial pneumonitis following total body irradiation for bone marrow transplantation using two different dose rates

    International Nuclear Information System (INIS)

    A total of 22 patients with leukemia have undergone allogeneic bone marrow transplantation (BMT) by the Quebec Co-operative Group for Marrow Transplantation from 1980 to 1982. All patients received 900 cGy total body irradiation (TBI), in a single fraction, on the day preceding BMT. The first 11 patients were treated on a cobalt unit at a constant dose rate of 4.7 to 6.3 cGy/min. Six of these patients developed interstitial pneumonitis (IP). The clinical course of three patients, two with idiopathic and one with drug-induced pneumonitis, was mild and recovery was complete in all. The other three patients developed severe infectious IP and two died. The next 11 patients were treated with a sweeping beam technique on a 4 MV linear accelerator delivering a total tumor dose of 900 cGy at an average dose rate of 6.0 to 6.5 cGy/min but an instantaneous dose rate of 21.0 to 23.5 cGy/min. Eight patients developed severe IP. Five of these were idiopathic and four died. Three were infectious and all died. The fatality of interstitial pneumonitis appeared to be greater in the group treated with the sweeping beam technique

  1. Calibration of semiconductors diodes for in vivo dosimetry in total body irradiation treatments; Calibracao de diodos semicondutores para dosimetria in vivo em tratamentos de irradiacao de corpo inteiro

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Fernanda F.; Costa, Alessandro M.; Ghilardi Netto, Thomaz, E-mail: ferretti.oliveira@gmail.com [Universidade de Sao Paulo (FFCLRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Ciencias e Letras. Departamento de Fisica; Amaral, Leonardo L. [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Hospital das Clinicas. Servico de Radioterapia

    2012-08-15

    This paper presents the results of in vivo dosimetry with p-type semiconductors diodes, EDP-15 (Scanditronix Wellhoefer) of two patients who underwent total body irradiation treatments, at Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto University of Sao Paulo (HCFMRP-USP). The diodes were well calibrated and the calibration factors were determined with the aid of a reference ionization chamber (FC065, IBA dosimetry, sensitive volume of 0.65 cm{sup 3}).The calibration was performed in a Total Body Irradiation (TBI) setup, using solid water phantoms. Different lateral thicknesses from one patient were simulated and then the calibration factors were determined by means of maximum depth dose readings (half of the lateral thickness). The response difference between diode readings and the prescribed dose for both treatments was below 4%. This difference is in agreement as recommended by International Commission on Radiation Units (ICRU), which is {+-}5%. (author)

  2. Total-body irradiation and cataract incidence: A randomized comparison of two instantaneous dose rates

    International Nuclear Information System (INIS)

    To assess the influence of instantaneous total-body irradiation dose rate in hematological malignancies, the authors randomized 157 patients according to different instantaneous dose rates. Patients have undergone a total-body irradiation before bone-marrow transplantation according to two different techniques: Either in one fraction (1000 cGy given to the midplane at the level of L4, and 800 cGy to the lungs) or in six fractions (1200 cGy over 3 consecutive days to the midplane at the level of L4, and 900 cGy to the lungs). Patients were randomized according to two instantaneous dose rates, called LOW and HIGH, in single-dose (6 vs. 15 cGy/min) and fractionated (3 vs. 6 cGy/min) TBI groups; there were 77 cases for the LOW and 80 for the HIGH groups, with 57 patients receiving single-dose (28 LOW, 29 HIGH) and 100 patients receiving fractionated total-body irradiation (49 LOW, 51 HIGH). As of July 1992, 16 of 157 patients developed cataracts after 17 to 46 months, with an estimated incidence of 23% at 5 years. Four of 77 patients in the LOW group, 12 of 80 patients in the HIGH group developed cataracts, with 5-year estimated incidences of 12% and 34%, respectively. Ten of 57 patients in the single-dose group, and 6 of 100 patients in the fractionated group developed cataracts, with 5-year estimated incidences of 39% and 13%, respectively. When the subgroups were considered, in the single-dose group, 3 of 28 LOW patients, and 7 of 29 HIGH patients developed cataracts, with 5-year estimated incidences of 24% and 53%, respectively; in the fractionated group, 1 of 49 LOW patients, and 5 of 51 HIGH patients developed cataracts, with 5-year estimated incidences of 4% and 22%, respectively. There was no statistically significant difference in terms of 5-year estimated cataract incidence between the patients receiving steroids and those not. The instantaneous dose rate was the only independent factor influencing the cataractogenesis. 18 refs., 5 figs., 1 tab

  3. Acute Radiation Syndrome Severity Score System in Mouse Total-Body Irradiation Model.

    Science.gov (United States)

    Ossetrova, Natalia I; Ney, Patrick H; Condliffe, Donald P; Krasnopolsky, Katya; Hieber, Kevin P

    2016-08-01

    Radiation accidents or terrorist attacks can result in serious consequences for the civilian population and for military personnel responding to such emergencies. The early medical management situation requires quantitative indications for early initiation of cytokine therapy in individuals exposed to life-threatening radiation doses and effective triage tools for first responders in mass-casualty radiological incidents. Previously established animal (Mus musculus, Macaca mulatta) total-body irradiation (γ-exposure) models have evaluated a panel of radiation-responsive proteins that, together with peripheral blood cell counts, create a multiparametic dose-predictive algorithm with a threshold for detection of ~1 Gy from 1 to 7 d after exposure as well as demonstrate the acute radiation syndrome severity score systems created similar to the Medical Treatment Protocols for Radiation Accident Victims developed by Fliedner and colleagues. The authors present a further demonstration of the acute radiation sickness severity score system in a mouse (CD2F1, males) TBI model (1-14 Gy, Co γ-rays at 0.6 Gy min) based on multiple biodosimetric endpoints. This includes the acute radiation sickness severity Observational Grading System, survival rate, weight changes, temperature, peripheral blood cell counts and radiation-responsive protein expression profile: Flt-3 ligand, interleukin 6, granulocyte-colony stimulating factor, thrombopoietin, erythropoietin, and serum amyloid A. Results show that use of the multiple-parameter severity score system facilitates identification of animals requiring enhanced monitoring after irradiation and that proteomics are a complementary approach to conventional biodosimetry for early assessment of radiation exposure, enhancing accuracy and discrimination index for acute radiation sickness response categories and early prediction of outcome. PMID:27356057

  4. Abrogation of bone marrow allograft resistance in mice by increased total body irradiation correlates with eradication of host clonable T cells and alloreactive cytotoxic precursors

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, E.; Lapidot, T.; Gozes, D.; Singer, T.S.; Reisner, Y.

    1987-01-15

    Host-vs-graft activity presents a major obstacle for transplantation of T cell-depleted bone marrow in HLA-mismatched patients. In a primate model, conditioned exactly like leukemia patients, it was shown that residual host clonable T cells, as well as alloreactive cytotoxic precursors, were present in peripheral blood and spleen after completion of cytoreduction. We have now extended this study in a mouse model for allogeneic bone marrow transplantation. C/sub 3/H/HeJ mice were treated by 9 Gy total body irradiation (TBI), and 24 hr later their spleen cells were cultured in the presence of T cell growth factor and phytohemagglutinin according to the limit dilution procedure. After 7 days of culture the average frequency of clonable cells was 2.5 X 10(-3) compared with 37 X 10(-3) in the spleens of normal mice. The T cell derivation of the growing cells was ascertained by complement-mediated cytotoxicity with anti-Thy-1 as well as with anti-Lyt-2 and anti-Ly-3T4. In parallel, we found that the initial engraftment rate of bone marrow allograft in mice given 9 Gy TBI was lower than that found in recipients of syngeneic marrow. The initial engraftment rate was measured by the number of colony-forming units in the spleen and by splenic uptake of /sup 125/IUdR. A slight increase in TBI from 9 Gy to 11 Gy markedly reduced the difference in the number of spleen colony-forming units or the IUdR uptake between recipients of allogeneic and syngeneic bone marrow. This increase in TBI also coincided with eradication of detectable clonable T cells. Moreover, in mice transplanted with T cell-depleted bone marrow after 9 Gy TBI, we also demonstrate that cytotoxicity against donor-type target cells is present in the spleen 10 to 14 days posttransplantation, whereas in mice treated by 11 Gy TBI such alloreactivity could not be detected.

  5. Abrogation of bone marrow allograft resistance in mice by increased total body irradiation correlates with eradication of host clonable T cells and alloreactive cytotoxic precursors

    International Nuclear Information System (INIS)

    Host-vs-graft activity presents a major obstacle for transplantation of T cell-depleted bone marrow in HLA-mismatched patients. In a primate model, conditioned exactly like leukemia patients, it was shown that residual host clonable T cells, as well as alloreactive cytotoxic precursors, were present in peripheral blood and spleen after completion of cytoreduction. We have now extended this study in a mouse model for allogeneic bone marrow transplantation. C3H/HeJ mice were treated by 9 Gy total body irradiation (TBI), and 24 hr later their spleen cells were cultured in the presence of T cell growth factor and phytohemagglutinin according to the limit dilution procedure. After 7 days of culture the average frequency of clonable cells was 2.5 X 10(-3) compared with 37 X 10(-3) in the spleens of normal mice. The T cell derivation of the growing cells was ascertained by complement-mediated cytotoxicity with anti-Thy-1 as well as with anti-Lyt-2 and anti-Ly-3T4. In parallel, we found that the initial engraftment rate of bone marrow allograft in mice given 9 Gy TBI was lower than that found in recipients of syngeneic marrow. The initial engraftment rate was measured by the number of colony-forming units in the spleen and by splenic uptake of 125IUdR. A slight increase in TBI from 9 Gy to 11 Gy markedly reduced the difference in the number of spleen colony-forming units or the IUdR uptake between recipients of allogeneic and syngeneic bone marrow. This increase in TBI also coincided with eradication of detectable clonable T cells. Moreover, in mice transplanted with T cell-depleted bone marrow after 9 Gy TBI, we also demonstrate that cytotoxicity against donor-type target cells is present in the spleen 10 to 14 days posttransplantation, whereas in mice treated by 11 Gy TBI such alloreactivity could not be detected

  6. Late Effects of Total-Body Gamma Irradiation on Cardiac Structure and Function in Male Rhesus Macaques.

    Science.gov (United States)

    DeBo, Ryne J; Lees, Cynthia J; Dugan, Greg O; Caudell, David L; Michalson, Kris T; Hanbury, David B; Kavanagh, Kylie; Cline, J Mark; Register, Thomas C

    2016-07-01

    Heart disease is an increasingly recognized, serious late effect of radiation exposure, most notably among breast cancer and Hodgkin's disease survivors, as well as the Hiroshima and Nagasaki atomic bomb survivors. The purpose of this study was to evaluate the late effects of total-body irradiation (TBI) on cardiac morphology, function and selected circulating biomarkers in a well-established nonhuman primate model. For this study we used male rhesus macaques that were exposed to a single total-body dose of ionizing gamma radiation (6.5-8.4 Gy) 5.6-9.7 years earlier at ages ranging from ∼3-10 years old and a cohort of nonirradiated controls. Transthoracic echocardiography was performed annually for 3 years on 20 irradiated and 11 control animals. Myocardium was examined grossly and histologically, and myocardial fibrosis/collagen was assessed microscopically and by morphometric analysis of Masson's trichrome-stained sections. Serum/plasma from 27 irradiated and 13 control animals was evaluated for circulating biomarkers of cardiac damage [N-terminal pro B-type natriuretic protein (nt-proBNP) and troponin-I], inflammation (CRP, IL-6, MCP-1, sICAM) and microbial translocation [LPS-binding protein (LBP) and sCD14]. A higher prevalence of histological myocardial fibrosis was observed in the hearts obtained from the irradiated animals (9/14) relative to controls (0/3) (P = 0.04, χ(2)). Echocardiographically determined left ventricular end diastolic and systolic diameters were significantly smaller in irradiated animals (repeated measures ANOVA, P effects including a high incidence of myocardial fibrosis, reduced left ventricular diameter and elevated systemic inflammation. Additional prospective studies are required to define the time course and mechanisms underlying radiation-induced heart disease in this model. PMID:27333082

  7. A comparison of single-dose and fractionated total-body irradiation on the development of pneumonitis following bone marrow transplantation

    International Nuclear Information System (INIS)

    Purpose: A review of 132 consecutive patients who received bone marrow transplant for various malignancies was conducted to determine factors associated with increased risk in developing interstitial pneumonitis (IP) as the result of total body irradiation (TBI). Twenty-four patients were excluded because 22 did not receive TBI and two had insufficient records. Methods and Materials: Patients were conditioned with TBI and various drug regimens. Eighteen patients received a single 6.0 Gy dose of x-rays. The remaining 90 were treated with three doses of 3.33 Gy separated by 24 h. All patients were followed for at least 18 months for the purposes of determining the IP incidence. Results: Twenty-seven of there 108 (25%) patients developed IP; 19 (17.6%) died. The 2-year estimated incidence of IP was 24 and 18.6% for fatal IP. The etiology was determined to be idiopathic in 12 patients, the result of cytomegalovirus in 6 patients, and caused by a variety of other infectious organisms in 9 patients. We were unable to demonstrate a statistically significant increase in IP with age (adults vs. children), dose regimen, use of methotrexate for graft-vs.-host disease prophylaxis, the presence of acute graft-vs.-host disease, time from diagnosis to transplant, or transplant type (allogeneic vs. autologous). Conclusions: The incidence of fatal IP reported here is similar to that reported by other institutions utilizing hyperfractionated TBI protocols. Our data do not support the need for hyperfractionation to reduce the risk of IP

  8. An experimental model of acute encephalopathy after total body irradiation in the rat: effect of Ginkgo biloba extract (EGb 761); Effet de l'extrait de Ginkgo biloba (EGb 761) chez le rat sur un modele experimental d'encephalopathie aigue apres irradiation corporelle totale

    Energy Technology Data Exchange (ETDEWEB)

    Lamproglou, I.; Bok, B. [Hopital Bichat, 75 - Paris (France); Boisserie, G.; Mazeron, J.J.; Baillet, F. [Hopital Pitie-Salpetriere, 75 - Paris (France); Drieu, K. [IHB-IPSEN, 75 - Paris (France)

    2000-06-01

    To define the therapeutic effect of Ginkgo biloba extract (EGb 761) in an experimental model of acute encephalopathy following total body irradiation in rats. Ninety four-month-old rats received 4.5 Gy total body irradiation (TBI) at day 1 while 15 rats received sham irradiation. A behavioural study based on a conditioning test of negative reinforcement, the one-way avoidance test, was performed test, was performed after irradiation. Orally treatment was started one day (study A) or twenty two days (study B) after irradiation and repeated daily for twelve days. In the irradiated group, three subgroups were defined according to the treatment received: EGb 761 (50 mg/kg), EGb 761 (100 mg/kg), water. This work comprised two consecutive studies. In study A (45 rats) the one-way avoidance test was administered daily from day 7 to day 14. In study B (45 rats) the behavioural test was performed from day 28 to day 35. Study A (three groups of 15 rats): following TBI, irradiated rats treated with water demonstrated a significant delay in a learning the one-way avoidance test in comparison with sham-irradiated rats (P < 0.0002) or irradiated rats treated with EGb 761 (50 mg/kg; P < 0.007) or EGb 761 (100 mg/kg; P < 0.0002). The irradiated rats, treated with EGb 761 (50 or 100 mg/kg) did not differ from the sham-irradiated controls. Study B (three groups of 15 rats): the irradiated rats, treated with water of EGb 761 (50 or 100 mg/kg) did not differ from the sham-irradiated controls. (authors)

  9. Traumatic Brain Injury (TBI): Moderate or Severe

    Science.gov (United States)

    Traumatic Brain Injury (TBI) Moderate or Severe Definition A TBI is classified as moderate or severe when a patient experiences ... skull and enters the brain Defense and Veterans Brain Injury Center PATFIAE MN TI LSI ES Traumatic Brain ...

  10. Anti-CD3 preconditioning separates GVL from GVHD via modulating host dendritic cell and donor T-cell migration in recipients conditioned with TBI

    OpenAIRE

    Li, Nainong; Chen, Ying; He, Wei; Yi, Tangsheng; Zhao, Dongchang; Zhang, Chunyan; Lin, Chia-Lei; Todorov, Ivan; Kandeel, Fouad; Forman, Stephen; Zeng, Defu

    2009-01-01

    Host dendritic cells (DCs) play a critical role in initiating graft-versus-host disease (GVHD) and graft-versus-leukemia (GVL), and separation of GVL from GVHD remains a major challenge in the treatment of hematologic malignancies by allogeneic hematopoietic cell transplantation (HCT). Here, we show that preconditioning with anti-CD3 monoclonal antibody before conditioning with total body irradiation (TBI) prevents GVHD but retains GVL in a HCT model of major histocompatibility complex (MHC)–...

  11. Dosimetric aspects of inverse-planned modulated-arc total-body irradiation

    International Nuclear Information System (INIS)

    Purpose: To develop optimal beam parameters and to verify the dosimetric aspects of the recently developed modulated-arc total-body irradiation (MATBI) technique, which delivers an inverse-planned dose to the entire body using gantry rotation. Methods: The patient is positioned prone and supine underneath the gantry at about 2 m source-to-surface distance (SSD). Then, up to 28 beams irradiate the patient from different gantry angles. Based on full-body computed-tomography (CT) images of the patient, the weight of each beam is optimized, using inverse planning, to create a uniform body dose. This study investigates how to best simulate patients and the ideal beam setup parameters, such as field size, number of beams, and beam geometry, for treatment time and dose homogeneity. In addition, three anthropomorphic water phantoms were constructed and utilized to verify the accuracy of dose delivery, with both diode array and ion chamber measurements. Furthermore, to improve the accuracy of the new technique, a beam model is created specifically for the extended-SSD positioning for MATBI. Results: Low dose CT scans can be utilized for dose calculations without affecting the accuracy. The largest field size of 40 × 40 cm2 was found to deliver the most uniform dose in the least amount of time. Moreover, a higher number of beams improves dose homogeneity. The average dose discrepancy between ion chamber measurements and extended-SSD beam model calculations was 1.2%, with the largest discrepancy being 3.2%. This average dose discrepancy was 1.4% with the standard beam model for delivery at isocenter. Conclusions: The optimum beam setup parameters, regarding dose uniformity and treatment duration, are laid out for modulated-arc TBI. In addition, the presented dose measurements show that these treatments can be delivered accurately. These measurements also indicated that a new beam model did not significantly improve the accuracy of dose calculations. The optimum beam setup

  12. Liposomal Nanoparticles of a Spleen Tyrosine Kinase P-Site Inhibitor Amplify the Potency of Low Dose Total Body Irradiation Against Aggressive B-Precursor Leukemia and Yield Superior Survival Outcomes in Mice

    Directory of Open Access Journals (Sweden)

    Fatih M. Uckun

    2015-06-01

    Full Text Available This study was designed to improve the efficacy of radiation therapy against radiation-resistant leukemia. We report that the potency of low dose radiation therapy against B-precursor acute lymphoblastic leukemia (BPL can be markedly enhanced by combining radiation with a liposomal nanoparticle (LNP formulation of the SYK-P-site inhibitor C61 (“C61-LNP”. C61-LNP plus low dose total body irradiation (TBI was substantially more effective than TBI alone or C61-LNP alone in improving the event-free survival outcome NOD/SCID mice challenged with an otherwise invariably fatal dose of human ALL xenograft cells derived from relapsed BPL patients. C61-LNP plus low dose TBI also yielded progression-free survival, tumor-free survival and overall survival outcomes in CD22ΔE12×BCR–ABL double transgenic mice with advanced stage, radiation-resistant BPL with lymphomatous features that were significantly superior to those of mice treated with TBI alone or C61-LNP alone.

  13. Total body irradiation in hematopoietic stem cell transplantation

    OpenAIRE

    Fundagul Andic

    2014-01-01

    Total body irradiation is used in conjunction with chemotherapy as a conditioning regimen in the treatment of many disease such as leukemia, myelodysplastic syndrome, aplastic anemia, multiple myeloma and lymphoma prior to the hematopoetic stem cell transplantation. The main purposes of the hematopoetic stem cell transplantation are eradication of the recipient bone marrow and any residual cancer cells, creation of space in the receipient bone marrow for donor hematopoetic stem cells, and imm...

  14. Combined total body X-ray irradiation and total skin electron beam radiotherapy with an improved technique for mycosis fungoides

    International Nuclear Information System (INIS)

    Twelve consecutive patients with advanced stage mycosis fungoides (MF) were treated with combined total body X ray irradiation (TBI) and total skin electron beam radiotherapy (EBRT). Six had generalized plaque disease and dermatopathic nodes, three had tumor stage disease and node biopsy positive for mycosis fungoides, and three had erythroderma/Sezary syndrome. The treatment regimen consisted of split course total body X ray irradiation, given in twice weekly 15 cGy fractions to 75 cGy, then total skin electron beam radiation therapy given in once weekly 400 cGy fractions to a total dose of 2400 cGy. Underdosed areas and areas of greatest initial involvement were boosted 400 cGy twice weekly for an additional 1200 cGy. This was followed by a second course of total body X ray irradiation, to a total dose of 150 cGy. The total skin electron beam radiotherapy technique is a modification of an established six position EBRT technique for mycosis fungoides. Measurements to characterize the beam with and without a lexan scattering plate, demonstrated that the combination of no-plate beams produced better dose uniformity with a much higher dose rate. This improved technique is particularly advantageous for elderly and/or frail patients. Nine (75%) of the 12 patients achieved complete response (CR). The other three had significant improvement with greater than 80% clearing of their disease and resolution of symptoms. All six patients with generalized plaque disease achieved complete response and remained free of disease from 2 to 16 months. Two of three node positive patients also achieved complete response; one, with massive biopsy-documented mycosis fungoides nodal disease and deep open tumors, remained relapse-free over 2 years. Only one of the three patients with erythroderma/Sezary syndrome achieved a complete response, which was short lived

  15. Place of low-dose total body irradiation in the treatment of localized follicular non-Hodgkin's lymphoma: results of a pilot study

    International Nuclear Information System (INIS)

    Purpose: In a first prospective nonrandomized trial, 107 patients with Stage III and IV 'low-grade' lymphomas have been treated with a combination of chemotherapy and low-dose total body irradiation (LD-TBI). This study shows that this scheme of LD-TBI was very well tolerated, gave a high response rate (83%), and extended RFS. It incited us to start a pilot study on localized follicular lymphomas. Methods and Materials: From January 1986 through October 1994, 34 patients with previously untreated localized low-grade non-Hodgkin's lymphomas have been included in a prospective trial with LD-TBI followed by radical involved field radiotherapy (IF-RT). Patients received two courses of whole body irradiation of 0.75 Gy in 5 fractions and 1 week separated by a rest period of 2 weeks. After 1 month, patients were reevaluated, and received 40 Gy in 20 fractions, and 4 weeks on initially pathological lymph node areas. Eight patients have been excluded from the study: 4 after histologic review (2 centrocytic, 1 lymphocytic, 1 centroblastic) and 4 patients with Stage IV because of bone-marrow involvement. The remaining 26 patients were 11 men and 15 women, 50 years old median age (mean: 50.2; range: 35-73.5) with clinical Stage I (10 pts), II1 (8 pts), and II2 (8 pts). All patients received the planned treatment. Results: Clinical tolerance was excellent, and the hematological follow-up shows a mean nadir value of 3.9.109/1 (2.1-8.1) for leucocytes, 13.4 g/l (10.8-15.4) for hemoglobin, and 124.109/l (46-216) for platelets, with a median delay of 3.2 months. Of 26 patients, 24 achieved complete remission (CR) after the LD-TBI that was before the IF-RT. All patients, except one, were in complete remission after IF-RT. Nineteen patients remain alive without any evidence of disease, with a median follow-up of 56.2 months. Five patients relapsed; 3 of them died. Conclusion: As delivered, this schedule of LD-TBI give a very high rate of CR in localized follicular non

  16. Low-dose total body irradiation as first-line treatment of localized follicular non-Hodgkin's lymphoma. Results of a pilot study

    International Nuclear Information System (INIS)

    Purpose/Objective: In a first prospective non randomized trial, 107 patients with stage III and IV 'low-grade' lymphomas have been treated with a combination of chemotherapy and low-dose Total Body Irradiation (LD-TBI) [Richaud and Hoerni, 1992]. This study show that this scheme of LD-TBI was very well tolerated, gave a high response rate (83%) and extended RFS. It incite us to start a pilot study on localized follicular lymphomas. Materials and Methods: From January 1986 through October 1995, 34 patients with localized low-grade non-Hodgkin's lymphomas have been treated in first intention by LD-TBI followed by radical involved field radiotherapy (IF-RT). Patients received two courses of whole body irradiation of 0.75 Gy in 5 fractions and one week separated by a rest period of two weeks. After one month, patients were reevaluated and received 40 Gy in 20 fractions and 4 weeks on initially pathological lymph nodes areas. Eight patients have been excluded from the study : 4 after histologic review (2 centrocytic, 1 lymphocytic, 1 centroblastic), 4 patients were stage IV with bone marrow involvement. The remaining 26 patients were 11 male and 14 female, 50.2 years old mean age (range : 35-73.5) with clinical stage I (10 pts), II1 (8 pts) and II2 (8 pts). All patients received the planned treatment. Results: Clinical tolerance was excellent and the haematologic follow-up show a mean nadir value of(3.9.109(l (2.1-8.1))) for leucocytes, (13.4 g(l (10.8-15.4))) for haemoglobin and (124.109(l (46-216))) for platelets with a median delay of 3.2 months. Clinical complete remission was obtained after the LD-TBI and before the IF-RT for 24 out of 26 patients. All patients, excepted one, were in complete remission after IF-RT. Nineteen patients remain alive without any evidence of disease with a median follow-up of 56.2 months. Five patients relapsed : three of them died. Conclusion: As delivered, this schedule of LD-TBI give a very high rate of complete clinical remission in

  17. A modified 60C teletherapy unit for total body irradiation

    International Nuclear Information System (INIS)

    Purpose: A modified teletherapy unit to achieve total body irradiation with a vertical beam in a conventional treatment room. Methods and Materials: A standard 60C teletherapy unit has been modified to achieve total body irradiation with a vertical beam in a conventional treatment room. Patients are treated in prone and supine positions. Removal of the adjustable collimator assembly of this standard machine provides a circular field of 196 cm in diameter at 167 cm from the source. Second, the machine has been elevated by about 50 cm on a metallic base to enlarge irradiation field to obtain 248 cm in diameter at 210 cm from the source, and to encompass tall patients under better conditions. A special lead conical beam flattening filter, 10-mm thick at the center, was designed to compensate the spatial inhomogeneity of the beam. An instantaneous dose rate of 6.10-2 Gy/min is attained at the L4 level (midplane) in an average 20-cm thick patient with a source activity of 5099 RHM (air kerma rate of 44.8 Gy·h-1·m2). Between February 2, 1984 and December 27, 1990, 244 total body irradiations were performed either by single dose (n = 69, 10 Gy were given to midplane at L4 level in about 6 to 8 h, 8 Gy to the lungs), or by fractionated dose (n = 175, 12 Gy were given in 6 fractions over 3 consecutive days to midplane at L4 level, 9 Gy to the lungs). Results: The dose distribution is similar than the ones obtained by a linear accelerator with patients lying on their sides. Conclusion: Patients were treated in a comfortable and highly reproductible position. Organ shielding was easily achievable. This could be a less expensive and reasonable alternative to linear accelerator

  18. {sup 18}F-FDG uptake by spleen helps rapidly predict the dose level after total body irradiation in a Tibetan minipig model

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yu Jue; Gu, Wei Wang [Southern Medical University, Department of Laboratory Animal Center, Guangzhou, Guangdong (China); Wu, Shao Jie; Guo, Kun Yuan; Chen, Chi [Southern Medical University, Department of Hematology, Zhujiang Hospital, Guangzhou, Guangdong (China); Xie, Qiang; Cai, Liang [Chinese People' s Armed Police Forces, Department of Oncology and PET/CT, Guangdong Provincial Corp Hospital, Guangzhou, Guangdong (China); Zou, Fei [Southern Medical University, School of Public Health and Tropical Medicine, Guangzhou, Guangdong (China)

    2012-09-15

    To investigate whether {sup 18}F- FDG uptake can be applied in dosimetry to facilitate the rapid and accurate evaluation of individual radiation doses after a nuclear accident. Forty-eight Tibetan minipigs were randomised into a control group (n = 3) and treatment groups (n = 45). {sup 18}F-FDG combined positron-emission tomography and computed tomography (PET/CT) were carried out before total body irradiation (TBI) and at 6, 24 and 72 h after receiving TBI doses ranging from 1 to 11 Gy. Spleen tissues and blood samples were also collected for histological examination, apoptosis and blood analysis. Mean standardised uptake values (SUVs) of the spleen showed significant differences between the experimental and the control groups. Spleen SUV at 6 h post-irradiation showed significant correlation with radiation dose; Spearman's correlation coefficient was 0.97 (P < 0.01). Histological observations showed that damage to the splenic lymphocyte became more severe with an increase in the radiation dose. Moreover, apoptosis was one of the major routes of splenic lymphocyte death, which was also confirmed by flow cytometry analysis. In the Tibetan minipig model, radiation doses have a close relationship with the {sup 18}F-FDG uptake of the spleen. This finding suggests that {sup 18}F-FDG PET/CT may be useful for the rapid detection of individual radiation doses. (orig.)

  19. Long-term results of total body irradiation in adults with acute lymphoblastic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Marnitz, Simone; Zich, Alexander; Budach, Volker; Jahn, Ulrich; Neumann, Oliver [Charite University Medicine, Department of Radiation Oncology, Berlin (Germany); Martus, Peter [University Tuebingen, Institute of Clinical Epidemiology and Applied Biostatistics, Tuebingen (Germany); Arnold, Renate [Charite University Medicine, Campus CVK, Department of Hematology and Oncology, Bone Marrow Transplant Unit, Berlin (Germany)

    2014-05-15

    The aim of this chart review of adult patients treated for acute lymphoblastic leukemia (ALL) with total body irradiation (TBI) was to evaluate early and late toxicity and long-term outcome. A total of 110 adult patients (34 ± 12 years) with ALL underwent TBI (6 fractions of 2 Gy for a total of 12 Gy) as a part of the treatment regimen before transplantation. Treatment-related toxicity, mortality, and hematologic outcome are reported. Mean follow-up was 70 months. The 2- and 5-year leukemia-free survival rates were 78 and 72 %, respectively. In all, 29 % (32/110) patients suffered from medullary recurrence after a median time of 7 months. Gender was the only statistically significant prognostic factor in terms of overall survival in favor of female patients. Treatment-related mortality and overall survival after 2 and 5 years were 16 and 22 %, and 60 and 52.7 %, respectively. The most frequent late reaction wascGVHD of the skin (n = 33, 30 %). In addition, 15.5 % (17/110 patients) suffered pulmonary symptoms, and 6 patients developed lung fibrosis. Eyes were frequently affected by the radiation (31/110 = 28 %); 12 of 110 patients (11 %) presented with symptoms from osteoporosis, 5 of 110 patients (4.5 %) developed hypothyreosis and 2 patients diabetes mellitus. Of the male patients, 11 % reported erectile dysfunction or loss of libido, while 2 of 36 women reported menopausal syndrome at the mean time of 28 months after treatment with requirement for substitution. No women became pregnant after treatment. No acute or late cardiac toxicities were documented in our patients. No secondary malignancies were documented. Although hematologic outcome was in the upper range of that reported in the literature, treatment-related mortality (TRM) and medullary recurrences remain a challenge. Sophisticated radiation techniques allow for decreasing toxicity to certain organs and/or dose escalation to the bone marrow in highly selected patients in order to improve therapeutic

  20. Total body 100-mGy X-irradiation does not induce Alzheimer's disease-like pathogenesis or memory impairment in mice

    International Nuclear Information System (INIS)

    The cause and progression of Alzheimer's disease (AD) are poorly understood. Possible cognitive and behavioral consequences induced by low-dose radiation are important because humans are exposed to ionizing radiation from various sources. Early transcriptional response in murine brain to low-dose X-rays (100 mGy) has been reported, suggesting alterations of molecular networks and pathways associated with cognitive functions, advanced aging and AD. To investigate acute and late transcriptional, pathological and cognitive consequences of low-dose radiation, we applied an acute dose of 100-mGy total body irradiation (TBI) with X-rays to C57BL/6J Jms mice. We collected hippocampi and analyzed expression of 84 AD-related genes. Mouse learning ability and memory were assessed with the Morris water maze test. We performed in vivo PET scans with 11C-PIB, a radiolabeled ligand for amyloid imaging, to detect fibrillary amyloid beta peptide (Aβ) accumulation, and examined characteristic AD pathologies with immunohistochemical staining of amyloid precursor protein (APP), Aβ, tau and phosphorylated tau (p-tau). mRNA studies showed significant downregulation of only two of 84 AD-related genes, Apbb1 and Lrp1, at 4 h after irradiation, and of only one gene, Il1α, at 1 year after irradiation. Spatial learning ability and memory were not significantly affected at 1 or 2 years after irradiation. No induction of amyloid fibrillogenesis or changes in APP, Aβ, tau, or p-tau expression was detected at 4 months or 2 years after irradiation. TBI induced early or late transcriptional alteration in only a few AD-related genes but did not significantly affect spatial learning, memory or AD-like pathological change in mice. (author)

  1. Patterns of failure following total body irradiation and bone marrow transplantation with or without a radiotherapy boost for advanced neuroblastoma

    International Nuclear Information System (INIS)

    Purpose: To evaluate the patterns of failure and outcome of patients undergoing high-dose chemotherapy, total body irradiation (TBI), and bone marrow transplantation (BMT) for advanced/relapsed pediatric neuroblastoma, with emphasis on the impact of a radiotherapy boost to primary and metastatic sites. Methods and Materials: Between May 1986 and June 1993, 26 patients with advanced neuroblastoma underwent high-dose chemotherapy and TBI followed by BMT at our institution. The majority of patients were over the age of 2 years (73%) and were Stage IV at diagnosis (81%). Multiple metastatic sites were involved including bone (17), bone marrow (15), distant nodes (11), liver (5), lung (4) and brain (1). Twenty patients (77%) received cyclophosphamide (50 mg/kg x 4 days) and TBI as consolidation therapy. TBI was delivered to a total dose of 12 Gy given in 2 Gy twice daily (b.i.d.) fractions over the 3 days preceding bone marrow infusion. A local radiotherapy boost of 8-24 Gy was given to 13 out of 26 patients (50%) to the primary and/or metastatic sites immediately prior to or following induction chemotherapy according to physician judgement. Sites not amenable to a radiotherapy boost included the bone marrow, diffuse/bilateral lung involvement, and multiple bone metastases (> four sites). Results: The actuarial overall survival of the 26 patients was 40.4% at 3 and 5 years, with a progression-free survival at 5 years of 38.5%. Six patients died of transplant-related toxicity (23%). The use of cyclophosphamide as high-dose consolidation chemotherapy was significantly better than other multidrug regimens used in terms of overall survival (p < 0.0001) and progression-free survival (p = 0.0004). The presence of liver involvement prior to BMT was a significant adverse prognostic factor by multivariate analysis. Of the 20 patients surviving the transplant, 10 (50%) underwent a local radiotherapy boost. The patterns of failure were as follows: 3 out of 10 'boost' patients

  2. High-dose vincristine, fractionated total-body irradiation and cyclophosphamide as conditioning regimen in allogeneic and autologous bone marrow transplantation for childhood acute lymphoblastic leukaemia in second remission: a 7-year Italian multicentre study

    International Nuclear Information System (INIS)

    We investigated the feasibility and efficacy of high-dose vincristine (4 mg/m2 over 4 d) combined with fractionated total body irradiation (F-TBI) (200 cGy x 2 over 3 d) and cyclophosphamide (60 mg/kg for 2 d) as a preparative regimen in allogeneic (AlloBMT) and autologous (ABMT) bone marrow transplantation for 75 consecutive children (median age at transplant 8.5 years) with acute lymphoblastic leukaemia in second complete remission (CR). Median duration of first CR was 26 and 25 months in the AlloBMT and ABMT group, respectively. We conclude that the conditioning regimen with high-dose vincrostine combined with cyclophosphamide and F-TBI is feasible and promising although its therapeutic advantage should be tested in larger series of patients enrolled in randomized studies. (author)

  3. Relative effect of radiation dose rate on hemopoietic and nonhemopoietic lethality of total-body irradiation

    International Nuclear Information System (INIS)

    Experiments were undertaken to determine the influence of dose rate on the toxicity of total-body irrdiation (TBI) with and without syngeneic bone-marrow rescue in mice. The results showed a much greater dose-rate dependence for death from nonhemopoietic toxicity than from bone-marrow ablation, with the ratio of LD50's increasing from 1.73 at 25 cGy/min to 2.80 at 1 cGy/min. At the higher dose rates, dose-limiting nonhemopoietic toxicity resulted from late organ injury, affecting the lungs, kidneys, and liver. At 1 cGy/min the major dose-limiting nonhemopoietic toxicity was acute gastrointestinal injury. The implications of these results in the context of TBI in preparation for bone-marrow transplantation are discussed. 15 refs., 4 figs

  4. Total body irradiation in hematopoietic stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Fundagul Andic

    2014-06-01

    Full Text Available Total body irradiation is used in conjunction with chemotherapy as a conditioning regimen in the treatment of many disease such as leukemia, myelodysplastic syndrome, aplastic anemia, multiple myeloma and lymphoma prior to the hematopoetic stem cell transplantation. The main purposes of the hematopoetic stem cell transplantation are eradication of the recipient bone marrow and any residual cancer cells, creation of space in the receipient bone marrow for donor hematopoetic stem cells, and immunosuppression to prevent rejection of donor stem cells in the case of an allotransplant. [Archives Medical Review Journal 2014; 23(3.000: 398-410

  5. Post-irradiation changes in acetylcholinesterase and butyrylcholinesterase activity in blood platelets of whole-body irradiated rats

    International Nuclear Information System (INIS)

    After 24, 96 and 144 hours following whole-body irradiation of rats with 8 Gy an increased acetylcholinesterase activity was found in platelets. The activity of butyrylcholinesterase in platelets increased in all investigated intervals after whole-body irradiation of rats with 8 Gy. The highest values were recorded after 144, 192 and 264 hours. (author)

  6. Effect of Black Grape Juice against Heart Damage from Acute Gamma TBI in Rats

    Directory of Open Access Journals (Sweden)

    Edson Ramos de Andrade

    2013-09-01

    Full Text Available The aim of this study was to evaluate the potential positive effect of black grape juice (BGJ on lipid peroxidation considering Total Body Irradiation (TBI in Wistar rats. As a potential feasible means of evaluation in situ, blood serum lactate dehydrogenase (LDH levels were evaluated as a marker for heart damage from acute radiation syndrome (ARS. Twenty rats were divided into four groups, two of them being irradiated by gamma-rays from a Co-60 source. Animals were treated by gavage with 2 mL per day of BGJ or placebo for one week before and 4 days after 6 Gy whole body gamma-irradiation, when they were euthanasiated. LDH on serum and lipid peroxidation on heart tissue were evaluated. High concentration of metabolites from lipid peroxidation in heart, and high LDH level on serum were found only in gamma-irradiated group given placebo, mainly at the first 24 h after radiation. Phytochemical analysis of BGJ was performed by determining total phenolics, flavonoids, and tannins followed by a high-performance liquid chromatography (HPLC/DAD analysis, which showed resveratrol as the major constituent. Results suggest that BGJ is a good protective candidate compound against heart damage from ARS and its effects suggest its use as a radiomodifier.

  7. High-energy total body irradiation as preparation for bone marrow transplantation in leukemia patients: treatment technique and related complications

    International Nuclear Information System (INIS)

    Purpose: Bone marrow transplantation with conditioning regimens that include total-body irradiation (TBI) is widely used in patients with acute lymphoblastic and acute myelocytic leukemias. The major causes of death in this population are relapse of leukemia, infection, and treatment related complications. Our purpose was to achieve a homogenous radiation dose distribution and to minimize the dose to the lungs, liver, and kidneys so that the incidence of organ injury was reduced. Methods and Materials: Dose to the bone marrow, midplane, and periphery was quantified by use of thermoluminescent detectors in a bone-equivalent tissue phantom. In an effort to reduce the risk of complications, we treated relapsed or refractory leukemia patients with TBI administered in fractionated, parallel opposed large fields with 24 MV photons, using tissue compensation and partial-transmission lung shielding. Tissue toxicities were then determined. Results: Dose quantitation in bone-equivalent and tissue-equivalent phantoms demonstrated that backscatter and pair production interactions adjacent to bone increased the bone marrow dose by 6 to 11%. At an SSD of 400 cm and at patient diameters of 20 to 40 cm, the percent inhomogeneity across the phantom with 24 MV photons was 0 to 0.3%, compared to 4 to 6% for 6 MV photons. End-organ toxicities consisted of clinical interstitial pneumonitis in six patients, idiopathic interstitial pneumonitis in three patients, renal toxicity in seven patients, and veno-occlusive disease of the liver in one patient. Toxicities did not correlate with fractionation schedule. Conclusions: Total-body irradiation administered with 24 MV photons increases the dose deposition in bone marrow through pair production and backscatter interactions occurring in bone. Because percent depth dose increases with SSD, the 24 MV beam is more penetrating at a 400 cm distance than at 100 cm and dose homogeneity is improved with higher energies. Thus, the incidence of

  8. Myeloproliferative disorders in patients with rheumatoid arthritis treated with total body irradiation

    International Nuclear Information System (INIS)

    Four patients with refractory rheumatoid arthritis were treated with total body irradiation administered in two sittings, 300 to 400 rads to each half of the body. All four patients had taken antimetabolites prior to receiving total body irradiation, and two continued to use them after total body irradiation. Two patients had taken alkylating agents before, and one had used them after total body irradiation. All patients showed clinical improvement. However, in two patients myeloproliferative disorders developed: a myelodysplastic preleukemia at 40 months after total body irradiation in one and acute myelogenous leukemia at 25 months in the other. Total body irradiation differs from total nodal irradiation in the total dose of irradiation (300 to 400 rads versus 2,000 to 3,000), and in the duration of the therapy (two sittings versus treatment over several weeks to months). Furthermore, the patients in the total body irradiation study frequently used cytotoxic drugs before and/or after irradiation, whereas in one total nodal irradiation study, azathioprine (2 mg/kg per day or less) was permitted, but no other cytotoxic agents were allowed. Rheumatologists may therefore face a binding decision when deciding to treat a patient with rheumatoid arthritis with either a cytotoxic drug or irradiation

  9. Myeloproliferative disorders in patients with rheumatoid arthritis treated with total body irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Urowitz, M.B.; Rider, W.D.

    1985-01-21

    Four patients with refractory rheumatoid arthritis were treated with total body irradiation administered in two sittings, 300 to 400 rads to each half of the body. All four patients had taken antimetabolites prior to receiving total body irradiation, and two continued to use them after total body irradiation. Two patients had taken alkylating agents before, and one had used them after total body irradiation. All patients showed clinical improvement. However, in two patients myeloproliferative disorders developed: a myelodysplastic preleukemia at 40 months after total body irradiation in one and acute myelogenous leukemia at 25 months in the other. Total body irradiation differs from total nodal irradiation in the total dose of irradiation (300 to 400 rads versus 2,000 to 3,000), and in the duration of the therapy (two sittings versus treatment over several weeks to months). Furthermore, the patients in the total body irradiation study frequently used cytotoxic drugs before and/or after irradiation, whereas in one total nodal irradiation study, azathioprine (2 mg/kg per day or less) was permitted, but no other cytotoxic agents were allowed. Rheumatologists may therefore face a binding decision when deciding to treat a patient with rheumatoid arthritis with either a cytotoxic drug or irradiation.

  10. Response of adrenal gland to whole body 60Co irradiation

    International Nuclear Information System (INIS)

    Whole body of the adult albino rates was exposed to 60Co radiation in a single dose of 600 R. Following irradiation the adrenal serotonin level was found higher till the end of 8th week except a fall on 14th day, whereas the blood 5HT level remained lower than the normal except a slight rise at the end of 1st week and dropped down at 14 days followed by a further rise. The blood catecholamine level was found increased at the end of 14th day followed by a fall at 4th and 8th weeks, but the levels were moving round the normal value. The histological studies of adrenal gland showed degranulation and hypertrophy of adrenal cortex and medullary cells at various intervals of post-irradiation. On the whole it is observed that maximum changes in the level of biogenic amines take place within 14 days after irradiation, and maximum rate of mortality also coincide with this period. Thus bringing out the fact that adrenal bioamines play an important role in the vital activities of the animals. (author)

  11. Genetics and outcomes after traumatic brain injury (TBI): What do we know about pediatric TBI?

    OpenAIRE

    Kurowski, Brad; Martin, Lisa J.; Wade, Shari L.

    2012-01-01

    Human genetic association studies in individuals with traumatic brain injury (TBI) have increased rapidly over the past few years. Recently, several review articles evaluated the association of genetics with outcomes after TBI. However, almost all of the articles discussed in these reviews focused on adult TBI. The primary objective of this review is to gain a better understanding of which genes and/or genetic polymorphisms have been evaluated in pediatric TBI. Our initial search identified 1...

  12. 20 years of experience in static intensity-modulated total-body irradiation and lung toxicity. Results in 257 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, R.A.; Schultze, J.; Jensen, J.M.; Hebbinghaus, D.; Galalae, R.; Kimmig, B.N. [University Hospital of Schleswig-Holstein (UHK), Kiel (Germany). Dept. of Radiotherapy

    2007-10-15

    Purpose: To analyze lung complications after allogeneic or autologous transplantation following total-body irradiation (TBI) with compensators, so-called sIMRT (static intensity-modulated radiotherapy). Patients and Methods: Between 1983 and 1998, 257 patients with different hematologic malignancies underwent TBI in six fractions to a total dose of 12 Gy within 3 consecutive days (212 with 11 Gy lung dose) prior to allogeneic (n = 174) or autologous (n = 83) transplantation. 40 patients were < 16 years of age. Minimum follow-up time was 5 years. Median follow-up period was 110 months (13-231 months). Results: 5-year survival rate was 47.9%, 5-year tumor-related mortality 23%, 5-year treatment-related mortality 29.2% (12 Gy lung dose: 53.3% {+-} 14.6%, 11 Gy: 24.1% {+-} 5.7%). Interstitial pneumonitis (IP) developed in 28 of 257 patients (10.9% {+-} 3.8%). IP incidences in the allogeneic and autologous groups were 14.4% ({+-} 5.6%) and 3.6% (0-7.6%), respectively. IP incidences with 12/11 Gy lung dose were 22% ({+-} 12%)/8.5% ({+-} 3.7%). IP mortality was 9.3% ({+-} 3.6%). 13 of 28 patients with IP had a cytomegalovirus infection, five an acute graft-versus-host disease grade IV of the lungs. IP incidences with 12/11 Gy lung dose were 25% (9-50%)/4.2% (0.2-19.1%) in patients < 16 years, and 20.7% (9.4-37.4%) and 13.3% ({+-} 6.5%) in older patients after allogeneic transplantation. Conclusion: Compensator-generated static intensity-modulated TBI with a total dose of 12 Gy and a lung dose of 11 Gy is a modern and comfortable treatment with moderate lung toxicity, small dose inhomogeneities and little setup failure before transplantation. Especially patients < 16 years of age benefit from lung dose reduction.

  13. Pharmacological immunosuppression reduces but does not eliminate the need for total-body irradiation in nonmyeloablative conditioning regimens for hematopoietic cell transplantation.

    Science.gov (United States)

    Mielcarek, Marco; Torok-Storb, Beverly; Storb, Rainer

    2011-08-01

    In the dog leukocyte antigen (DLA)-identical hematopoietic cell transplantation (HCT) model, stable marrow engraftment can be achieved with total-body irradiation (TBI) of 200 cGy when used in combination with postgrafting immunosuppression. The TBI dose can be reduced to 100 cGy without compromising engraftment rates if granulocyte colony-stimulating factor (G-CSF)-mobilized peripheral blood mononuclear cells (G-PBMC) are infused with the marrow. T cell-depleting the G-PBMC product abrogates this effect. These results were interpreted to suggest that the additional T cells provided with G-PBMC facilitated engraftment by overcoming host resistance. We therefore hypothesized that the TBI dose may be further reduced to 50 cGy by augmenting immunosupression either by (1) tolerizing or killing recipient T cells, or (2) enhancing the graft-versus-host (GVH) activity of donor T cells. To test the first hypothesis, recipient T cells were activated before HCT by repetitive donor-specific PBMC infusions followed by administration of methotrexate (MTX) (n = 5), CTLA4-Ig (n = 4), denileukin diftitox (Ontak; n = 4), CTLA4-Ig + MTX (n = 8), or 5c8 antibody (anti-CD154) + MTX (n = 3). To test the second hypothesis, recipient dendritic cells were expanded in vivo by infusion of Flt3 ligand given either pre-HCT (n = 4) or pre- and post-HCT (n = 5) to augment GVH reactions. Although all dogs showed initial allogeneic engraftment, sustained engraftment was seen in only 6 of 42 dogs (14% of all dogs treated in 9 experimental groups). Hence, unless more innovative pharmacotherapy can be developed that more forcefully shifts the immunologic balance in favor of the donor, noncytotoxic immunosuppressive drug therapy as the sole component of HCT preparative regimens may not suffice to ensure sustained engraftment. PMID:21220032

  14. C-reactive protein and serum amyloid A as early-phase and prognostic indicators of acute radiation exposure in nonhuman primate total-body irradiation model

    International Nuclear Information System (INIS)

    Terrorist radiological attacks or nuclear accidents could expose large numbers of people to ionizing radiation. In mass-casualty radiological incidents early medical-management requires triage tools for first-responders to quantitatively identify individuals exposed to life-threatening radiation doses and for early initiation (i.e., within one day after radiation exposure) of cytokine therapy for treatment of bone marrow acute radiation syndrome. Herein, we present results from 30 rhesus macaques total-body irradiated (TBI) to a broad dose range of 1-8.5 Gy with 60Co γ-rays (0.55 Gy min-1) and demonstrate dose- and time-dependent changes in blood of C-reactive protein (CRP), serum amyloid A (SAA), and interleukin 6 (IL-6) measured by enzyme linked immunosorbent assay (ELISA). CRP and SAA dose-response results are consistent with ∼1 Gy and ∼0.2 Gy thresholds for photon-exposure at 24 h after TBI, respectively. Highly significant elevations of CRP and SAA (p = 0.00017 and p = 0.0024, respectively) were found in animal plasma at 6 h after all TBI doses suggesting their potential use as early-phase biodosimeters. Results also show that the dynamics and content of CRP and SAA levels reflect the course and severity of the acute radiation sickness (ARS) and may function as prognostic indicators of ARS outcome. These results demonstrate proof-of-concept that these radiation-responsive proteins show promise as a complementary approach to conventional biodosimetry for early assessment of radiation exposures and may also contribute as diagnostic indices in the medical management of radiation accidents.

  15. Prospective evaluation of pulmonary function in cancer patients treated with total body irradiation, high-dose melphalan, and autologous hematopoietic stem cell transplantation

    International Nuclear Information System (INIS)

    Pulmonary function tests (standard vital capacity, SVC; total lung capacity, TLC; forced expiratory volume in 1 second-forced vital capacity ratio, FEV1/FVC; carbon monoxide transfer factor, DLCO) were prospectively evaluated in patients (median age 25 years, 13-52 years; median follow-up 20 months, 6-51 months) with Hodgkin's disease (15 patients), non-Hodgkin's lymphoma (9 patients), and inflammatory breast cancer (3 patients) treated with sequential high-dose therapy comprising the following phases over approximately 2 months: (a) cyclophosphamide (7 g/m2); (b) vincristine (1.4 mg/m2), methotrexate (8 g/m2), and cisplatinum (120 mg/m2) or etoposide (2 g/m2); (c) total body irradiation (TBI; 12.5 gy, 5 fractions over 48 hours), intravenous melphalan (120-180 mg/m2), and transplantation of autologous peripheral blood and/or bone marrow hematopoietic stem cells. Within 2 months after transplantation, 12 patients also received 25 Gy radiotherapy boost to mediastinum and clavicular regions. In vivo dosimetry evaluations of fractionated TBI treatments showed that mean radiation dose absorbed by lungs was 12.18 Gy (97.4% of TBI dose). Despite such a high radiation dose, we observed only transient and subclinical decrease of SVC, TLC, and DLCO. The decrease of SVC, TLC, and DLCO was more evident and prolonged in patients receiving radiotherapy boost. All parameters progressively recovered to normal values within 2 years after transplantation. In contrast, FEV1/FVC remained within normal limits in all patients, thus demonstrating the absence of obstructive ventilatory changes. In addition, no interstitial pneumonia was observed

  16. C-reactive protein and serum amyloid A as early-phase and prognostic indicators of acute radiation exposure in nonhuman primate total-body irradiation model

    Energy Technology Data Exchange (ETDEWEB)

    Ossetrova, N.I., E-mail: ossetrova@afrri.usuhs.mil [Armed Forces Radiobiology Research Institute, 8901 Wisconsin Avenue, Bldg. 42, Bethesda, MD 20889-5603 (United States); Sandgren, D.J.; Blakely, W.F. [Armed Forces Radiobiology Research Institute, 8901 Wisconsin Avenue, Bldg. 42, Bethesda, MD 20889-5603 (United States)

    2011-09-15

    Terrorist radiological attacks or nuclear accidents could expose large numbers of people to ionizing radiation. In mass-casualty radiological incidents early medical-management requires triage tools for first-responders to quantitatively identify individuals exposed to life-threatening radiation doses and for early initiation (i.e., within one day after radiation exposure) of cytokine therapy for treatment of bone marrow acute radiation syndrome. Herein, we present results from 30 rhesus macaques total-body irradiated (TBI) to a broad dose range of 1-8.5 Gy with {sup 60}Co {gamma}-rays (0.55 Gy min{sup -1}) and demonstrate dose- and time-dependent changes in blood of C-reactive protein (CRP), serum amyloid A (SAA), and interleukin 6 (IL-6) measured by enzyme linked immunosorbent assay (ELISA). CRP and SAA dose-response results are consistent with {approx}1 Gy and {approx}0.2 Gy thresholds for photon-exposure at 24 h after TBI, respectively. Highly significant elevations of CRP and SAA (p = 0.00017 and p = 0.0024, respectively) were found in animal plasma at 6 h after all TBI doses suggesting their potential use as early-phase biodosimeters. Results also show that the dynamics and content of CRP and SAA levels reflect the course and severity of the acute radiation sickness (ARS) and may function as prognostic indicators of ARS outcome. These results demonstrate proof-of-concept that these radiation-responsive proteins show promise as a complementary approach to conventional biodosimetry for early assessment of radiation exposures and may also contribute as diagnostic indices in the medical management of radiation accidents.

  17. Subclinical pulmonary function defects following autologous and allogeneic bone marrow transplantation: relationship to total body irradiation and graft-versus-host disease

    International Nuclear Information System (INIS)

    Pulmonary function results pre- and post-transplant, to a maximum of 4 years, were analyzed in 98 patients with haematological disorders undergoing allogeneic (N = 53) or autologous bone marrow transplantation (N = 45) between 1982 and 1988. All received similar total body irradiation based regimens ranging from 9.5 Gy as a single fraction to 14.4 Gy fractionated. FEV1/FVC as a measure of airway obstruction showed little deterioration except in patients experiencing graft-versus-host disease in whom statistically significant obstructive ventilatory defects were evident by 6 months post-transplant (p less than 0.01). These defects appeared to be permanent. Restrictive ventilatory defects, as measured by reduction in TLC, and defects in diffusing capacity (DLCO and KCO) were also maximal at 6 months post-transplant (p less than 0.01). Both were related, at least in part, to the presence of GVHD (p less than 0.01) or use of single fraction TBI with absorbed lung dose of 8.0 Gy (p less than 0.05). Fractionated TBI resulted in less marked restricted ventilation and impaired gas exchange, which reverted to normal by 2 years, even when the lung dose was increased from 11.0 Gy to between 12.0 and 13.5 Gy. After exclusion of patients with GVHD (30% allografts) there was no significant difference in pulmonary function abnormalities between autograft and allograft recipients

  18. A new Bayesian model applied to cytogenetic partial body irradiation estimation

    International Nuclear Information System (INIS)

    A new zero-inflated Poisson model is introduced for the estimation of partial body irradiation dose and fraction of body irradiated. The Bayes factors are introduced as tools to help determine whether a data set of chromosomal aberrations obtained from a blood sample reflects partial or whole body irradiation. Two examples of simulated cytogenetic radiation exposure data are presented to demonstrate the usefulness of this methodology in cytogenetic biological dosimetry. (authors)

  19. Response of hepatic hematopoiesis to whole body irradiation

    International Nuclear Information System (INIS)

    Extensive hepatic erythropoiesis, granulocytopoiesis and megakaryocytopoiesis occur in adult mice given methylcellulose (MC). This appears to be a compensatory response to MC induced hemolytic anemia and thrombocytopenia. The present study was undertaken to evaluate the effects of whole body irradiation (WBI) upon established hepatic hematopoiesis (HH) as well as its effect when given before the induction of HH. Established hepatic erythroid and granulocytic foci were significantly decreased 24 hours after 100 or 300 rads. The D0 for erythroid and granulocytic foci was 107+-10 rads and 95+-20 rads respectively, similar to those reported for murine marrow and spleen cell CFUsub(s). Megakaryocytes were more radioresistant, gradually declining over 7 days to 50% of control values following 100 rads and with a D0 of 347+-7 rads; suggesting a differential radiation sensitivity compared to erythroid and granulocytic foci. WBI, 100 and 300 rads, given before MC failed to prevent subsequent development of HH although both marrow and spleen responses were reduced. Hepatic granulocytic foci and marrow peroxidase positive cells were reduced by such treatment while erythroid and megakaryocytic foci were similar to controls. This suggests that irradiation damaged stem cells responded to MC with increased erythropoiesis and megakaryocytopoiesis at the expense of granulopoiesis. (author)

  20. Morphological studies on the healing process of tooth extraction wounds in whole body irradiated rats

    International Nuclear Information System (INIS)

    The present studies were performed to investigate the healing process of the tooth extraction wound in whole body irradiated rats and to clarify the effect of irradiation on bone metabolism. One hundred and seven Wistar rats of about 100 g body weight were used and divided into 3 groups. Whole body irradiated rats were given single exposure with a dose of 8 Gy. The region of the left upper molars of local irradiated rats as controls, was exposed to 8 Gy. On the 7th day after irradiation, the left upper first molar of each rat was extracted. The rats were sacrificed at intervals of 1 to 14 days after extraction. Non-irradiated rats were sacrificed at the same intervals after extraction. The maxillary bone including the extraction wound was evaluated, histologically, histometrically and ultrastructurally. From the histological and histometrical findings, the difference of the healing process between non-irradiated rats and locally irradiated rats is not significant. In whole body irradiated rats, the healing process especially in the socket was disturbed. The osteoblastic new bone formation following production of granulation tissue was interfered with. Ultrastructurally, the cytoplasmic organellae were poorly developed in the osteoblast and osteoid formation was reduced in the socket. But periosteal new bone formation was the same as that of the locally irradiated rats. In whole body irradiated rats, the osteoclasts in the interradicular alveolar bone were decreased and have smaller nuclei, compared with non-irradiated and locally irradiated rats. Histometrically, the amount of bone loss was decreased in whole body irradiated rats. Ultrastructurally, the cyoplasmic organellae and ruffled border were poorly developed in the osteoclasts of whole body irradiated rats. The findings suggested that irradiation induced cytological changes not only in osteoblasts but in osteoclasts and these changes resulted in the delayed healing of extraction wound. (author) 106 refs

  1. Osteochondroma after total body irradiation in bone marrow transplant recipients. Report of two cases

    International Nuclear Information System (INIS)

    We present two cases of osteochondroma after total body irradiation in bone marrow recipients, the first in a 6-year-old boy with juvenile chronic myelogenous leukemia and the second in a 13-year-old boy with acute myelogenous leukemia. The patients developed multiple osteochondromas three years and seven years, respectively, after 12 Gy of total body irradiation. Neither had a family history of hereditary multiple osteochondromatosis. A review of the English literature revealed only one report describing five cases of osteochondroma after 12 Gy of total body irradiation in bone marrow transplant recipients. Osteochondroma should be considered as an additional adverse effect of total body irradiation. (author)

  2. Accelerating total body irradiation with large field modulated arc therapy in standard treatment rooms without additional equipment

    Energy Technology Data Exchange (ETDEWEB)

    Polednik, Martin; Lohr, Frank; Ehmann, Michael; Wenz, Frederik [Universitaetsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Department of Radiation Oncology, Mannheim (Germany)

    2015-11-15

    The aim of this study was to develop a generic and ultra-efficient modulated arc technique for treatment with total body irradiation (TBI) without additional equipment in standard treatment rooms. A continuous gantry arc between 300 and 70 composed of 26 subarcs (5 per subarc) using a field size of 40 x 40 cm{sup 2} was used to perform the initial beam data measurements. The profile was measured parallel to the direction of gantry rotation at a constant depth of 9 cm (phantom thickness 18 cm). Beam data were measured for single 5 subarcs, dissecting the individual contribution of each subarc to a certain measurement point. The phantom was moved to 20 measurement positions along the profile. Then profile optimization was performed manually by varying the weighting factors of all segments until calculated doses at all points were within ± 1 %. Finally, the dose distribution of the modulated arc was verified in phantom thicknesses of 18 and 28 cm. The measured profile showed a relative mean dose of 99.7 % [standard deviation (SD) 0.7 %] over the length of 200 cm at a depth of 9 cm. The measured mean effective surface dose (at a depth of 2 cm) was 102.7 % (SD 2.1 %). The measurements in the 28 cm slab phantom revealed a mean dose of 95.9 % (SD 2.9 %) at a depth of 14 cm. The mean dose at a depth of 2 cm was 111.9 % (SD 4.1 %). Net beam-on-time for a 2 Gy fraction is approximately 8 min. This highly efficient modulated arc technique for TBI can replace conventional treatment techniques, providing a homogeneous dose distribution, dosimetric robustness, extremely fast delivery, and applicability in small treatment rooms, with no need for additional equipment. (orig.) [German] Das Ziel dieses Projekts war die Entwicklung einer generischen, hocheffizienten und modulierten Rotationsbestrahlungstechnik fuer Ganzkoerperbestrahlung (TBI, ''total body irradiation''), die ohne zusaetzliches Equipment in Standartbehandlungsraeumen angewendet werden kann. Ein

  3. SU-E-T-260: Pediatric Total Body Irradiation Calculations and In-Vivo Dosimetry Using Diodes and OSLD's

    International Nuclear Information System (INIS)

    Purpose: To verify that a photon total body irradiation (TBI) calculation method scales properly from adult to pediatric dimensions and to determine TBI in-vivo dosimetry correction factors for diodes and optically stimulated luminescent dosimeters (OSLD's). Methods: TBI technique used is 400 SAD 18 MV opposed laterals with beam spoiler. Water bags are used to supplement narrower lateral dimensions for patient treatments. To verify that dose calculations scale properly with decreasing dimensions, CAX doses were measured and compared to calculations for different rectangular phantom geometries: (L=length(cm), H=height(cm), d=depth(cm)): L(30)xH(30) (d=3-25), L(30)xH(12)(d=2–20), L(13)xH(13) (d=5–13), L(30)x(H=10–40) d=15, L(30–150) x H(10) (d=15). In infant geometry, measured off axis “leg” dose (L(30)xH(2.5–10.6), d=7)) was compared to CAX (“body” L(30)xH(10)(d=7) adjacent to “leg”). Entrance and exit doses were measured with surface diodes, diodes with buildup, OSLD's, as well as ion chambers for comparison. Correction factors ((ion chamber CAX dose)/(in vivo dose)) were calculated for surface diodes, diodes with buildup, OSLD's, and ion chamber. Results: All rectangular phantom measurements agree with calculated within 2.5%. For L(30)xH(30), L(30)xH(12), L(13)xH(13), L(30)x(H=10–40) and L(30–80)xH(10) agreement was within 1%. For the infant geometry, the ratio of leg dose to CAX varies from 0.956 (h=2.5) to 0.995 (h=10.6). The range of in-vivo dosimetry entrance+exit to CAX dose correction factors varied by dosimeter (diode: 0.883–1.015, surface diode: 1.008–1.214, ion chamber: 0.924–1.084, OSLD: 0.920–1.106). Conclusion: TBI calculations scaled properly to pediatric dimensions. In-vivo dosimetry with various detectors demonstrated similar trends with different magnitudes. OSLD measurements agreed well with ion chamber measurements

  4. Immunosuppression by whole-body irradiation and its effect on oedema in experimental cerebral ischaemia

    International Nuclear Information System (INIS)

    The effect of global immunosuppression by sublethal whole body X-irradiation on the development of cerebral oedema was assessed 24 h after right middle cerebral artery occulustion in the rat. Irradiation produced a significant leucopaenia and thrombocytopaenia, and significantly reduced cortical oedema when compared to non-irradiated control animals. (au)

  5. Immunosuppression by whole-body irradiation and its effect on oedema in experimental cerebral ischaemia

    Energy Technology Data Exchange (ETDEWEB)

    Strachan, R.D.; Kane, P.J.; Mendelow, A.D. (Department of Surgery, Neurosurgery, University of Newcastle-Upon-Tyne (United Kingdom)); Cook, S.; Chambers, I.R.; Clayton, C.B. (Department of Medical Physics, University of Newcastle-Upon-Tyne (United Kingdom))

    1992-01-01

    The effect of global immunosuppression by sublethal whole body X-irradiation on the development of cerebral oedema was assessed 24 h after right middle cerebral artery occulustion in the rat. Irradiation produced a significant leucopaenia and thrombocytopaenia, and significantly reduced cortical oedema when compared to non-irradiated control animals. (au).

  6. Whole-body. gamma. -irradiation in the treatment of hemoblastoses in man

    Energy Technology Data Exchange (ETDEWEB)

    Shishkova, T.V.; Danilova, N.B.; Khrushchev, V.G.; Grammatikati, V.S.

    1982-11-01

    An analysis of foreign literature on treatment acute leukoses with irradiation and transplantation of allogenic bone marrow is given. It is shown that whole-body irradiation used to increase treatment efficiency of man hemoblastosis are widely applied nowadays abroad. Bone marrow transplantation including compulsory whole-body irradiation with 10 Gy is the only practicable attempt to eradicate leukosis. Whole-body irradiation unlike chemotherapy provides more durable survival rate without recurrence; it doesn't require hospitalization and continuity of treatment following the general course; it doesn't produce toxic complications.

  7. Whole-body ν-irradiation in the treatment of hemoblastoses in man

    International Nuclear Information System (INIS)

    An analysis of foreign literature on treatment acute leukoses with irradiation and transplantation of allogenic bone marrow is given. It is shown that whole-body irradiation used to increase treatment efficiency of man hemoblastosis are widely applied nowadays abroad. Bone marrow transplantation including compulsory whole-body irradiation with 10 Gy is the only practicable attempt to eradicate leukosis. Whole-body irradiation unlike chemotherapy provides more durable survival rate without recurrence; it doesn't require hospitalization and continuity of treatment following the general course; it doesn't produce toxic complications

  8. Rheological properties of blood after whole body gamma-irradiation

    International Nuclear Information System (INIS)

    This work aims to investigate the influence of whole body gamma irradiation on the rheological properties of rat's blood . The applied shear rate was from 12 to 375 s-1. low shear viscosity (up to 100 s-1) depends mainly on the erythrocytes aggregation while the high shear viscosity depends on the erythrocytes deformability. Adult male rats were exposed to 1, 2.5, 3.5,5,7 and 9 Gy single doses. The consistency index, apparent viscosity, yield stress and aggregation index were increased after exposure to gamma radiation . The dielectric properties of the erythrocytes, in the low frequency range (60 hz to 40 khz), were measured in order to investigate the changes in the membrane surface charge . The relative permittivity and relaxation time showed significant decrease after exposure to the lowest dose and continue to decrease as the dose increased. The obtained results showed that increase in the blood viscosity and aggregation index can be attributed to the decrease in the erythrocyte surface charges

  9. Rheological properties of blood after whole body gamma-irradiation

    International Nuclear Information System (INIS)

    The study of rheological properties of blood has special interest; since it is a circulating fluid exposed to shear rates during its life time. This work aims to investigate the influence of whole body gamma irradiation on the rheological properties of rat's blood. The applied shear rate was from 12 to 375 s-1. Low shear viscosity (up to 100 s-1) depends mainly on the erythrocytes aggregation while the high shear viscosity depends on the erythrocytes deformability. Materials and Methods: Adult male rats were exposed to 1, 2.5, 3.5, 5, 7 and 9 Gy single doses. The consistency index, apparent viscosity, yield stress and aggregation index were increased after exposure to gamma radiation. The dielectric properties of the erythrocytes, in the low frequency range (60 Hz to 40 k Hz), were measured in order to investigate the changes in the membrane surface charge. Results: The results obtained indicate that the viscosity, consistency index and yield stress increased after the exposure to the lowest dose taken; 1 Gy, and continued to increase as the exposure dose increased up to dose 7 Gy and then decrease after exposure to 9 Gy. The relative permittivity and relaxation time showed significant decrease after exposure to the lowest dose and continue to decrease as the dose increased. Conclusion: The obtained results can be attributed to the decrease of membrane surface charge after exposure to gamma radiation. The decrease in the membrane surface charge is known to decrease the repulsion between the cells and increase blood viscosity.

  10. Low Dose Total Body Irradiation Combined With Recombinant CD19-Ligand × Soluble TRAIL Fusion Protein is Highly Effective Against Radiation-resistant B-precursor Acute Lymphoblastic Leukemia in Mice

    Directory of Open Access Journals (Sweden)

    Fatih M. Uckun

    2015-04-01

    Full Text Available In high-risk remission B-precursor acute lymphoblastic leukemia (BPL patients, relapse rates have remained high post-hematopoietic stem cell transplantation (HSCT even after the use of very intensive total body irradiation (TBI-based conditioning regimens, especially in patients with a high “minimal residual disease” (MRD burden. New agents capable of killing radiation-resistant BPL cells and selectively augmenting their radiation sensitivity are therefore urgently needed. We report preclinical proof-of-principle that the potency of radiation therapy against BPL can be augmented by combining radiation with recombinant human CD19-Ligand × soluble TRAIL (“CD19L–sTRAIL” fusion protein. CD19L–sTRAIL consistently killed radiation-resistant primary leukemia cells from BPL patients as well as BPL xenograft cells and their leukemia-initiating in vivo clonogenic fraction. Low dose total body irradiation (TBI combined with CD19L–sTRAIL was highly effective against (1 xenografted CD19+ radiochemotherapy-resistant human BPL in NOD/SCID (NS mice challenged with an otherwise invariably fatal dose of xenograft cells derived from relapsed BPL patients as well as (2 radiation-resistant advanced stage CD19+ murine BPL with lymphomatous features in CD22ΔE12xBCR-ABL double transgenic mice. We hypothesize that the incorporation of CD19L–sTRAIL into the pre-transplant TBI regimens of patients with very high-risk BPL will improve their survival outcome after HSCT.

  11. Study on Dosimetry Used TLD Dosimeter and Body Mass Index at Total Body Irradiation

    International Nuclear Information System (INIS)

    The aim of study is to expose a more uniform dose depending on the relationship between a body mass index in patients who underwent radiation therapy and an acquired dosimetric information by using a thermoluminescent dosimeter. Since 2006 to August 2011 we investigated 28 people who underwent radiation therapy were enrolled in AMC. Each patient was measured on the head, neck, chest, abdomen, pelvis, thigh, knee joint, and ankle joint using the thermoluminescent dosimeter. The measurement value of each points compared with the prescribed center point, abdominal point, and dose measurements of points on which to base the abdomen and the patient's body mass index (BMI) were compared with reference point, abdomen dose. 28 patients on prescribed dose in the abdomen by which the center point, an average dose was 100.6±5.5, and the other seven measuring points with the average maximum difference among the head, neck, chest, pelvic, thigh, knee, and ankle were 92.8±4.2%, 97.6±6.2%, 96.4±5.5%, 102.6±5.3%, 103.4±7.9%, 95.8±5.9%, 96.1±5.5%. The relationship of abdominal point dose and the patient's body mass index (BMI) was analyzed a scatter plot, and the result of linear relationship analysis by regression method, the regression of the dose (y) was -1.009 BMI (x) plus 123.3 and coefficient of determination (R2) was represented 0.697. The total body irradiation treatment process was evaluated the dose deviation and then the prescribed dose by which the average abdominal dose was satisfied with 100.6±5.5%. Results of the relationship analysis between BMI and dose, if we apply the correction value for each patients, it can be achieved more uniform dose delivery.

  12. Some biochemical effects of partial body irradiation in case of combined radiation action

    International Nuclear Information System (INIS)

    ATPase and creatinkinase activity of water extracts from the brain, liver and spleen of rats has been studied 5, 12, 19 and 26 days after X-irradiation (50 R) of the whole body, anterior one-third and hind two-thirds of the body, and external β-irradiation (Kr85, 3.05 krads) delivered separately and in a combination. It has been shown that under conditions, partial exposures are comparable by their biochemical effectiveness to the action of the whole-body irradiation. The combined exposure was, on the whole, less effective than separate ones

  13. Influence of whole-body irradiation on calcium and phosphate homeostasis in the rat

    International Nuclear Information System (INIS)

    Previous irradiation studies have revealed marked alterations in calcium metabolism. Moreover, the maintenance of calcium homeostasis with parathyroid hormone or calcium salts has been reported to reduce radiation lethality. Therefore, the present study was designed to evaluate the influence of irradiation on calcium homeostasis in the rat. Nine hundred rad of whole-body irradiation produced a significant depression of both plasma calcium and phosphate at 4 days postirradiation. This effect of irradiation was observed to be dose-dependent over a range of 600 to 1200 rad, and possibly related to irradiation-induced anorexia. The physiological significance of these observations is discussed

  14. Altered Mitochondrial Dynamics and TBI Pathophysiology

    Directory of Open Access Journals (Sweden)

    Tara Diane Fischer

    2016-03-01

    Full Text Available Mitochondrial function is intimately linked to cellular survival, growth, and death. Mitochondria not only generate ATP from oxidative phosphorylation, but also mediate intracellular calcium buffering, generation of reactive oxygen species (ROS, and apoptosis. Electron leakage from the electron transport chain, especially from damaged or depolarized mitochondria, can generate excess free radicals that damage cellular proteins, DNA, and lipids. Furthermore, mitochondrial damage releases pro-apoptotic factors to initiate cell death. Previous studies have reported that traumatic brain injury (TBI reduces mitochondrial respiration, enhances production of ROS, and triggers apoptotic cell death, suggesting a prominent role of mitochondria in TBI pathophysiology. Mitochondria maintain cellular energy homeostasis and health via balanced processes of fusion and fission, continuously dividing and fusing to form an interconnected network throughout the cell. An imbalance of these processes, particularly an excess of fission, can be detrimental to mitochondrial function, causing decreased respiration, ROS production, and apoptosis. Mitochondrial fission is regulated by the cytosolic GTPase, dynamin-related protein 1 (Drp1, which translocates to the mitochondrial outer membrane to initiate fission. Aberrant Drp1 activity has been linked to excessive mitochondrial fission and neurodegeneration. Measurement of Drp1 levels in purified hippocampal mitochondria showed an increase in TBI animals as compared to sham controls. Analysis of cryo-electron micrographs of these mitochondria also showed that TBI caused an initial increase in the length of hippocampal mitochondria at 24 hours post-injury, followed by a significant decrease in length at 72 hours. Post-TBI administration of Mdivi-1, a pharmacological inhibitor of Drp1, prevented this decrease in mitochondria length. Mdivi-1 treatment also reduced the loss of newborn neurons in the hippocampus and improved

  15. Altered Mitochondrial Dynamics and TBI Pathophysiology.

    Science.gov (United States)

    Fischer, Tara D; Hylin, Michael J; Zhao, Jing; Moore, Anthony N; Waxham, M Neal; Dash, Pramod K

    2016-01-01

    Mitochondrial function is intimately linked to cellular survival, growth, and death. Mitochondria not only generate ATP from oxidative phosphorylation, but also mediate intracellular calcium buffering, generation of reactive oxygen species (ROS), and apoptosis. Electron leakage from the electron transport chain, especially from damaged or depolarized mitochondria, can generate excess free radicals that damage cellular proteins, DNA, and lipids. Furthermore, mitochondrial damage releases pro-apoptotic factors to initiate cell death. Previous studies have reported that traumatic brain injury (TBI) reduces mitochondrial respiration, enhances production of ROS, and triggers apoptotic cell death, suggesting a prominent role of mitochondria in TBI pathophysiology. Mitochondria maintain cellular energy homeostasis and health via balanced processes of fusion and fission, continuously dividing and fusing to form an interconnected network throughout the cell. An imbalance of these processes, particularly an excess of fission, can be detrimental to mitochondrial function, causing decreased respiration, ROS production, and apoptosis. Mitochondrial fission is regulated by the cytosolic GTPase, dynamin-related protein 1 (Drp1), which translocates to the mitochondrial outer membrane (MOM) to initiate fission. Aberrant Drp1 activity has been linked to excessive mitochondrial fission and neurodegeneration. Measurement of Drp1 levels in purified hippocampal mitochondria showed an increase in TBI animals as compared to sham controls. Analysis of cryo-electron micrographs of these mitochondria also showed that TBI caused an initial increase in the length of hippocampal mitochondria at 24 h post-injury, followed by a significant decrease in length at 72 h. Post-TBI administration of Mitochondrial division inhibitor-1 (Mdivi-1), a pharmacological inhibitor of Drp1, prevented this decrease in mitochondria length. Mdivi-1 treatment also reduced the loss of newborn neurons in the

  16. SU-E-T-501: Normal Tissue Toxicities of Pulsed Low Dose Rate Radiotherapy and Conventional Radiotherapy: An in Vivo Total Body Irradiation Study

    International Nuclear Information System (INIS)

    Purpose: Pulsed low dose rate radiotherapy (PLDR) is a re-irradiation technique for therapy of recurrent cancers. We have previously shown a significant difference in the weight and survival time between the mice treated with conventional radiotherapy (CRT) and PLDR using total body irradiation (TBI). The purpose of this study was to investigate the in vivo effects of PLDR on normal mouse tissues.Materials and Methods: Twenty two male BALB/c nude mice, 4 months of age, were randomly assigned into a PLDR group (n=10), a CRT group (n=10), and a non-irradiated control group (n=2). The Siemens Artiste accelerator with 6 MV photon beams was used. The mice received a total of 18Gy in 3 fractions with a 20day interval. The CRT group received the 6Gy dose continuously at a dose rate of 300 MU/min. The PLDR group was irradiated with 0.2Gyx20 pulses with a 3min interval between the pulses. The mice were weighed thrice weekly and sacrificed 2 weeks after the last treatment. Brain, heart, lung, liver, spleen, gastrointestinal, urinary and reproductive organs, and sternal bone marrow were removed, formalin-fixed, paraffin-embedded and stained with H and E. Morphological changes were observed under a microscope. Results: Histopathological examination revealed atrophy in several irradiated organs. The degree of atrophy was mild to moderate in the PLDR group, but severe in the CRT group. The most pronounced morphological abnormalities were in the immune and hematopoietic systems, namely spleen and bone marrow. Brain hemorrhage was seen in the CRT group, but not in the PLDR group. Conclusions: Our results showed that PLDR induced less toxicity in the normal mouse tissues than conventional radiotherapy for the same dose and regimen. Considering that PLDR produces equivalent tumor control as conventional radiotherapy, it would be a good modality for treatment of recurrent cancers

  17. SU-E-T-501: Normal Tissue Toxicities of Pulsed Low Dose Rate Radiotherapy and Conventional Radiotherapy: An in Vivo Total Body Irradiation Study

    Energy Technology Data Exchange (ETDEWEB)

    Cvetkovic, D; Zhang, P; Wang, B; Chen, L; Ma, C [Fox Chase Cancer Center, Philadelphia, PA (United States)

    2014-06-01

    Purpose: Pulsed low dose rate radiotherapy (PLDR) is a re-irradiation technique for therapy of recurrent cancers. We have previously shown a significant difference in the weight and survival time between the mice treated with conventional radiotherapy (CRT) and PLDR using total body irradiation (TBI). The purpose of this study was to investigate the in vivo effects of PLDR on normal mouse tissues.Materials and Methods: Twenty two male BALB/c nude mice, 4 months of age, were randomly assigned into a PLDR group (n=10), a CRT group (n=10), and a non-irradiated control group (n=2). The Siemens Artiste accelerator with 6 MV photon beams was used. The mice received a total of 18Gy in 3 fractions with a 20day interval. The CRT group received the 6Gy dose continuously at a dose rate of 300 MU/min. The PLDR group was irradiated with 0.2Gyx20 pulses with a 3min interval between the pulses. The mice were weighed thrice weekly and sacrificed 2 weeks after the last treatment. Brain, heart, lung, liver, spleen, gastrointestinal, urinary and reproductive organs, and sternal bone marrow were removed, formalin-fixed, paraffin-embedded and stained with H and E. Morphological changes were observed under a microscope. Results: Histopathological examination revealed atrophy in several irradiated organs. The degree of atrophy was mild to moderate in the PLDR group, but severe in the CRT group. The most pronounced morphological abnormalities were in the immune and hematopoietic systems, namely spleen and bone marrow. Brain hemorrhage was seen in the CRT group, but not in the PLDR group. Conclusions: Our results showed that PLDR induced less toxicity in the normal mouse tissues than conventional radiotherapy for the same dose and regimen. Considering that PLDR produces equivalent tumor control as conventional radiotherapy, it would be a good modality for treatment of recurrent cancers.

  18. Effects of local and whole body irradiation on appearance of osteoclasts during wound healing of tooth extraction sockets in rats

    International Nuclear Information System (INIS)

    We examined effects of local and whole body irradiation before tooth extraction on appearance and differentiation of osteoclasts in the alveolar bone of rat maxillary first molars. Wistar rats weighting 100 g were divided into three groups: non-irradiation group, local irradiation group, and whole body irradiation group. In the local irradiation group, a field made with lead blocks was placed over the maxillary left first molar tooth. In the whole body irradiation group, the animals were irradiated in cages. Both groups were irradiated at 8 Gy. The number of osteoclasts around the interradicular alveolar bone showed chronological changes common to non-irradiated and irradiated animals. Several osteoclasts appeared one day after tooth extraction, and the maximal peak was observed 3 days after extraction. Local irradiation had no difference from non-irradiated controls. In animals receiving whole body irradiation, tooth extraction one day after irradiation caused smaller number of osteoclasts than that 7 day after irradiation during the experimental period. Whole body-irradiated rats had small osteoclasts with only a few nuclei and narrow resorption lacunae, indicating deficiency of radioresistant osteoclast precursor cells. Injection of intact bone marrow cells to whole body-irradiated animals immediately after tooth extraction recovered to some content the number of osteoclasts. These findings suggest that bone resorption in the wound healing of alveolar socket requires radioresistant, postmitotic osteoclast precursor cells from hematopoietic organs, but not from local sources around the alveolar socket, at the initial phase of wound healing. (author)

  19. Local proliferation and extrahepatic recruitment of liver macrophages (Kupffer cells) in partial-body irradiated rats

    International Nuclear Information System (INIS)

    The relative significance of local proliferation and extrahepatic recruitment of Kupffer cells was investigated by partial-body irradiation before the induction of macrophage hyperplasia by zymosan. There was no difference in growth of the Kupffer cells population between nonirradiated rats and rats irradiated with the liver shielded, whereas irradiation of the liver with the rest of the body (bone marrow) shielded resulted in strong inhibition of growth (-61%). Splenectomy combined with bone marrow irradiation inhibited growth to a lesser extent as compared to liver irradiation (-38%). Monocyte and other leukocyte numbers were strongly reduced in peripheral blood and their accumulation in the liver was completely prevented by bone marrow irradiation. Our results demonstrate that local proliferation of resident Kupffer cells represents the predominant source for their increased number during hyperplasia

  20. Hematological Effects of Total or Partial Irradiation of the Human Body

    International Nuclear Information System (INIS)

    Many studies have been devoted to hematological effects of total body irradiation in various animal species, but there are few human data. In addition, the origin of these documents limited value. It is indeed, sometimes accidentally irradiated subjects, including irradiation was not uniform and that the dosimetry performed a posteriori, is random, sometimes irradiated patients or for the treatment of cancer or to suppress immunological reactions so that a transplant of tissue or an organ transplant, and one may wonder if the reactions such subjects are similar to those of normal subjects. Documents valid for partial irradiation of a human body by a single session even fewer and almost all relate to accidental irradiation

  1. Characteristics of a Teflon rod antenna for millimeter and submillimeter wave irradiation on living bodies

    OpenAIRE

    TATSUKAWA, Toshiaki; Doi, Akitaka; TERANAKA, Masato; Takashima, Hitoshi; Goda, Fuminori; Idehara, Toshitaka; Ogawa, Isamu; KANEMAKI, Tomohiro; NISHIZAWA, Seiji; NAMBA, Tunetoyo

    2003-01-01

    The development of a millimeter and submillimeter wave catheter for irradiation on living bodies using a Teflon rod dielectric antenna is described. The power sources of electromagnetic wave are an Impatt oscillator (90 GHz, 0.3 W) and gyrotron (302 GHz, 30 W). Irradiation tests using various Teflon rod dielectric antennas were performed on beef livers. Irradiation results were considered by microwave theory and ray optics.

  2. Total body irradiation as a form of preparation for bone marrow transplantation

    International Nuclear Information System (INIS)

    The history of total body irradiation and bone marrow transplantation is surprisingly old. Following the success of Thomas et al. in the 1970s, bone marrow transplantation appeared to be the sole curative treatment modality for high-risk leukemia. A supralethal dose of total body irradiation was widely accepted as a form of preparation for bone marrow transplantation. In this paper, I described the present status of bone marrow transplantation for leukemia patients in Japan based on the IVth national survey. Since interstitial pneumonitis was one of the most life threatening complications after bone marrow transplantation, I mentioned the dose, dose-rate and fraction of total body irradiation in more detail. In addition, I dealt with some problems of the total body irradiation, such as dose prescription, compensating contour as well as inhomogeneity, and shielding for the highrisk organs. (author) 82 refs

  3. Changes in plasma (hydrocortisone) levels after whole-body irradiation with ultraviolet rays of defined wavelengths

    International Nuclear Information System (INIS)

    One hour after whole-body irradiation with a radiation source having its maximum of emission in the UVB range, at a radiation dose of 0.44 J/cm2, a significant fall in the mean values of the blood plasma hydrocortisone level (p<0.05) was seen which exceeded the normal daytime variation. This effect could not be elicited by UVA whole-body irradiation. The ACTH concentrations in the blood plasma remained unchanged. Upon daily repetition of the UVB radiation exposure at increasing doses over a period of 12 days, the reaction of the fall in hydrocortisone repeatedly occurred again attaining the same value. The hydrocortisone concentrations of the suction blister liquid were unaltered after the UVB whole-body irradiation. The phenomenon of the fall in plasma hydrocortisone observed shortly after UVB whole-body irradiation is claimed by the author to be due to UVB-radiation-induced epidermal glucocorticoid consumption. (orig./MG)

  4. Change in the mineralization of the healing bone callus after whole-body irradiation in mice

    International Nuclear Information System (INIS)

    The delayed consolidation of diaphysial long-bone fractures in mice subjected to whole-body X-irradiation is expressed biochemically by a faulty mineralization of the repair callus. This deficiency is proportional to the irradiation intensity and is not corrected by previous administration of cycteamine

  5. Report of the work party: comparison of total body irradiation techniques for bone marrow transplantation

    International Nuclear Information System (INIS)

    The report presents a survey of total body irradiation techniques for bone marrow transplantation in nine institutions in North America and England. The survey compares their nominal dose, dose rate, point of dose prescription, type of machine used, patient's position during treatment, and use of compensators. This experience has emphasized the need for a system of uniform dose reporting and for uniform dose prescription in total body irradiation

  6. Allogeneic bone marrow transplantation with conditioning regimen of total body irradiation/busulfan/melphalan for 16 patients in children with high-risk leukemia and lymphoma

    International Nuclear Information System (INIS)

    We report the therapeutic results of allogeneic bone marrow transplantations (BMT) for 16 children with high-risk leukemia and lymphoma. The conditioning regimen consisted of total body irradiation (TBI) (12 Gy), busulfan (Bu) (4 mg/kg x 2 days), and melphalan (L-PAM) (70 mg/m2 x 2 or 3 days). Graft-versus-host disease (GVHD) prophylaxis was performed with cyclosporin (CsA) + methotrexate (MTX) (4 cases) and CsA + MTX-methyl-prednisolone (11 cases). Seven patients had acute lymphocytic leukemia, 6 acute nonlymphocytic leukemia, 2 B-cell type non-Hodgkin's lymphoma, and 1 peripheral T-cell lymphoma. Nine patients were in complete remission (CR) and 7 in non CR at BMT. Nine patients received transplants from HLA-matched related (MR) donors, 4 from HLA-mismatched related (MisR) donors, and 3 from unrelated (UR) donors. Seven of the cases, all of which were transplanted from MR, have continued complete remission for 15-47 (median 27) months. Nine patients, of which seven were transplanted from MisR/UR, died from complications from fungal pneumonia (3), cytomegalovirus pneumonitis (1), GVHD (1), rhabdomyolysis (1), lymphoproliferative disorder (1), rejection (1), and relapse (1). These results suggest that the combination of TBI, Bu, and L-PAM as a BMT regimen has a significant anti-neoplastic benefit and is considered to be useful; however, considering the high rate of fatal transplant-related complications, more refinement is required, especially for transplants from MisR and UR donors. (author)

  7. Effect of cytarabine, melphalan, and total body irradiation as conditioning for autologous stem cell transplantation for patients with AML in first remission

    International Nuclear Information System (INIS)

    Current results of autologous stem cell transplantation (SCT) suggest that this procedure may prolong disease free survival in patients with acute myelojd leukemia (AML). Autologous SCT is increasingly used as treatment for AML in first remission. The aim of this study was to evaluate the outcome of autologous SCT for patients with AML in first remission treated by autologous SCT using cytarabine, melphalan and total body irradiation (TBI) as the conditioning regimen. Between January 1995 and December 1999, 29 patients with AML in first remission underwent autologous SCT. The median age of patients was 33 years (range, 16 to 47). The conditioning regimen consisted of cytarabine (3.0 gm/m2 for 3 days), melphalan (100 mg/m2 for 1 day) and TBI (total 1000 cGy in five fractions over 3 days). The median follow up was 40 months with a range of 3 to 58 months. The 4-year cumulative probability of disease free survival was 69.0%, and median survival was 41.5 months. The 4-year relapse rate was 27.6%. The factor influencing disease free survival and relapse rate was the French-American-British (FAB) classification (M3 group vs. other groups; p=0.048, p=O.043). One patient died from treatment-related toxicity. Although the small number of patients does not allow us to draw any firm conclusion, our results were encouraging and suggest that the association of cytarabine, melphalan and TBJ as a conditioning regimen for autologous SCT for AML in first remission appears to be safe and effective

  8. Allogeneic bone marrow transplantation with conditioning regimen of total body irradiation/busulfan/melphalan for 16 patients in children with high-risk leukemia and lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoshihara, Takao; Fujii, Noriko [Matsushita Memorial Hospital, Moriguchi, Osaka (Japan); Naya, Mayumi [and others

    1999-02-01

    We report the therapeutic results of allogeneic bone marrow transplantations (BMT) for 16 children with high-risk leukemia and lymphoma. The conditioning regimen consisted of total body irradiation (TBI) (12 Gy), busulfan (Bu) (4 mg/kg x 2 days), and melphalan (L-PAM) (70 mg/m{sup 2} x 2 or 3 days). Graft-versus-host disease (GVHD) prophylaxis was performed with cyclosporin (CsA) + methotrexate (MTX) (4 cases) and CsA + MTX-methyl-prednisolone (11 cases). Seven patients had acute lymphocytic leukemia, 6 acute nonlymphocytic leukemia, 2 B-cell type non-Hodgkin`s lymphoma, and 1 peripheral T-cell lymphoma. Nine patients were in complete remission (CR) and 7 in non CR at BMT. Nine patients received transplants from HLA-matched related (MR) donors, 4 from HLA-mismatched related (MisR) donors, and 3 from unrelated (UR) donors. Seven of the cases, all of which were transplanted from MR, have continued complete remission for 15-47 (median 27) months. Nine patients, of which seven were transplanted from MisR/UR, died from complications from fungal pneumonia (3), cytomegalovirus pneumonitis (1), GVHD (1), rhabdomyolysis (1), lymphoproliferative disorder (1), rejection (1), and relapse (1). These results suggest that the combination of TBI, Bu, and L-PAM as a BMT regimen has a significant anti-neoplastic benefit and is considered to be useful; however, considering the high rate of fatal transplant-related complications, more refinement is required, especially for transplants from MisR and UR donors. (author)

  9. Busulfan, cyclophosphamide and fractionated total body irradiation as a conditioning regimen for allogeneic bone marrow transplantation in patients with non-lymphocytic hematopoietic malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Hiroshi [Jikei Univ., Tokyo (Japan). School of Medicine

    1996-11-01

    Allogeneic bone marrow transplantation (BMT) with the conditioning regimen of 8 mg/kg of busulfan (BUS), 120 mg/kg of cyclophosphamide (CPM) and 10 Gy of total body irradiation (TBI) was evaluated in the patients with non-lymphocytic hematopoietic malignancies. The disease distribution of the 22 patients was as follows; 14 in the standard risk group (SRG), 8 in the high risk group (HRG). SRG included the patients with acute myeloid leukemia (AML) in the first complete remission, chronic myelogenous leukemia (CML) in chronic phase and myelodysplastic syndrome with refractory anemia, while HRG included the patients with refractory AML and CML in blastic phase. The median age of patients was 33 years old (y.o.), and the median observation period was 34.5 months No relapse occurred, but 8 patients (36%) died of various complications. Ail the patients who died of interstitial pneumonitis (4 cases) were 40 y.o. and more. Acute graft-versus-host disease (GvHD) and chronic GvHD were clinically controllable. The probability of disease-free survival rate at 5 years (5y-DFS) was 50.0% in overall patients. The 5y-DFS was 57.1% in HRG (7 cases), while 54.3% in SRG (13 cases) donated from the HLA identical siblings (20 cases). In these 13 patients in SRG, the 5y-DFS was 100% in patients under 40 y.o. (6 cases), while the probability of disease-free survival rate at 3 years was 68.6% and the 5y-DFS was 0% in patients over 40 y.o. (7 cases). Our data indicate that the conditioning regimen combining BUS, CPM and TBI for allogeneic BMT is promising for the treatment of the patients of HRG and the patients under 40 y.o. in SRG. (author)

  10. Preventing Older Adult Falls and TBI

    Centers for Disease Control (CDC) Podcasts

    2008-03-05

    This podcast provides tips on how older adults can prevent falls and related injuries, such as traumatic brain injuries (TBI).  Created: 3/5/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 3/7/2008.

  11. Whole-body irradiation transiently diminishes the adrenocorticotropin response to recombinant human interleukin-1α

    International Nuclear Information System (INIS)

    Recombinant human interleukin-1α (rhIL-1α) has significant potential as a radioprotector and/or treatment for radiation-induced hematopoietic injury. Both IL-1 and whole-body ionizing irradiation acutely stimulate the hypothalamic-pituitary-adrenal axis. We therefore assessed the interaction of whole-body irradiation and rhIL-1α in altering the functioning of the axis in mice. Specifically, we determined the adrenocorticotropin (ACTH) and corticosterone responses to rhIL-1α administered just before and hours to days after whole-body or sham irradiation. Our results indicate that whole-body irradiation does not potentiate the rhIL-1α-induced increase in ACTH levels at the doses used. In fact, the rhIL-1α-induced increase in plasma ACTH is transiently impaired when the cytokine is administered 5 h after, but not 1 h before, exposure to whole-body irradiation. The ACTH response may be inhibited by elevated corticosterone levels after whole-body irradiation, or by other radiation-induced effects on the pituitary gland and hypothalamus. 36 refs., 3 figs

  12. Physical exercise tolerance in patients with chronic lymphoproliferative diseases after whole-body therapeutic gamma irradiation

    International Nuclear Information System (INIS)

    It is stated that physical workability remains practically at the initial level after a course of fractionated whole-body therapeutic gamma irradiation at the integral doze of 1 Gy obtained during two weeks and at the integral dose of 2 Gy obtained during 4 weeks. Tendency to decrease of systolic arterial pressure (AP) is noted under fractionated whole-body therapeutic gamma irradiation at the integral dose of 1 Gy that should be necessarily taken into account under irradiation of patients with reduced AP and patients receiving hypotensive preparations for accompanying arterial hypertension

  13. Perturbations in phosphoinositide metabolism and protein kinase C activity in mouse liver following whole body irradiation

    International Nuclear Information System (INIS)

    The involvement of the signal transduction pathway in mouse liver following whole body irradiation was investigated. Mice were exposed to 60Co gamma rays (3 Gy) and sacrificed after different time intervals. Various elements of phosphatidyl inositol signal transduction pathway were investigated. Alterations could be seen as early as 15 min of irradiation. These changes are reflected in elevation in DAG levels and increased activation of PKC, an enzyme which is involved in tumorigenesis. The chronological appearance of various transducers following whole body irradiation is of significance since these early effects may set the stage for radiation-induced tumorigenesis and hence may be used to manipulate tumor response to radiotherapy. (author)

  14. Employment of whole-body ν-irradiation in chronic lymphoid leukemia and malignant lymphomas

    International Nuclear Information System (INIS)

    There are presented data showing that whole-body therapeutic ν-irradiation is an effective method of treatment of chronic lymphoid leukosis and lymphomas. Rapid lymphopenic effect, satisfactory diminution of lymph nodes and spleen sizes testify to the effect. The necessity of further investigation of the treatment method is underlined. It is of interest to trace the fate of lymphocyte subpopulations in the course and after treatment. The urgency of working out a most rational scheme for whole-body therapeutic irradiation and for investigating indications for local irradiation of various groups of lymphatic nodes is indicated

  15. Employment of whole-body. gamma. -irradiation in chronic lymphoid leukemia and malignant lymphomas

    Energy Technology Data Exchange (ETDEWEB)

    Danilova, N.B.; Baranov, A.E.; Khrushchev, V.G.; Grammatikati, V.S.; Murav' eva, L.I.; Strashnenko, E.S.

    1982-11-01

    There are presented data showing that whole-body therapeutic ..gamma..-irradiation is an effective method of treatment of chronic lymphoid leukosis and lymphomas. Rapid lymphopenic effect, satisfactory diminution of lymph nodes and spleen sizes testify to the effect. The necessity of further investigation of the treatment method is underlined. It is of interest to trace the fate of lymphocyte subpopulations in the course and after treatment. The urgency of working out a most rational scheme for whole-body therapeutic irradiation and for investigating indications for local irradiation of various groups of lymphatic nodes is indicated.

  16. The effect of whole body irradiation on the action of strong analgesics of mice

    International Nuclear Information System (INIS)

    The effect of whole body irradiation of male mice with single doses of 3 and 7 Gy (60Co source) on analgesic action of three morphine-like drugs was studied. Over the first 6 days after irradiation, the analgesic effect of alfentanil and fentanyl was significantly less pronounced in irradiated animals than in control ones. During the subsequent period of 24 days till the end of experiment, the analgesic effect in irradiated animals gradually increased reaching and exceeding the control values. On the contrary, the analgesic effect of butorphanole was less pronounced in irradiated animals than in control ones, although the difference was not significantly. The difference between butorphanole and other two drugs are probably due to chemical structure and the metabolic fate in the body. (author) 8 refs.; 2 figs

  17. The pupal body temperature and inner space temperature of cocoon under microwave irradiation

    International Nuclear Information System (INIS)

    The temperature of pupal surface,body and inner space of cocoon on cocoon drying of microwave irradiation was investigated to make clear the effect of temperature with pupa and cocoon shell. After pupal surface temperature and body temperature were risen rapidly in early irradiation and slowly thereafter, these were done fast again. Then these rising degrees fell. The variation of inner space temperature consists three terms: as the first stage of rapidly rising on early irradiation, the second stage of slowly doing and the third stage of fast doing again in temperature. In the first stage and the second stage, the higher the temperature of sending air during irradiation was, the shorter the term was and the higher the reached temperature was. The surface, pupal body and inner space have reached higher temperature than the sending air before cocoon drying was over

  18. Change in the Casimir force between semiconductive bodies by irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Inui, Norio [Graduate School of Engineering, University of Hyogo, 2167, Shosha, Himeji, Hyogo, 671-2280 (Japan)

    2007-11-15

    Two topics relevant to the Casimir force (retarded van der Waals force), which is exerted between neutral objects due to the quantum vacuum fluctuations of the electromagnetic field are discussed- First, the enhancement of the Casimir between silicon plates by irradiation is considered. Irradiation generates free carriers inside silicon and it can cause enhancement of the Casimir force between silicon membranes. The temporal behavior of the Casimir force between two parallel silicon membranes after irradiating the surface with UV pulse laser is numerically studied. Based on the Lifshitz theory accounting for thickness of the slabs, the Casimir force as a function of time and the finite size effect of the thickness is calculated. The our experiment in progress to demonstrate the enhancement of the Casimir force by irradiation is also refer. Second, the influence of optical adsorption on the Casimir force acting between a metallic sphere and a semiconductive plate illuminated with Gaussian light beam is considered. The Casimir torque and the lateral Casimir force result form the inhomogeneous photonionization. Taking into account the spatial inhomogeneousness of the plasma frequency in the semiconductive plate, the dependence of the Casimir force on the distance between the optical axis and the center of the sphere is computed within the proximity force approximation.

  19. Change in the Casimir force between semiconductive bodies by irradiation

    International Nuclear Information System (INIS)

    Two topics relevant to the Casimir force (retarded van der Waals force), which is exerted between neutral objects due to the quantum vacuum fluctuations of the electromagnetic field are discussed- First, the enhancement of the Casimir between silicon plates by irradiation is considered. Irradiation generates free carriers inside silicon and it can cause enhancement of the Casimir force between silicon membranes. The temporal behavior of the Casimir force between two parallel silicon membranes after irradiating the surface with UV pulse laser is numerically studied. Based on the Lifshitz theory accounting for thickness of the slabs, the Casimir force as a function of time and the finite size effect of the thickness is calculated. The our experiment in progress to demonstrate the enhancement of the Casimir force by irradiation is also refer. Second, the influence of optical adsorption on the Casimir force acting between a metallic sphere and a semiconductive plate illuminated with Gaussian light beam is considered. The Casimir torque and the lateral Casimir force result form the inhomogeneous photonionization. Taking into account the spatial inhomogeneousness of the plasma frequency in the semiconductive plate, the dependence of the Casimir force on the distance between the optical axis and the center of the sphere is computed within the proximity force approximation

  20. Radioprotective effects of dipyridamole. Effect on lipid peroxidation in mouse spleen after whole-body irradiation

    International Nuclear Information System (INIS)

    We have investigated the effects of dipyridamole, which has radioprotective effects in mice, on radiation damage in the mouse spleen. The level of thiobarbituric acid-reactive substances (TBARS) in the spleen, a measure of free radical initiated lipid peroxidation, increased significantly between 6 and 10 Gy 4 days after whole-body irradiation (p<0.05). Also, the TBARS in the spleen increased linearly between days 2 and 10 after 9 Gy whole-body irradiation. The TBARS concentration in the spleen 4 days after irradiation was reduced significantly from 5.15±0.97 nmole/mg protein to 3.76±0.35 nmole/mg protein by dipyridamole treatment (1hr before irradiation, 2 mg i.p.) (p<0.01), but no effects were observed with 2 mg i.p. dipyridamole treatment after irradiation. The weight of the spleen decreased significantly between 6 (31%) to 10 Gy (21%) 4 days after whole-body irradiation (p<0.05). The spleen weight 2 day after 9 Gy whole-body irradiation (40.2±1.8 mg) decreased significantly as compared with the control group (125.8±16.8 mg, p< O.01), and the decrease in spleen weight was related to the time lapse (after irradiation from 2 to 10 days). The slight inhibition effect on the decrease of spleen weight was observed by dipyridamole treatment 2 days after 9 Gy whole-body irradiation. These results suggest that the radioprotective effects of dipyridamole are related to the inhibition of lipid peroxidation and to participation in the early phase of apoptosis in spleen cells. (author)

  1. Protection from radiation induced changes in liver and serum transaminase of whole body gamma irradiated rats

    International Nuclear Information System (INIS)

    Whole body gamma irradiation of rats with a dose of 5.5 Gy induced significant changes in the activity of liver and serum transaminase. The results indicated that this radiation dose caused a significant increase in the activity of serum Got and GPT on the third and seventh days after irradiation. This was followed by significant decreases on the fourteenth post-irradiation day. The activity of Got returned to is control activity, while the activity of GPT was significantly above the control on the twenty ones post-irradiation day. The activity of Got, in the liver of irradiated rats was elevated during the post-irradiation days, but on the twenty one day activity was about the normal value. The activity of liver GPT firstly decreased and then increased very much but attained the control level on the fourteenth after irradiation. The intraperitoneal injection of testosterone-vitamin E mixture 10 days before whole body gamma irradiation caused complete recovery for the activity of liver and serum Got. No indication of remarkable recovery in the case of GPT activity was recorded either in liver or in serum of irradiated rats. The applied mixture could protect against radiation induced changes in Got activity of liver and serum but could not protect or ameliorate the changes which occurred in the activity of GPT of the two tissues. 2 tab

  2. Segmental pancreatic allograft survival in baboons treated with combined irradiation and cyclosporine: a preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    du Toit, D.F.; Heydenrych, J.J.; Smit, B.; Louw, G.; Zuurmond, T.; Laker, L.; Els, D.; Weideman, A.; Wolfe-Coote, S.; van der Merwe, E.A.

    1985-04-01

    The present study was undertaken to evaluate the effectiveness of cyclosporine (CS) alone, total lymphoid irradiation (TLI) alone, and CS in combination with total body irradiation (TBI) in suppressing segmental pancreatic allograft rejection in totally pancreatectomized outbred chacma baboons. The administration of CS 25 mg/kg/day and 50 mg/ kg/day resulted in mean graft survival of 21.5 days and 24.5 days, respectively. CS 85 mg/kg/day resulted in median graft survival of 9 days. There was a wide daily fluctuation of CS serum trough levels exhibited between primates receiving the same oral dose. TBI in excess of 300 rads resulted in irreversible bone marrow suppression. Modest results were achieved in recipients of TBI-76 rads (38 x 2 rads), with median graft survival of 21 days, results not different from recipients treated with CS. TLI recipients of 600 rads (150 x 4 rads) resulted in median pancreatic graft survival of 16 days. TBI together with oral CS administration exhibited no synergistic or additive effect and a single peroperative donor-specific blood transfusion did not enhance pancreatic allograft survival in this model. However, of 10 primates receiving TBI 100 rads (50 x 2 rads) and CS 25 mg/kg/day administered orally indefinitely, four remained normoglycemic for more than 60 days. TBI 100 rads (50 x 2 rads) together with oral and parenteral CS resulted in necrotizing enterocolitis in four of six recipients.

  3. The Gottingen Minipig Is a Model of the Hematopoietic Acute Radiation Syndrome: G-Colony Stimulating Factor Stimulates Hematopoiesis and Enhances Survival From Lethal Total-Body γ-Irradiation

    International Nuclear Information System (INIS)

    Purpose: We are characterizing the Gottingen minipig as an additional large animal model for advanced drug testing for the acute radiation syndrome (ARS) to enhance the discovery and development of novel radiation countermeasures. Among the advantages provided by this model, the similarities to human hematologic parameters and dynamics of cell loss/recovery after irradiation provide a convenient means to compare the efficacy of drugs known to affect bone marrow cellularity and hematopoiesis. Methods and Materials: Male Gottingen minipigs, 4 to 5 months old and weighing 9 to 11 kg, were used for this study. We tested the standard off-label treatment for ARS, rhG-CSF (Neupogen, 10 μg/kg/day for 17 days), at the estimated LD70/30 total-body γ-irradiation (TBI) radiation dose for the hematopoietic syndrome, starting 24 hours after irradiation. Results: The results indicated that granulocyte colony stimulating factor (G-CSF) enhanced survival, stimulated recovery from neutropenia, and induced mobilization of hematopoietic progenitor cells. In addition, the administration of G-CSF resulted in maturation of monocytes/macrophages. Conclusions: These results support continuing efforts toward validation of the minipig as a large animal model for advanced testing of radiation countermeasures and characterization of the pathophysiology of ARS, and they suggest that the efficacy of G-CSF in improving survival after total body irradiation may involve mechanisms other than increasing the numbers of circulating granulocytes

  4. The Gottingen Minipig Is a Model of the Hematopoietic Acute Radiation Syndrome: G-Colony Stimulating Factor Stimulates Hematopoiesis and Enhances Survival From Lethal Total-Body γ-Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Moroni, Maria, E-mail: maria.moroni@usuhs.edu [Radiation Countermeasures Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland (United States); Ngudiankama, Barbara F. [Laboratory of Viral Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, Maryland (United States); Christensen, Christine [Division of Comparative Pathology, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland (United States); Olsen, Cara H. [Biostatistics Consulting Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland (United States); Owens, Rossitsa [Radiation Countermeasures Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland (United States); Lombardini, Eric D. [Veterinary Medicine Department, Armed Forces Research Institute of Medical Sciences, Bangkok (Thailand); Holt, Rebecca K. [Veterinary Science Department, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland (United States); Whitnall, Mark H. [Radiation Countermeasures Program, Armed Forces Radiobiology Research Institute, Uniformed Services University of the Health Sciences, Bethesda, Maryland (United States)

    2013-08-01

    Purpose: We are characterizing the Gottingen minipig as an additional large animal model for advanced drug testing for the acute radiation syndrome (ARS) to enhance the discovery and development of novel radiation countermeasures. Among the advantages provided by this model, the similarities to human hematologic parameters and dynamics of cell loss/recovery after irradiation provide a convenient means to compare the efficacy of drugs known to affect bone marrow cellularity and hematopoiesis. Methods and Materials: Male Gottingen minipigs, 4 to 5 months old and weighing 9 to 11 kg, were used for this study. We tested the standard off-label treatment for ARS, rhG-CSF (Neupogen, 10 μg/kg/day for 17 days), at the estimated LD70/30 total-body γ-irradiation (TBI) radiation dose for the hematopoietic syndrome, starting 24 hours after irradiation. Results: The results indicated that granulocyte colony stimulating factor (G-CSF) enhanced survival, stimulated recovery from neutropenia, and induced mobilization of hematopoietic progenitor cells. In addition, the administration of G-CSF resulted in maturation of monocytes/macrophages. Conclusions: These results support continuing efforts toward validation of the minipig as a large animal model for advanced testing of radiation countermeasures and characterization of the pathophysiology of ARS, and they suggest that the efficacy of G-CSF in improving survival after total body irradiation may involve mechanisms other than increasing the numbers of circulating granulocytes.

  5. Dynamics of Delayed p53 Mutations in Mice Given Whole-Body Irradiation at 8 Weeks

    International Nuclear Information System (INIS)

    Purpose: Ionizing irradiation might induce delayed genotoxic effects in a p53-dependent manner. However, a few reports have shown a p53 mutation as a delayed effect of radiation. In this study, we investigated the p53 gene mutation by the translocation frequency in chromosome 11, loss of p53 alleles, p53 gene methylation, p53 nucleotide sequence, and p53 protein expression/phosphorylation in p53+/+ and p53+/- mice after irradiation at a young age. Methods and Materials: p53+/+ and p53+/- mice were exposed to 3 Gy of whole-body irradiation at 8 weeks of age. Chromosome instability was evaluated by fluorescence in situ hybridization analysis. p53 allele loss was evaluated by polymerase chain reaction, and p53 methylation was evaluated by methylation-specific polymerase chain reaction. p53 sequence analysis was performed. p53 protein expression was evaluated by Western blotting. Results: The translocation frequency in chromosome 11 showed a delayed increase after irradiation. In old irradiated mice, the number of mice that showed p53 allele loss and p53 methylation increased compared to these numbers in old non-irradiated mice. In two old irradiated p53+/- mice, the p53 sequence showed heteromutation. In old irradiated mice, the p53 and phospho-p53 protein expressions decreased compared to old non-irradiated mice. Conclusion: We concluded that irradiation at a young age induced delayed p53 mutations and p53 protein suppression.

  6. Type 2 Diabetes is a Delayed Late Effect of Whole-Body Irradiation in Nonhuman Primates

    Science.gov (United States)

    Kavanagh, Kylie; Dendinger, Michael D.; Davis, Ashley T.; Register, Thomas C.; DeBo, Ryne; Dugan, Greg; Cline, J. Mark

    2015-01-01

    One newly recognized consequence of radiation exposure may be the delayed development of diabetes and metabolic disease. We document the development of type 2 diabetes in a unique nonhuman primate cohort of monkeys that were whole-body irradiated with high doses (6.5–8.4 Gy) 5–9 years earlier. We report here a higher prevalence of type 2 diabetes in irradiated monkeys compared to age-matched nonirradiated monkeys. These irradiated diabetic primates demonstrate insulin resistance and hypertriglyceridemia, however, they lack the typical obese presentation of primate midlife diabetogenesis. Surprisingly, body composition analyses by computed tomography indicated that prior irradiation led to a specific loss of visceral fat mass. Prior irradiation led to reductions in insulin signaling effectiveness in skeletal muscle and higher monocyte chemoattractant protein 1 levels, indicative of increased inflammation. However, there was an absence of large defects in pancreatic function with radiation exposure, which has been documented previously in animal and human studies. Monkeys that remained healthy and did not become diabetic in the years after irradiation were significantly leaner and smaller, and were generally smaller and younger at the time of exposure. Irradiation also resulted in smaller stature in both diabetic and nondiabetic monkeys, compared to nonirradiated age-matched controls. Our study demonstrates that diabetogenesis postirradiation is not a consequence of disrupted adipose accumulation (generalized or in ectopic depots), nor generalized pancreatic failure, but suggests that peripheral tissues such as the musculature are impaired in their response to insulin exposure. Ongoing inflammation in these animals appears to be a consequence of radiation exposure and can interfere with insulin signaling. The reasons that some animals remain protected from diabetes as a late effect of irradiation are not clear, but may be related to body size. The translational

  7. Effects of total body irradiation on functions of small intestinal intraepithelial lymphocytes

    International Nuclear Information System (INIS)

    Objective: To explore the characteristics of intestinal mucosal immunity after gamma irradiation. Methods: The number, proliferation activity, cytotoxic activity of small intestinal intraepithelial lymphocytes (IELs), and the TNF-α and TGF-β concentrations in supernatant of cultured IELs were studied using IELs freshly isolated from whole small intestine of Kunming strain mice after 3,8 and 12 Gy total body 60Co γ-irradiation. Results: (1) The number of IELs in small intestinal mucosa of all irradiated mice significantly decreased at 8 h, reaching the lowest level at 48-72 h post-irradiation, then began to rise, but it still did not return to its normal level on day 15. (2) The proliferation activity and cytotoxic activity of IELs isolated from irradiated mice were reduced sharply. They followed the same pattern of decreasing at 8h, reaching the lowest level at 48-72 h post-irradiation, then began to rise, but it did not return to their normal levels on day 15. (3) The TNF-α and TGF-β concentrations in supernatant of cultured IELs isolated from irradiated mice were elevated at 8h, reaching their peak at 48-72 h. Conclusion: The decrease in number and important functions of IELs is one of the factors damaging the intestinal mucosal immunity barrier after total body irradiation

  8. Changes in Serum Zinc, Copper and Ceruloplasmin Levels of Whole Body Gamma Irradiated Rats

    International Nuclear Information System (INIS)

    Rats are whole body irradiated with different Gamma radiation doses. Zinc and Copper, two important trace elements in the biological processes and Ceruloplasmin, a protein which carries more than 95% of serum Cu and has important roles in many vital processes are followed up in the irradiated rat sera. This work aimed to determine the changes in the serum levels of the three parameters (Zinc, Copper and Ceruloplasmin) through eight weeks follow up period (1st, 2nd, 3rd, 4th, 6th, and 8th week) post whole body gamma irradiation with three sub-lethal doses (2, 3.5 and 5 Gy) of rats. All the experimental animals did not receive any medical treatment. Zinc and Copper were measured using discrete nebulization flame atomic absorption spectrometry. Ceruloplasmin was measured using a colorimetric method. The statistical analyses of the results show that the Zinc levels of the irradiated groups decreased significantly post irradiation and then were recovered at the 6th week post irradiation. The Copper levels of the irradiated groups increased significantly and then were recovered at 6th week post irradiation. The levels of Ceruloplasmin in the same groups increased significantly throughout the whole follow up period. The conclusion is that, Zinc, Copper and Ceruloplasmin levels changed significantly in the irradiated groups compared to the control group with a maximum effect noted in the groups irradiated with the higher doses and that the lower dose irradiated groups recover earlier than the higher ones. Also the correlation between Copper and Zinc is reversible at different doses and that between Copper and Ceruloplasmin is direct

  9. Total body irradiation (sweeping beam technique) prior bone marrow transplantation

    International Nuclear Information System (INIS)

    There are given the principle and basic informations about Sweeping beam technique with gantry rotation on LINAC ORION 6. The whole process of treatment is presented here: CT - determination of reference points and reference slices (AP, PA) Simulator - localization of lung shielding (AP, PA) Linac - determination of some physical parameters - simulation of radiation technique Treatment planning - calculation of treatment time and number of sweeps - determination of lung shielding Model laboratory - preparation of lung shielding blocks - blocks position and fixation Radiation therapy - verification of shielding blocks - patient irradiation (AP, PA) Dosimetry in-vivo - determination of patient's doses At the end the presentation of physical results with group of 55 patients is reported

  10. The effects of 3Gy total body irradiation on mouse intestinal intraepithelial lymphocytes' number and functions

    International Nuclear Information System (INIS)

    To explore the characteristics of intestinal mucosal immunity after radiation injury, IEL number, proliferation activity, cytotoxic activity as well as the TNF-α and TGF-β concentrations of supernatant of cultured IEL were studied using IEL freshly isolated from whole small intestine of Kunming strain mice received 3Gy total body 60Co γ-ray irradiation. The proliferation activity, cytotoxic activity as well as the number of IEL in small intestinal mucosa were significantly decreased at 8h post-irradiation, reaching lowest level at 72h. The TNF-α and TGF-β concentrations of supernatant of cultured IEL isolated from irradiated mice were elevated at 8h, reaching peak at 72h. The decrease in number and functions of IEL may play an important role in the damage intestinal mucosal immunity barrier after total body irradiation

  11. Time course of lipolytic activity and lipid peroxidation after whole-body gamma irradiation of rats

    Energy Technology Data Exchange (ETDEWEB)

    Rejholcova, M.; Wilhelm, J.

    1989-01-01

    The content of fluorescing products of lipid peroxidation (LFP) and hormone-stimulated lipolytic activity were determined in rat epididymal adipose tissue during a 29-day interval after whole-body gamma irradiation. An increase in LFP was accompanied by a decrease in lipolytic activity. It is suggested that these effects are interrelated and that the decrease in lipolysis in irradiated, semi fasting rats is an additional deteriorating factor leading to death in some animals.

  12. The clinical experience and results of total body irradiation for the cases of refractory leukemia

    International Nuclear Information System (INIS)

    Five patients suffering from refractory leukemia were treated by Cyclophosphamide and total body irradiation followed by bone marrow transplantation. Total body irradiation with 10 MV Linac x-ray (1000 - 1280 rad, peak absorbed dose) followed by bone marrow transplantation is considered to be a relatively safe procedure. The dose distribution of the total body irradiation shows clinically suitable homogeniety. Although there is no long-term survivor in this study, no relapse sign of leukemia was found at autopsy. Therefore, some possibility of cure can be expected from this experience. There are many problems such as Graft-versus-host disease, susceptability to infection, etc., but this combination therapy will be able to contribute to improve the clinical course of refractory leukemia. (author)

  13. Type 2 Diabetes is a Delayed Late Effect of Whole-Body Irradiation in Nonhuman Primates

    OpenAIRE

    Kavanagh, Kylie; Dendinger, Michael D.; Davis, Ashley T.; Register, Thomas C.; DeBo, Ryne; Dugan, Greg; Cline, J. Mark

    2015-01-01

    One newly recognized consequence of radiation exposure may be the delayed development of diabetes and metabolic disease. We document the development of type 2 diabetes in a unique nonhuman primate cohort of monkeys that were whole-body irradiated with high doses (6.5–8.4 Gy) 5–9 years earlier. We report here a higher prevalence of type 2 diabetes in irradiated monkeys compared to age-matched nonirradiated monkeys. These irradiated diabetic primates demonstrate insulin resistance and hypertrig...

  14. Behavior of peripheral reticulocytes following whole-body irradiation and stimulation of the bone marrow

    International Nuclear Information System (INIS)

    The relative reticulocyte content and the average Fe uptake of peripheral reticulocytes were investigated in rats after blood loss and whole-body irradiation as well as after a combined treatment for a time of 15 days. The acute loss of blood caused a rapid increase of cellular uptake within 24 hours, whereas after irradiation a considerable diminution could be observed. In addition to a direct stimulation or inhibition of bone marrow activity a direct influence of blood loss and irradiation on reticulocytes is discussed. (author)

  15. Four cases of protracted whole body irradiation (Algerian accident 1978)

    International Nuclear Information System (INIS)

    A 25 Ci iridium-192 source accidentally lost was introduced in a room where among others four young female patients (14 - 20 years old) one of them pregnant were irradiated during 4/5 weeks, 6/8 hours daily, cumulating skin doses in the range of 2500r and mean medullary doses in the range of 1250r. They developed a very protracted infections and haemorragic syndrome during which they were treated successfully by haematologic compensatory therapy with enormous quantities of packed isolated blood cells (R.B.C., W.B.C., platelets) and massive antibiotic, antimycotic and hydro-electrolytic therapy. The dosimetric (physical and biological) problems are discussed and the clinical and biological data are given in detail

  16. Clinical aspects of accidents resulting in acute total body irradiation

    International Nuclear Information System (INIS)

    That the management of whole body radiation injury involves: (1) watchful waiting, (2) observation of the hematologic parameters, (3) use of antibiotics, platelet red cell and possibly granulocyte transfusions, (4) administration of hemopoietic molecular regulators of granulopoiesis, and (5) bone marrow transplantation as the last line of defense. The clinical indication for the preceding will not be discussed, since this will be a subject of later speakers in this conference. Certainly, if a radiation casualty is fortunate enough to have an identical twin, a marrow transplant may be lifesaving and certainly can do no harm to the patient, and there is little risk to the donor

  17. Entire litters developed from transferred eggs in whole body x-irradiated female mice

    International Nuclear Information System (INIS)

    The sensitivity of mouse eggs to sublethal x-irradiation was determined in vitro and in vivo with regard to the development of donor litters in foster mothers. One thousand seven hundred fifty-eight unfertilized eggs of agouti dark-eyed donor mice were transferred into 293 unirradiated or x-irradiated, mated female pink-eyed mice. Two hundred thirty-nine recipients became pregnant; of these 35 produced litters containing solely dark-eyed fetuses. Sublethal doses of x-radiation administered to donor eggs in vitro before transferring into unirradiated recipients did not influence significantly the number of litters of exclusively dark-eyed fetuses produced. However, recipients irradiated by 250 roentgens (r) produced more solely dark-eyed litters than did those irradiated with 100 r. In 21 pregnant females irradiated by 100 r, only 3 (14%) developed solely dark-eyed fetuses as compared to 22 pregnant females irradiated by 250 r, of which 13 (59%) developed solely dark-eyed fetuses, all from unirradiated, transferred eggs. Of another group of 22 pregnant females which received 250 r body irradiation and subsequently received eggs also irradiated by 250 r, only 7 (32%) produced litters of dark-eyed fetuses. No one female of these three groups carried native fetuses. Such radiation-induced infertility resulting from damage of native eggs rather than loss of mother's ability to carry a pregnancy, is frequently remedied by egg transfer

  18. Effects of low dose half-body irradiation on immune function in patients with malignant tumor

    International Nuclear Information System (INIS)

    Objective: To evaluate the effects on the immune function by low dose half-body irradiation. Methods: Twenty patients, 13 non-Hodgkin's lymphoma and 7 small cell lung cancer, were randomly divided into two groups: HBR and RR. 10 patients of HBR were administrated with routine radiotherapy and low dose of half-body irradiation with 10 cGy once, twice every week. The routine radiotherapy was performed 6-8 h after low dose half-body irradiation and the total dose is 100 cGy. The other 10 patients of RR were given with routine radiotherapy alone. The changes in CD4, CD8, CD25 and CD56 of the peripheral blood lymphocyte between HBR and RR were measured by flow cytometry pro-, midst- and post-radiotherapy. Results: The CD4+/CD8+ for RR patients was decreased after irradiation (P4+, as well as the expression of CD25+ and CD56+ molecule were significantly increased (P8+ was decreased pro-, post- radiotherapy (P4+/CD8+ was increased midst- (P<0.05) and post-radiotherapy (P<0.01). Conclusions: Low dose half-irradiation could enhance the immune function. (authors)

  19. Acute effects of whole body gamma irradiation on exocrine pancreatic secretion in the pig

    International Nuclear Information System (INIS)

    Reports on radiation damage to the pancreas deal essentially with long-term morphological changes with few data on pancreatic exocrine function. The aim of this work was to study the acute effects of whole body irradiation on volume and enzyme activities in the pancreatic juice. A whole body gamma irradiation (6 Gy) was investigated in pigs with continuous sampling of pancreatic juice before and after exposure via an indwelling catheter in the pancreatic duct. For each sample collected, total protein concentration and enzyme activities of trypsin, chymotrypsin, elastase, lipase and amylase were determined. Pancreatic juice volume was monitored during all periods of collection. The volume of pancreatic juice secreted daily decreased one day after irradiation and remained lower than the control values over the experimental period. Total proteins secreted in the pancreatic juice and total activities of pancreatic enzymes were reduced similarly. On the other hand, only specific activities of elastase and lipase were affected by irradiation. Whole body gamma irradiation resulted in a rapid and marked decrease of exocrine pancreatic secretion, in terms of volume as well as secreted enzymes. This may contribute in part to the intestinal manifestations of the acute and/or late radiation syndrome. (author)

  20. Changes in serum amylase and its isoenzymes after whole body irradiation

    International Nuclear Information System (INIS)

    A study was carried out to assess the effect of total body irradiation on pancreatic and parotid isoenzymes of amylase in patients about to undergo bone-marrow transplantation who had received high-dose cyclophosphamide. Twelve patients were studied, enzyme activity being measured before and at various times after total body irradiation. Serum total amylase activity rose rapidly within 12 hours of irradiation to a maximum at 36 hours, returning to normal by six days; most of the increase was derived from salivary damage, with a much smaller pancreatic component. These results confirm that radiation produces acute changes in amylase activity, which may be of use in assessing radiation-induced damage. (author)

  1. The influence of hypoxia on the hematological radiation response following whole-body irradiation of dogs

    International Nuclear Information System (INIS)

    To determine the protective effect of hypoxia in the hematopoietic radiation response 9 beagles were exposed to whole body X irradiation with 3.0 Gy medium line dosis (MLD) and after 10 weeks to a second 60Co-gamma whole-body irradiation with 6.5 Gy MLD, 5 animals being exposed under respiratory hypoxia of 7.5% O2 and 4 under normal oxygen conditions. 4 animals were sham-irradiated under 7.5% hypoxia. The effect of hypoxia found expression in a distinct decrease of neutropenia and a lesser extent of lymphopenia after 3.0 Gy MLD. The highest effect was obtained with respect to a significant increase of the effectiveness of the regenerative events. After 6.5 Gy MLD and the subsequent peracute course of the radiation syndrome the protective effect could be observed less clearly

  2. Bone Marrow Transplantation, 20 years of experience with total body irradiation in the 'Hermanos Ameijeiras' hospital

    International Nuclear Information System (INIS)

    Using Total Body Irradiation (ICT) for bone marrow transplants is indicated in several hematological malignancies such as Acute and Chronic Myeloid Leukemia, Acute Lymphocytic Leukemia, Lymphoma and Myelodysplastic Syndrome. The odds of survival with this procedure than those obtained with standard treatments in this type of condition, ensuring a better life expectancy for these patients. (Author)

  3. Subtotal body irradiation with linear accelerator as preparation for marrow engraftment in aplastic anemia

    International Nuclear Information System (INIS)

    Two cases of multitransfused severe aplastic anemia were retransplanted with bone marrow from the same HLA compatible sibling donors after subtotal body irradiation (800 r). Only minor non hematologic toxicity was observed. No permanent take was seen in relation to this procedure. During the survival time of the patients (78-120 days) no signs of interstitial pneumonia were observed

  4. Caffeine protects mice against whole-body lethal dose of γ-irradiation

    International Nuclear Information System (INIS)

    Administration of caffeine (1,3,7-trimethylxanthine), a major component of coffee, to Swiss mice at doses of 80 or 100 mg/kg body weight 60 min prior to whole-body lethal dose of γ-irradiation (7.5 Gy) resulted in the survival of 70 and 63% of animals, respectively, at the above doses in contrast to absolutely no survivors (LD-100/25 days) in the group exposed to radiation alone. Pre-treatment with a lower concentration of caffeine (50 mg/kg) did not confer any radioprotection. The protection exerted by caffeine (80 mg/kg), however, was reduced from 70 to 50% if administered 30 min prior to irradiation. The trend statistics reveal that a dose of 80 mg/kg administered 60 min before whole-body exposure to 7.5 Gy is optimal for maximal radioprotection. However, caffeine (80 mg/kg) administered within 3 min after irradiation offered no protection. While there is documentation in the literature that caffeine is an antioxidant and radioprotector against the toxic pathway of radiation damage in a wide range of cells and organisms, this is the first report demonstrating unequivocally its potent radioprotective action in terms of survival of lethally whole-body irradiated mice. (author)

  5. Mitochondrial monoaminoxidase activity and serotonin content in rat brain after whole-body γ-irradiation

    International Nuclear Information System (INIS)

    It is shown that γ-irradiation of albino rats with a dose of 30 Gy leads to pronounced phase changes in monoaminoxidase activity and serotonin content in rat brain at early times after whole-body exposure. These is a similar direction of changes in the activity of the enzyme and in the content of the substrate adequate to the latter

  6. Total body irradiation with a 10 MV linear accelerator in conjunction with bone marrow transplantation

    International Nuclear Information System (INIS)

    Total body irradiation (1000 rad, single dose) in conjunction with chemotherapy and bone marrow transplantation is a therapy for acute leukemia. We show that a 10 MV linear accelerator is a suitable source of radiation for these procedures. Dosimetric and clinical results are presented for 25 patients who were treated between 5/76 and 12/78

  7. Modelling and validation for total body irradiation using a 3D planning system

    International Nuclear Information System (INIS)

    Pinnacle treatment planning system has been successfully commissioned for total body irradiation and will be used for patient treatments in near future. The actual dose delivered to patients will be monitored with TLDs and diode array and the agreement with the prescribed dose will be further investigated

  8. Whole-body irradiation technique: physical aspects; Tecnica de irradiacion corporal total: aspectos fisicos

    Energy Technology Data Exchange (ETDEWEB)

    Venencia, D.; Bustos, S.; Zunino, S. [Instituto Privado de Radioterapia. Obispo Oro 425. Cordoba 5000 (Argentina)

    1998-12-31

    The objective of this work has been to implement a Total body irradiation technique that fulfill the following conditions: simplicity, repeatability, fast and comfortable positioning for the patient, homogeneity of the dose between 10-15 %, short times of treatments and In vivo dosimetric verifications. (Author)

  9. Effect of Hippophae leaves on neurotransmitters and hematological parameters in whole body irradiated rats

    International Nuclear Information System (INIS)

    Till date no approved radio-protective agent is available world over. WR-2721 had severe side effects and was behaviourally toxic even at sub-lethal doses of ionizing radiation. Seabuckthorn (Hippophae rhamnoides L.) is known for its nutraceutical and therapeutic values. Our studies demonstrated that treatment with leaves of H. rhamnoides rendered > 90% whole body radioprotection in 60Co-g-irradiated (10 Gy) mice population in comparison to 100% death in non-Hippophae treated irradiated (10 Gy) mice population. Our studies also demonstrated that treatment with leaves of H. rhamnoides prevented conditioned taste aversion (CTA) in irradiated (2 Gy) Sprague-Dawley rats. The present study was planned to evaluate the effects of aqueous extract of Hippophae leaves on changes in levels of neurotransmitters ((acetylcholine esterase (AChE) and dopamine (DA)) in plasma and brain, haematological parameters in blood/plasma; and brain histology in Sprague-Dawley rats showing CTA after 60Co-g-irradiation (2 Gy). The results showed that whole body 60Co-g-irradiation (2 Gy) (i) increased the levels of Ach, Eepinephrine (E) and norepinephrine (NE); oxidative stress (MDA and NO), and (ii) decreased the levels of DA; WBC counts and RBC counts and antioxidants (GSH), in comparison to untreated control. Treatment with 12 mg/kg b.w. drug concentration, prior to irradiation significantly (p<0.05) (i) decreased the levels of AChE, E and NE, and MDA and NO levels in plasma and brain, and (ii) increased the WBC counts; RBC counts and levels of antioxidants (GSH), in comparison to radiation control group. Histological changes in brain were also recorded. The results demonstrated that Hippophae leaves extract had neuro-protective and reduced oxidative stress in brain of whole body irradiated mice and could be, thereby contributing to behavioural protection. (author)

  10. Effects of whole-body x irradiation on the biogenesis of creatine in the rat

    International Nuclear Information System (INIS)

    Influences of whole-body x irradiation on various aspects of creatine metabolism have been studied. Exposures to sublethal or lethal doses of x radiation results in excessive urinary excretion as well as higher accumulation of creatine in the skeletal muscle of x-irradiated rats. A sudden fall in CPK activity in muscle with a concomitant rise in serum suggests that changes in serum and tissue CPK activity are of an adaptive nature in rats exposed to sublethal doses of x radiation. In vitro studies on creatine synthesis shows that transaminidase and methyl transferase activities in kidneys and liver, respectively, are decreased on the 5th day in the x-irradiated, are decreased on the 5th day in the x-irradiated rat. However, on the 8th day, the enzyme activities are restored to normal

  11. The effect of total-body γ-irradiation on pigeons

    International Nuclear Information System (INIS)

    A study of the effects of total-body 60Coγ radiation (200 to 2000 rad) on the common pigeon (Columba livia) has indicated a LD 50/30 of 950 +- 50 rad. There were no deaths before 6 days and the peak frequency in average deaths occurred 9 days after irradiation. Most of the birds showed small changes in activity or behaviour in the first five days. A histopathological study was made of femoral bone marrow from irradiated (1000 rad) pigeons sacrificed 1 to 18 days post-irradiation. Slight aplasia was observed on the first day after irradiation, moderately marked on the third day and extensive on the fourth and fifth days. At the end of the second week regeneration was observed as the primitive lymphocyte-like cells were differentiating into granulocytes and erythrocytes. (UK)

  12. Low dose-rate irradiation in the treatment of acute myelogenous leukaemia in first remission

    International Nuclear Information System (INIS)

    Thirty-six patients with acute myelogenous leukaemia (AML) in first remission received sibling bone marrow transplants following cyclophosphamide and a single dose of 1000 rad total body irradiation (TBI). The preparation programme for a patient undergoing a bone marrow transplant is described. The aim of the cyclophosphamide and TBI is to eradicate all active bone marrow present in the patient and to reduce the immune response of the patient to the graft, thus preventing rejection. The cobalt unit and treatment box used for the TBI is described together with details of the planning for TBI including test doses on the patient. The procedure on the day of the 8 hour TBI treatment is then given. The likely reactions following the TBI and the graft are described. Of these transplanted patients, 64% remain alive, well and disease-free, nine of them for more than one year and one surviving more than three years. These results are a significant improvement on the results of AML treated with chemotherapy and immunotherapy. (U.K.)

  13. The role of low-dose total body irradiation in treatment of non-Hodgkin's lymphoma: a new look at an old method

    International Nuclear Information System (INIS)

    The use of low-dose total body irradiation (LTBI) in treatment of lymphomatous malignancies dates back to the 1920s. The usual practice was to give very low individual TBI fraction sizes (0. 1-0.25 Gy) several times a week to a total dose of 1.5-2 Gy. Despite this very low total dose, LTBI could induce long term remissions and was always as effective as the chemotherapy to which it was compared. In modem radiotherapy, LTBI is still a valid option in treatment of chronic lymphocytic leukaemia (CLL) and the advanced stages of indolent low-grade non-Hodgkin's lymphoma (NHL). Its use in the early stages of low-grade NHL is under investigation in a large multi-institutional trial. The efficacy of LTBI is believed to stem from three mechanisms, namely; immune-enhancement, induction of apoptosis, and the intrinsic hypersensitivity to low-radiation doses demonstrated in many cell lines and tumour systems. Thus, LTBI seems to provide 'alternative' mechanisms of action against cancer cells. This should encourage researchers to explore strategies that integrate LTBI in new and innovative experimental treatment protocols that explore the possible synergism between LTBI and chemotherapy, biological response modifiers and/or immunotherapy. The increased incidence of secondary leukaemia that occurs when LTBI is combined with alkylating agents and/or total lymphoid irradiation should be kept in mind when designing such protocols as it may limit the use of LTBI in highly curable diseases and young patients in whom long survival is expected. (author)

  14. Protective Role Of Fresh Pomegranate Against Oxidative Damage In Whole Body Gamma Irradiated Male Albino Rats

    International Nuclear Information System (INIS)

    Twenty four male albino rats, body weight 100-130 g, were used to evaluate the protective role of fresh pomegranate fruit intake for 30 days on the damage induced by single dose of 6 Gy whole body gamma irradiation. The rats were randomly and equally divided into four groups: group (1): control, group (2): irradiated with 6 Gy, group (3): pomegranate for 30 days and group (4): pomegranate for 30 days followed by 6 Gy whole body irradiation. At the end of the experiment, all rats were sacrificed after 12 hours fasting then sera were separated for the determination of sugar, total antioxidant, lipid profile and liver and kidney functions. Results showed that gamma radiation caused significant decline (P<0.05) in serum total antioxidant, total protein, albumin, HDL-C and blood glucose with significant elevation (P<0.05) in other hepato-renal markers in addition to serum total cholesterol, triglycerides and LDL-C. These changes were significantly attenuated in irradiated animals pre-treated with whole fresh pomegranate fruit leading to the conclusion that pre-intake of pomegranate fruit had a radio- protective effect. This protection of this whole fruit may be due to the increased total antioxidant level leading to free radical scavenging

  15. Low Dietary Protein Status Potentiating Risk of Health Hazard in Whole Body Gamma Irradiated Rats

    International Nuclear Information System (INIS)

    Investigations were planned to assess the changes in certain biochemical parameters as affected by the synergistic effect of exposure to fractionated doses of rays and / or feeding on different protein levels. The date showed that animals kept on normal or low protein diet exhibited a significant decrease in serum total protein and glucose. Also , a significant increase was recorded in insulin level in rats exposed at the radiation dose level of 20 Gy. Exposure to cumulative doses of irradiation has aggrevated the hyperglycemic effect of high protein diet with a significant and marked increase of insulin at all the applied doses. Animals fed normal high or low protein diet were found to exert significant decreases in T3, T4 while a significant increase in TSH of high protein group occurred as a result of exposure to cumulative doses of gamma-irradiation. Rats kept on low protein diet exhibited losses in body weight, hypercholesterolemia, low levels of phospholipids and triglycerides as compared with the normal protein diet group. In contrast high protein diet group showed no serious effects. Irradiation has potentiated body weight losses, hypotriglyceridemia and hypercholesterolemia in animal group fed low protein diet with a significant increase in serum phospholipids due to the higher radiation dose of 20 Gy. Protein deficiency acted synergistically with gamma irradiation and increased the susceptibility of body organs to radiation damage. Such findings contributed to the knowledge which stimulated the decrease of the internationally recognized occupational dose limits from 50 down to 20 m Sv (ICRP 1991)

  16. Fractionated homogenous total-body irradiation prior to bone marrow transplantation

    International Nuclear Information System (INIS)

    At the University of Kiel, myeloid and acute lymphatic leukemia is treated since 1983 by total-body irradiation applied prior to bone marrow transplantation. Dose deviations in the midplane caused by the irregular surface and tissue inhomogeneities of the patient are reduced down to +- 3.5% compared to the central ray, with the help of CT-based individual compensators. This method prevents above all an excessive dose to the lungs. The radiobiologic advantages of fractionated irradiation have been employed for all patients treated hitherto (n = 9). At present, a total body dose of 12 Gy in six fractions is applied within three days. There were no undesired acute radiogenic reactions except a mild acute mucositis found in all patients. Chronic side effects, especially in the lungs, were not demonstrated, too. However, the average follow-up time of 149 days has been rather short. One patient died from relapse of leukemia after a total dose of 10 Gy, another patient died because the transplanted bone marrow was rejected, and a third died from catheter sepsis. Six out of nine patients are in complete remission with a maximum index of Karnofsky. The limited experiences gained hitherto show that the homogeneous accelerated-fractionated total-body irradiation offers essential advantages compared to non-compensated single dose irradiation with respect to the prevention of undesired radiogenic effects in sound tissues and that its therapeutic efficacy is at least the same. (orig.)

  17. He-Ne Laser Auricular Irradiation Plus Body Acupuncture for Treatment of Acne Vulgaris in 36 Cases

    Institute of Scientific and Technical Information of China (English)

    Sun Lihong

    2006-01-01

    In order to observe the therapeutic effects of He-Ne laser auricular irradiation plus body acupuncture for acne vulgaris, 68 cases of acne vulgaris were randomly divided into a treatment group of 36 cases treated with He-Ne laser auricular irradiation plus body acupuncture, and a control group of 32 cases treated with body acupuncture only. The results showed that the cure rate was 77.8% in the treatment group and 46.9% in the control group (P<0.05), indicating that He-Ne laser auricular irradiation plus body acupuncture may exhibit better effects for acne vulgaris.

  18. Response of peripheral leucocytes to whole body irradiation and vitamin E treatment in white leghorn chick

    International Nuclear Information System (INIS)

    Radiation induced changes in peripheral blood leucocytes in 1 day old male white leghorn chicks were studied after whole body exposure to 2.25 Gy dose of gamma radiation at the rate of 0.50 Gy/sec with and without vitamin E. The changes in total leucocyte counts, lymphocytes and heterophils were observed at 1,3,5,7,14 and 28 days postirradiation. A pronounced leucocytopenia was noted in the initial post-irradiation period. The lymphocytes and heterophils showed a reciprocal relationship after radiation. With vitamin E treatment, considerable and faster recovery was noticed in the leucocytes after irradiation. (author). 16 refs., 3 figs

  19. Recombinant human thrombopoietin promotes hematopoietic reconstruction after severe whole body irradiation

    OpenAIRE

    Chao Wang; Bowen Zhang; Sihan Wang; Jing Zhang; Yiming Liu; Jingxue Wang; Zeng Fan; Yang Lv; Xiuyuan Zhang; Lijuan He; Lin Chen; Huanzhang Xia; Yanhua Li; Xuetao Pei

    2015-01-01

    Recombinant human thrombopoietin (rHuTPO) is a drug that is used clinically to promote megakaryocyte and platelet generation. Here, we report the mitigative effect of rHuTPO (administered after exposure) against severe whole body irradiation in mice. Injection of rHuTPO for 14 consecutive days following exposure significantly improved the survival rate of lethally irradiated mice. RHuTPO treatment notably increased bone marrow cell density and LSK cell numbers in the mice after sub-lethal irr...

  20. Loss of Ia-bearing splenic adherent cells after whole body ultraviolet irradiation

    International Nuclear Information System (INIS)

    Daily uv irradiation of mice results in a marked decrease in the antigen-presenting capability of SAC from these mice after 1 wk of uv exposure. To directly examine this cell population, we developed a technique for purifying SAC that involves passing mouse splenocytes through two cycles of glass adherence with an intervening incubation on rabbit anti-mouse Ig-coated dishes. SAC from externally uv irradiated mice prepared by this method, when pulsed with antigen, activate primed T cells to proliferate much less efficiently than SAC from normal mice. Both the proportion and absolute number of Ia-bearing cells in this purified SAC population from uv irradiated mice are considerably smaller than that seen in similarly prepared populations from normal mice. Previous adjuvant immunization was shown to override functional defects elicited by external uv irradiation. This demonstration of a uv irradiation induced selective loss of Ia bearing splenic adherent cells and the functional consequences of this loss provide further evidence for the importance of Ia-bearing accessory cells in antigen presentation of T dependent antigens, and provides insight into the origin of the immunologic defects induced by whole body uv irradiation

  1. Effect of whole body gamma irradiation on delayed hypersensitivity to dinitrofluorobenzene in CBA mice

    International Nuclear Information System (INIS)

    Effect of whole body γ-irradiation of CBA mice on the subsequent development of delayed hypersensitivity (DH) response to 2,4 dinitrofluorobenzene (DNFB) was studied. Mice were irradiated with 60Co-γrays 24 hr prior to the first epicutaneous sensitization with DNFB. Mice irradiated at doses up to 1.08 Gy showed unaltered DH response. Increasing doses resulted in progressive suppression of DH response and the D50 was 3.86 Gy. Marked reduction in the number of lymph node cells was observed in irradiated, sensitized as well as unsensitized mice. This could be due to interphase death of precursor cells (antigen-sensitive cells), resulting in lower number of effector lymphocytes for DH(Tsub(DH)). Furthermore, the maximum DH response in irradiated, sensitized mice was obtained later on in comparison with the controls. The effector lymphocytes from irradiated sensitized mice were, however, functionally unimpaired. It was observed that the radiation-induced suppression of DH to DNFB in these mice could be partly due to the damage to antigen sensitive cells and also to the cells other than effector lymphocytes which participated in the inflammatory reaction. (author)

  2. Optimum combination of targeted 131I and total body irradiation for treatment of disseminated cancer

    International Nuclear Information System (INIS)

    Purpose: Radiobiological modeling was used to explore optimum combination strategies for treatment of disseminated malignancies of differing radiosensitivity and differing patterns of metastatic spread. The purpose of the study was to derive robust conclusions about the design of combination strategies that incorporate a targeting component. Preliminary clinical experience of a neuroblastoma treatment strategy, which is based upon general principles obtained from modelling, is briefly described. Methods and Materials: The radiobiological analysis was based on an extended (dose-rate dependent) formulation of the linear quadratic model. Radiation dose and dose rate for targeted irradiation of tumors of differing size was in part based on microdosimetric considerations. The analysis was applied to several tumor types with postulated differences in the pattern of metastatic spread, represented by the steepness of the slope of the relationship between numbers of tumors present and tumor diameter. The clinical pilot study entailed the treatment of five children with advanced neuroblastoma using a combination of 131I metaiodobenzylguanidine (mIBG) and total body irradiation followed by bone marrow rescue. Results: The theoretical analysis shows that both intrinsic radiosensitivity and pattern of metastatic spread can influence the composition of the ideal optimum combination strategy. High intrinsic radiosensitivity generally favors a high proportion of targeting component in the combination treatment, while a strong tendency to micrometastatic spread favors a major contribution by total body irradiation. The neuroblastoma patients were treated using a combination regimen with an initially low targeting component (2 Gy whole body dose from targeting component plus 12 Gy from total body irradiation). The treatment was tolerable and resulted in remissions in excess of 9 months in each of these advanced neuroblastoma patients. Conclusions: Radiobiological analysis, which

  3. The effect of gamma-rays on the hemoglobin of whole-body irradiated mice

    International Nuclear Information System (INIS)

    Changes in the UV-visible absorption spectrum of mouse hemoglobin as a result of whole body irradiation were studied. White albino adult mice were exposed to a Cs-137 γ-source at a dose rate of 47.5 Gy/h to different absorbed dose values ranging from 1 to 8 Gy. Blood specimens were taken 24 h after irradiation. The UV-visible absorption spectra of hemoglobin of irradiated and control mice were measured in the wavelength range from 200 to 700 nm. The obtained results showed significant changes in the bands measured at 340 nm, in the Soret band measured at 410 nm, also, the α- and β-bands measured at 537 and 572 nm showed significant decrease in intensity with the absorbed dose increase. The absorbance measured at 630 nm showed no significant changes. The radiation effect on the animal hemoglobin was discussed on the basis of the obtained results. (Author)

  4. Radiation effects of some enzymatic activities in tissues of rats subjected to whole body gamma irradiation

    International Nuclear Information System (INIS)

    The present study deals with the changes produced in the activity of transaminases and cholinesterase in the tissues of male rats exposed to 6 Gy whole body-irradiation. The activity of these enzymes was estimated at 1, 3, 7 and 14 days following irradiation. The results indicated that radiation induced changes in the activity of glutamic oxaloacetic transaminase (GOT) and glutamic pyrovic transaminase (GPT) in liver brain and serum of white rats; as well as in the activity of liver and brain cholinesterase. Changes in the enzymatic activities are dependent on the time after irradiation and the tissue containing the enzyme. It could be concluded that each enzyme has a range of sensitivity to ionizing radiation according to its presence in the animal organ. This must serve cancer radiotherapy for patients

  5. Effect of ultra-low dose whole-body-irradiation on severe patients with myasthenia gravis

    International Nuclear Information System (INIS)

    An ultra-low dose whole body irradiation therapy was given to 5 patients with intractable bulbar syndrome, in a dose of 10 rad/fraction, 2 times a week for 5 weeks, with a total of 100 rad; and effects of this therapy on their clinical symptoms and immunological ability were discussed. In 3 of them, bulbar syndrome was improved, and the other one, the first irradiation was effective. The peripheral leukocyte count and lymphocyte count became lowest immediately after completion of the irradiation, and returned to the normal level within 1 to 2 months. The function of T-cells, especially suppressive T-cells, was recovered; and decrease in B-cells, resulted in a decrease in the AChR antibody titer. (Ueda, J.)

  6. Effect of ultra-low dose whole-body-irradiation on patients with severe myasthenia gravis

    Energy Technology Data Exchange (ETDEWEB)

    Arimori, Shigeru; Koriyama, Kenji (Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine)

    1982-12-01

    An ultra-low dose whole body irradiation therapy was given to 5 patients with intractable bulbar syndrome, in a dose of 10 rad/fraction, 2 times a week for 5 weeks, with a total of 100 rad; and effects of this therapy on their clinical symptoms and immunological ability were discussed. In 3 of them, bulbar syndrome was improved, and the other one, the first irradiation was effective. The peripheral leukocyte count and lymphocyte count became lowest immediately after completion of the irradiation, and returned to the normal level within 1 to 2 months. The function of T-cells, especially suppressive T-cells, was recovered; and decrease in B-cells, resulted in a decrease in the AChR antibody titer.

  7. Sesamol attenuates cytogenetic damages in bone marrow cells of whole body gamma irradiated mice

    International Nuclear Information System (INIS)

    Whole body radiation exposure cause damages to all vital organs and bone marrow is the most sensitive. Pre-treatment with antioxidant as single prophylactic dose is expected to lower induction of damages in bone marrow. In the present study we have focused on sesamol, a dietary antioxidant mediated radioprotection in bone marrow cells of gamma irradiated mice and compared with melatonin. Male C57BL/6 mice were intraperitoneally administered with sesamol (10 and 20 mg/kg body) and after 30 minutes exposed to whole body gamma radiation using 60Co Teletherapy unit. Mice were injected with 0.2 ml of a metaphase arresting agent (0.05% colchicine) intra-peritoneally 3 hours prior to sacrifice (24 hrs. post-irradiation). Bone marrow cells were flushed out from femurs of each animal and processed for chromosomal aberration assay. Another set of experiment without colchicine injection was performed to access the DNA damage in bone marrow using alkaline comet assay. At least 100 metaphases per animal were scored under light microscope to record various aberrations and total chromosomal aberrations (TCA) was calculated. Similar measurements were performed with melatonin for comparing the efficacy of sesamol. Gamma irradiation has increased the chromatid type aberrations (break formation, fragment) and chromosomal type aberrations (ring formation, acentric) in bone marrow cells. The results have shown significant (p< 0.001) increase in TCA of irradiated mice than control. While pre-treatment of sesamol and melatonin 10 mg/kg significantly (p<0.05) reduced the TCA. The extend of protection has increased at 20 mg/kg significantly (p<0.001) as evident from the reduced TCA compared to irradiated group. Interestingly, sesamol and melatonin have shown similar extent of reduction of TCA. Thus sesamol has demonstrated strong ability to protect bone marrow at low dosage. These investigations on sesamol mediated protection in bone marrow are likely to benefit development of

  8. Dose-effect relationships in total body irradiation on the healing of cutaneous wounds

    Institute of Scientific and Technical Information of China (English)

    冉新泽; 程天民; 林远; 屈纪富; 刘都户; 艾国平; 阎国和; 王文昌; 许汝福

    2003-01-01

    ObjectiveTo study the effects of dosages of total body irradiation on the healing process of cutaneous wounds and to observe the changes of wound area at different periods after injury.star rats. The single dosage varied from 1 to 8 Gy. Within 1 h after irradiation, two whole thickness circular cutaneduced on the back of the animals (combined injury groups). Same wounds were produced on rats with no irradiation (single wound group). Wound healing was observed at different points after injury. ResultsAfter total body irradiation with the dose of 1,2,3,4,5,6, 7 or 8 Gy, the wound healing was obviously retarded as the dosages increased. The wound area remained was larger in the large dosage groups than in the small dosage groups. Seven days after injury, there was 33.5% wound surface left unhealed in the single wound group, whereas in the combined injury groups, 35.4%, 38.1%, 41.6%, 48.8%, 53.9%, 63.7%, 69.2% and 73.9% of the wound surfaces remained unhealed, respectively. Statistical analysis showed marked correlations between the varioustimes after total body irradiation and various dosages to the percentage of unhealed wound surface. Nine dose-effect relation formulae were deduced according to the statistical results.ConclusionsIn soft tissue trauma combined with radiation injury, the delay of wound healingis related to the dose of radiation inflicted. It is also related to the time between injury and time of observation.

  9. DNA damage focus analysis in blood samples of minipigs reveals acute partial body irradiation.

    Directory of Open Access Journals (Sweden)

    Andreas Lamkowski

    Full Text Available Radiation accidents frequently involve acute high dose partial body irradiation leading to victims with radiation sickness and cutaneous radiation syndrome that implements radiation-induced cell death. Cells that are not lethally hit seek to repair ionizing radiation (IR induced damage, albeit at the expense of an increased risk of mutation and tumor formation due to misrepair of IR-induced DNA double strand breaks (DSBs. The response to DNA damage includes phosphorylation of histone H2AX in the vicinity of DSBs, creating foci in the nucleus whose enumeration can serve as a radiation biodosimeter. Here, we investigated γH2AX and DNA repair foci in peripheral blood lymphocytes of Göttingen minipigs that experienced acute partial body irradiation (PBI with 49 Gy (± 6% Co-60 γ-rays of the upper lumbar region. Blood samples taken 4, 24 and 168 hours post PBI were subjected to γ-H2AX, 53BP1 and MRE11 focus enumeration. Peripheral blood lymphocytes (PBL of 49 Gy partial body irradiated minipigs were found to display 1-8 DNA damage foci/cell. These PBL values significantly deceed the high foci numbers observed in keratinocyte nuclei of the directly γ-irradiated minipig skin regions, indicating a limited resident time of PBL in the exposed tissue volume. Nonetheless, PBL samples obtained 4 h post IR in average contained 2.2% of cells displaying a pan-γH2AX signal, suggesting that these received a higher IR dose. Moreover, dispersion analysis indicated partial body irradiation for all 13 minipigs at 4 h post IR. While dose reconstruction using γH2AX DNA repair foci in lymphocytes after in vivo PBI represents a challenge, the DNA damage focus assay may serve as a rapid, first line indicator of radiation exposure. The occurrence of PBLs with pan-γH2AX staining and of cells with relatively high foci numbers that skew a Poisson distribution may be taken as indicator of acute high dose partial body irradiation, particularly when samples are available

  10. Modulator Effect of Turmeric on Oxidative Damage in Whole Body Gamma Irradiated rats

    International Nuclear Information System (INIS)

    Because of its penetrating power and its ability to travel great distances, gamma rays are considered the primary hazard to the population during most radiological emergencies. So, there is a need to develop medical countermeasures to protect the first responders and remediation workers from biomedical effect of ionizing radiation. Turmeric has been reported to have many beneficial health effects, including a strong anti-oxidant effect, anti-inflammatory and anti-microbial properties. In the present study, turmeric was investigated as a therapeutic agent against hazards induced by ionizing radiation on kidney, liver, urinary and serum calcium levels and blood counts. A daily dose of 0.5 g/kg body weight was used in whole body gamma irradiated female rats with 3 Gy. Radiation effects were followed up for four weeks post irradiation. The results revealed that the administration of turmeric post-irradiation resulted in a significant inhibition in the frequency of radiation induced oxidative damage. It could be concluded that definite turmeric dose exerts a vital modulator role against gamma irradiation hazard

  11. Enhancement of committed hematopoietic stem cell colony formation by nandrolone decanoate after sublethal whole body irradiation

    International Nuclear Information System (INIS)

    The ability of an anabolic steroid, nandrolone decanoate, to increase committed topoietic stem cell (CFU-gm, CFU-e, and BFU-e) colony formation after sublethal irradiation was evaluated. Immediately after receiving whole body irradiation and on the next two days, each mouse was injected intraperitoneally with nandrolone decanoate (1.25 mg) in propylene glycol. Irradiated control mice received only propylene glycol. Compared to controls, drug-treated mice showed marked peripheral blood leukocytosis and more stable packed red cell volume. Drug-treated mice also demonstrated increased erythropoiesis, as CFU-e/BFU-e concentrations from both marrow (9% to 581%) and spleen (15% to 797%) were elevated. Granulopoiesis was increased similarly, as CFU-gm concentrations from marrow (38% to 685%) and spleen (9% to 373%) were elevated. These results demonstrate that nandrolone decanoate enhances hematopoietic stem cell recovery after sublethal whole body irradiation. This suggests that following hematopoietic suppression, nandrolone decanoate may stimulate the recovery of hematopoiesis at the stem cell level and in peripheral blood

  12. Effect of whole-body irradiation on wound macrophages and role of phenytoin sodium

    International Nuclear Information System (INIS)

    Macrophages play an important role in wound healing. The effect of 6 Gy whole-body irradiation on wound macrophages and the role of phenytoin sodium were studied by making an incision on rat dorsum, into which polyvinyl alcohol sponges were implanted. It was found that after irradiation the phagocytic function of wound macrophages, the release of tumor necrosis factor (TNFα) and interleukin-1 (IL-1) from wound macrophages, as well as the number of macrophages in wound were significantly decreased on days 3, 5 and 8 after wounding. Phenytoin sodium significantly increased the number of wound macrophages, improved the phagocytic function of macrophages and promoted release of TNFα and IL-1 from wound macrophages on days 3, 5 and 8 after wounding, no matter whether rats were irradiated or not. The results indicated that the important mechanism of impairing wound healing by whole-body irradiation was that the number and function of wound macrophages were decreased in early stage of wound healing. The role of phenytoin sodium in wound healing was increasing the number of wound macrophages and improving their function

  13. Enhancement of committed hematopoietic stem cell colony formation by nandrolone decanoate after sublethal whole body irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Gallicchio, V.S.; Chen, M.G.; Watts, T.D.

    1984-11-01

    The ability of an anabolic steroid, nandrolone decanoate, to increase committed topoietic stem cell (CFU-gm, CFU-e, and BFU-e) colony formation after sublethal irradiation was evaluated. Immediately after receiving whole body irradiation and on the next two days, each mouse was injected intraperitoneally with nandrolone decanoate (1.25 mg) in propylene glycol. Irradiated control mice received only propylene glycol. Compared to controls, drug-treated mice showed marked peripheral blood leukocytosis and more stable packed red cell volume. Drug-treated mice also demonstrated increased erythropoiesis, as CFU-e/BFU-e concentrations from both marrow (9% to 581%) and spleen (15% to 797%) were elevated. Granulopoiesis was increased similarly, as CFU-gm concentrations from marrow (38% to 685%) and spleen (9% to 373%) were elevated. These results demonstrate that nandrolone decanoate enhances hematopoietic stem cell recovery after sublethal whole body irradiation. This suggests that following hematopoietic suppression, nandrolone decanoate may stimulate the recovery of hematopoiesis at the stem cell level and in peripheral blood.

  14. Protection of hemopoietic tissue in whole-body gamma-irradiated mice by intramuscular cystamine

    International Nuclear Information System (INIS)

    Intramuscular administration of cystamine (150 mg/kg) prior to whole-body gamma irradiation with a dose of 8 Gy gave the same or better radioprotection of spleen hemopoiesis in mice as cystamine applied in the same amount intraperitoneally. Therefore the number of endogenous spleen colonies, as well as the incorporation of 59Fe and 125I-iodouridine into the spleen served as criteria of radiation injury. (author)

  15. Total body irradiation and bone marrow transplantation in some malignant tumors

    International Nuclear Information System (INIS)

    Available data and proper results of high-dose total body irradiation combined with chemotherapy and bone marrow transplantation in patients with leukemia and other disseminated malignant diseases are analyzed. It is shown that the therapeutic effect is determined by the total dose, dose per fraction, dose rate, and disease stage. Moderate fractionation is preferable; its efficacy is no leas than that of hyperfractionation, it is convenient for patients, and causes less complications than a single exposure

  16. Half body irradiation of patients with multiple bone metastases: a phase II trial

    DEFF Research Database (Denmark)

    Berg, Randi S; Yilmaz, Mette K; Høyer, Morten;

    2009-01-01

    AIM OF STUDY: The primary aim of this study was to evaluate the effect of half-body irradiation (HBI) on pain and quality of life in cancer patients with multiple bone metastases. The secondary aim was to evaluate side effects of the treatment. PATIENTS AND METHODS: A total of 44 patients received...... patients' global quality of life. CONCLUSION: Single fraction HBI is safe and effective providing long lasting pain reduction in 76% of patients with multiple bone metastases....

  17. Mechanisms of taurine hyperexcretion after whole-body irradiation of rats

    International Nuclear Information System (INIS)

    Mechanisms of postirradiation hyperexcretion of taurine with urine have been investigated. In the course of three days after a whole-body exposure of rats (700 rads), the excretion of taurine increases. The experiments in vitro have demonstrated that taurine synthesis decreases in the thymus and liver of irradiated animals. The experiments conducted have shown that the postirradiation hyperexcretion of taurine is partly due to its release from the lymohoid tissue (thymus)

  18. Eight years of whole body irradiation at Verone: clinical and physical experience in 115 patients (june 2000-december 2008); Huit ans d'irradiation corporelle totale a verone: experience clinique et physique chez 115 patients (juin 2000-decembre 2008)

    Energy Technology Data Exchange (ETDEWEB)

    Palazzi, M.; Benedetti, F.; Romano, M.; Maluta, S.; Compri, C.; Giri, M.G.; Meliado, G. [Azienda Ospedaliera, Verona (Italy)

    2009-10-15

    The multi fractionated whole-body irradiation has today replaced the technique of whole-body irradiation in single dose, that was at the origin of acute and delayed effects, especially pneumonia and cataract. The results and the tolerance of our whole-body irradiation pattern are similar to these ones mentioned in the national register of allogeneic marrow transplants. (N.C.)

  19. Late effects on gonadal function of cyclophosphamide, total-body irradiation, and marrow transplantation

    International Nuclear Information System (INIS)

    One hundred thirty-seven patients had gonadal function evaluated 1-11 years after marrow transplantation. All 15 women less than age 26 and three of nine older than age 26 who were treated with 200 mg/kg cyclophosphamide recovered normal gonadotropin levels and menstruation. Five have had five pregnancies resulting in three live births, one spontaneous abortion, and one elective abortion. Three of 38 women who were prepared with 120 mg/kg cyclophosphamide and 920-1200 rad total-body irradiation had normal gonadotropin levels and menstruation. Two had pregnancies resulting in one spontaneous and one elective abortion. Of 31 men prepared with 200 mg/kg cyclophosphamide, 30 had normal luteinizing hormone levels, 20 had normal follicle-stimulating hormone levels, and 10 of 15 had spermatogenesis. Four have fathered five normal children. Thirty-six of 41 men prepared with 120 mg/kg cyclophosphamide and 920-1750 rad total-body irradiation had normal luteinizing hormone levels, ten had normal follicle-stimulating hormone levels, and 2 of 32 studied had spermatogenesis. One has fathered two normal children. It was concluded that cyclophosphamide does not prevent return of normal gonadal function in younger women and in most men. Total-body irradiation prevents return of normal gonadal function in the majority of patients

  20. Design considerations for a neutron generator-based total-body irradiator

    International Nuclear Information System (INIS)

    The prompt- and delayed-gamma neutron activation techniques have been used for the non-invasive measurement of human body composition. In recent years, neutron irradiators have used only transuranic isotopic sources (238PuBe, 241AmBe, 252Cf). However, in today's security-minded environment, the use of alternate neutron sources may provide some advantages. Several designs for an irradiator that would use a high-output, miniature D-T neutron generator (MF Physics) have been examined. The use of this type of neutron source will lessen the storage, security, and transport issues associated with continuous-output isotopic neutron sources. To determine the scientific impact of this decision, Monte Carlo simulations (MCNP-4B2; Los Alamos National Laboratory) has been performed to aid in the design of the irradiator system, evaluating shielding materials, collimation, and source-to-subject distance, for the measurement of total body nitrogen (TBN). Based on internal flux distributions within the simulated body region of a subject, several design options were identified. The final design will be selected based on the optimization of precision, dose, and exposure time. (author)

  1. Physical aspects of the first corporal irradiation performed in Peru

    International Nuclear Information System (INIS)

    Total body irradiation (TBI) technique was applied for the first in Peru using an equipment of Theratronic Phoenix with a conventional Co-60 unit. Using the equipment, TBI was performed in 8 cases of Peru. The patient of the first case survived 3 years and 10 months after the treatment and is in good conditions at present. For TBI, a patient was placed in a delimiter composed of acrylic plate. The dose at the midpoint of patient was in a range from 3.6 Gy to 5 Gy. To calculate the time of treatment, depth dose percent (DPP) was determined using lithium fluoride thermo-luminescence dosimeter TLD-100. The uncertainty for the dose determination using TLD was around 3 %. To compensate for the dose reduction depending on the distance from the center of field, the curve surface of wax compensation filter was adjusted according to the distance. For either of the cases, irradiation was performed at 12 Gy. The compensatory AP and PA beams with a lung protector were not applied because there was no protector silhouette cutter. The hospital hired a 6 MeV linear accelerator to perform 10 cases of TBI, using the same techniques, applying the lateral lung protectors. (M.N.)

  2. Anorexia in rats after protracted whole-body irradiation with low doses

    International Nuclear Information System (INIS)

    In our experiments, carried out hitherto, concerning the effect of incorporated and radioactive substances, weight behaviour and food uptake have proved to be a sensitive test. With regard to these experiments and the half-life of the radionuclides used, it is reported about trial series in Wistar rats. These rats were applied, with Co-60 gamma irradiation, different whole-body doses protracted over 48 hours. A total of 32 groups of experimental animals (20 animals each) was exposed to irradiation doses of lethal, medium lethal, and sublethal ranges, control and pseudo-irradiation series included. The experiments were carried out under observance of constant irradiation and attitude conditions, night and day changes, as conditioned by the season, included. Even in the inferior sublethal range (12 to 24 R), a significant trend of decreased food uptake is registered. This trend remains for a short period after the end of irradiation, but then it returns to normal conditions. Furthermore, a new decrease with subsequent increase seems to become evident - about ten days after termination of the radiotherapy (especially after several hundred R); report about these items will be made later on. (orig.)

  3. Therapeutic application of IL-4 on total body irradiated mice with lethal doses

    International Nuclear Information System (INIS)

    In the present study, we determined the consequences of IL-4 treatment on survival hematopoietic recovery as well as acute inflammatory response of irradiated mice. Mice were total body irradiated with lethal doses of γ-rays and treated with IL-4 30 min or 2 h after exposure. Our data show an enhancement of the 30-day survival after 8 Gy irradiation, from 20% for placebo-treated mice to 75% with IL-4. It is generally admitted that the death of animals occurring in this dose range is due to hematopoietic syndrome. Therefore, we determined the efficacy of IL-4 on promoting the recovery of blood cell counts and progenitors in bone marrow. The hematopoietic status of animals is the same whether or not treated with IL-4. Given the anti-inflammatory properties of IL-4, we studied the consequences of IL-4 treatment on the inflammatory response within 24 h after 8 Gy exposure. We have shown that IL-4 treatment led to a limitation of the release of inflammatory mediators, such as IL-1β or KC, in the plasma or tissues of irradiated mice. On the other hand, IL-4 improved the ratio-induced metabolic and functional damages in the central nervous system. In conclusion, our results have shown an enhanced survival of IL-4 treated irradiated mice without improvement of hematopoietic reconstitution. Therapeutic potential of IL-4 could result, at least in part, from the limitation of the radio-induced inflammatory response. (author)

  4. Kidney and lung injury in irradiated rats protected from acute death by partial-body shielding

    International Nuclear Information System (INIS)

    Ninety-six CD-1 male rats were exposed to gamma-ray doses (0-25 Gy) in increments of 5 Gy. One femur, the surgically exteriorized GI tract, and the oral cavity were shielded during irradiation to protect against acute mortality from injury to the hematopoietic system, small intestine, and oral cavity. In addition, the thoraxes of half of the animals from each dose group were shielded. At approximately monthly intervals from 2 to 10 months after irradiation the hematocrit, plasma urea nitrogen (PUN), and 51Cr-EDTA clearance were measured. During the study 20 thorax-shielded and 19 thorax-irradiated animals died. All rats whose thoraxes received 25 Gy irradiation and three out of seven rats whose thoraxes received 20 Gy died 1 to 3 months postirradiation with massive pleural fluid accumulation. Shielding the thoraxes prevented this mode of death at these doses. Kidney injury was judged to be the primary cause of death of all thorax-shielded animals and 15- and 20-Gy thorax-irradiated animals. Animals with kidney damage had elevated PUN and reduced 51Cr-EDTA clearance and hematocrits. The relative merits of each of these end points in assessing radiation-induced kidney injury after total-body exposure are discussed

  5. Effects of supralethal total body irradiation and bone marrow reconstitution upon immunologic memory

    International Nuclear Information System (INIS)

    The transplantation of bone marrow from prospectively selected genotypically and pedigree DLA-identical donors into supralethally irradiated littermate and nonlittermate recipients within the Copperstown beagle colony has regularly resulted in the establishment of long-term chimerism, with no evidence of graft-versus-host disease in the recipients. It has been demonstrated that irradiated recipients exhibit significant decreases in their ability to muster primary immunological responses during the first months after reconstitution with bone marrow. Beyond the documented capacity of preirradiation blood transfusions to interfere with subsequent engraftment of allogeneic marrow, however, there have been no systematic studies of the possible effects of irradiation and bone marrow transplantation upon immunologic memory. The present study was designed in order to assess this question in greater detail, with particular regard to the effects of irradiation and bone marrow reconstitution upon host sensitization to skin allografts. The results indicate that, within the experimental limitations described, the state of sensitivity produced by first set skin allograft rejection is not affected significantly by supralethal total body irradiation and reconstitution of the recipient with allogeneic bone marrow

  6. Insulin-Like Growth Factor 1 Mitigates Hematopoietic Toxicity After Lethal Total Body Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Dunhua; Deoliveira, Divino; Kang, Yubin; Choi, Seung S. [Department of Medicine, Duke University Medical Center, Durham, North Carolina (United States); Li, Zhiguo [Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina (United States); Chao, Nelson J. [Department of Medicine, Duke University Medical Center, Durham, North Carolina (United States); Department of Pathology, Duke University Medical Center, Durham, North Carolina (United States); Department of Immunology, Duke University Medical Center, Durham, North Carolina (United States); Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina (United States); Chen, Benny J., E-mail: chen0032@mc.duke.edu [Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina (United States); Department of Medicine, Duke University Medical Center, Durham, North Carolina (United States)

    2013-03-15

    Purpose: To investigate whether and how insulin-like growth factor 1 (IGF-1) mitigates hematopoietic toxicity after total body irradiation. Methods and Materials: BALB/c mice were irradiated with a lethal dose of radiation (7.5 Gy) and treated with IGF-1 at a dose of 100 μg/dose intravenously once a day for 5 consecutive days starting within 1 hour after exposure. Survival and hematopoietic recovery were monitored. The mechanisms by which IGF-1 promotes hematopoietic recovery were also studied by use of an in vitro culture system. Results: IGF-1 protected 8 of 20 mice (40%) from lethal irradiation, whereas only 2 of 20 mice (10%) in the saline control group survived for more than 100 days after irradiation. A single dose of IGF-1 (500 μg) was as effective as daily dosing for 5 days. Positive effects were noted even when the initiation of treatment was delayed as long as 6 hours after irradiation. In comparison with the saline control group, treatment with IGF-1 significantly accelerated the recovery of both platelets and red blood cells in peripheral blood, total cell numbers, hematopoietic stem cells, and progenitor cells in the bone marrow when measured at day 14 after irradiation. IGF-1 protected both hematopoietic stem cells and progenitor cells from radiation-induced apoptosis and cell death. In addition, IGF-1 was able to facilitate the proliferation and differentiation of nonirradiated and irradiated hematopoietic progenitor cells. Conclusions: IGF-1 mitigates radiation-induced hematopoietic toxicity through protecting hematopoietic stem cells and progenitor cells from apoptosis and enhancing proliferation and differentiation of the surviving hematopoietic progenitor cells.

  7. Dose-effect relationship for cataract induction after single-dose total body irradiation and bone marrow transplantation for acute leukemia

    International Nuclear Information System (INIS)

    Purpose: To determine a dose-effect relationship for cataract induction, the tissue-specific parameter, α/β, and the rate of repair of sublethal damage, μ value, in the linear-quadratic formula have to be known. To obtain these parameters for the human eye lens, a large series of patients treated with different doses and dose rates is required. The data of patients with acute leukemia treated with single-dose total body irradiation (STBI) and bone marrow transplantation (BMT) collected by the European Group for Blood and Marrow Transplantation were analyzed. Methods and Materials: The data of 495 patients who underwent BMT for acute leukemia, who had STBI as part of their conditioning regimen, were analyzed using the linear-quadratic concept. The end point was the incidence of cataract formation after BMT. Of the analyzed patients, 175 were registered as having cataracts. Biologic effective doses (BEDs) for different sets of values for α/β and μ were calculated for each patient. With Cox regression analysis, using the overall chi-square test as the parameter evaluating the goodness of fit, α/β and μ values were found. Risk factors for cataract induction were the BED of the applied TBI regimen, allogeneic BMT, steroid therapy for >14 weeks, and heparin administration. To avoid the influence of steroid therapy and heparin on cataract induction, patients who received steroid or heparin treatment were excluded, leaving only the BED as a risk factor. Next, the most likely set of α/β and μ values was obtained. With this set, the cataract-free survival rates were calculated for specific BED intervals, according to the Kaplan-Meier method. From these calculations, cataract incidences were obtained as function of the BED at 120 months after STBI. Results: The use of BED instead of the TBI dose enabled the incidence of cataract formation to be predicted in a reasonably consistent way. With Cox regression analysis for all STBI data, a maximal chi-square value was

  8. State of the art of systemic irradiation for bone marrow transplantation

    International Nuclear Information System (INIS)

    This panel will first review the radiobiological principles underlying the use of total body irradiation (TBI) and radioimmunotherapy in preparation for bone marrow transplantation. Optimization of TBI, based on these principles, will then be discussed, with an emphasis on dose, time, and fractionation, as well as the effect of partial shielding of critical organs. Lastly, the clinical results of various conditioning regimens, including TBI-containing protocols as well as the use of radioimmunotherapy, will be presented. Although about half of leukemic patients who undergo marrow transplantation may enjoy a long-term disease-free survival with today's technology and skills, it is anticipated that there will be further improvements in the near future which will translate into both improved survival and quality of life, from the standpoint of greater protection of normal tissues and eradication of leukemic cells. This session will lay the foundation for understanding the basis of these advances

  9. Influence of radioprotectors on total body weight evolution and on oxygen consumption in lethal dose irradiated animals. (Preliminary study)

    International Nuclear Information System (INIS)

    Comparison of total body weight evolution and oxygen consumption in lethal dose irradiated animals, protected by various well known radioprotective substances, isolated or in mixture, with evolution and consumption of non protected animals irradiated at the same dose and with these of check animals

  10. Effect of whole-body irradiation on Michaelis-Menten constants of microsomal enzyme systems of rat liver

    International Nuclear Information System (INIS)

    The effect of whole-body irradiation on Michaelis-Menten constants of the NADPH cytochrome P-450 reductase (EC1.6.2.3.), the oxidative demethylation of ethylmorphine and glucose 6-phosphatase (EC3.1.3.9.), have been studied at 1, 4 and 7 days after irradiation. (Auth.)

  11. The content of mouse bone marrow and hepatic metallothioneins and human lymphocyte metallothioneins after whole-body γ-irradiation

    International Nuclear Information System (INIS)

    The increase in the content of bone marrow and hepatic metallothioneins (MT) in mice with the maximum at 30 hr after whole-body γ-irradiation was shown. The MT level in that tissues at that time correlated with the exposure dose. The MT content in lymphocytes of patient with acute lympholeucosis was increased after fractionated whole-body irradiation, that index also correlated with accumulated exposure dose

  12. Alterations in tissue lipids of rats subjected to whole-body X-irradiation

    International Nuclear Information System (INIS)

    Whole-body irradiation of rats at sublethal doses leads to hepatic lipid accumulation which reaches a maximum by the sixth day; this effect on lipid metabolism does not appear to be due to accompanying inanition but due to irradiation per se. The female rats show a greater and more consistent increase in liver lipids than males and this better response of the females is not abolished by prolonged administration of testosterone to these animals. An accumulation of triglycerides accounts for almost all the increases in total liver lipids, although smaller elevations in the levels of free fatty acids and cholesterol are also seen. Free fatty acids of liver show a marked decrease on the second day following irradiation. Serum lipids do not show any appreciable changes while adipose lipids progressively decrease reaching a minimum by the sixth day. Although an insufficiency of ATP may be responsible for lipid accumulation in the irradiated rat as in the case in rats treated with ethionine or orotic acid, adenine administration, which prevents fatty infiltration due to these chemical agents, does not protect against the radiation-induced increase in liver triglycerides. (orig.)

  13. Ciliary body and choroidal melanomas treated by proton beam irradiation. Histopathologic study of eyes

    International Nuclear Information System (INIS)

    Proton beam irradiation resulted in clinical and/or histopathological regression of large ciliary body and choroidal melanomas in three eyes. Enucleations were performed 6 1/2 weeks, five months, and 11 months after irradiation for angle-closure glaucoma from total retinal detachment, increase in retinal detachment, and neovascular glaucoma, respectively. A direct relationship was found between the length of the interval from irradiation to enucleation and the degree of histologic changes. Vascular changes in the tumors included endothelial cell swelling and decreased lumen size, basement membrane thickening, collapse of sinusoidal vessels, and thrombosis of vessels. Although apparently unaltered tumor cells remained, degenerative changes occurred in some melanoma cells, including lipid vacuoles in cytoplasm, pyknotic nuclei, and balloon cell formation. Patchy areas of necrosis and proteinaceous exudate were present. Pigment-laden macrophages were found near tumor vessels and all had a substantial chronic inflammatory infiltrate. The effect of proton beam irradiation on tumor vessels probably plays an important role in uveal melanoma regression

  14. Statistical Issues in TBI Clinical Studies

    Directory of Open Access Journals (Sweden)

    Paul eRapp

    2013-11-01

    Full Text Available The identification and longitudinal assessment of traumatic brain injury presents several challenges. Because these injuries can have subtle effects, efforts to find quantitative physiological measures that can be used to characterize traumatic brain injury are receiving increased attention. The results of this research must be considered with care. Six reasons for cautious assessment are outlined in this paper. None of the issues raised here are new. They are standard elements in the technical literature that describes the mathematical analysis of clinical data. The purpose of this paper is to draw attention to these issues because they need to be considered when clinicians evaluate the usefulness of this research. In some instances these points are demonstrated by simulation studies of diagnostic processes. We take as an additional objective the explicit presentation of the mathematical methods used to reach these conclusions. This material is in the appendices. The following points are made:1. A statistically significant separation of a clinical population from a control population does not ensure a successful diagnostic procedure.2. Adding more variables to a diagnostic discrimination can, in some instances, actually reduce classification accuracy.3. A high sensitivity and specificity in a TBI versus control population classification does not ensure diagnostic successes when the method is applied in a more general neuropsychiatric population. 4. Evaluation of treatment effectiveness must recognize that high variability is a pronounced characteristic of an injured central nervous system and that results can be confounded by either disease progression or spontaneous recovery. A large pre-treatment versus post-treatment effect size does not, of itself, establish a successful treatment.5. A procedure for discriminating between treatment responders and nonresponders requires, minimally, a two phase investigation. This procedure must include a

  15. Early biochemical changes in rat lungs following whole-body exposure to external ionizing irradiation

    International Nuclear Information System (INIS)

    Some biochemical and cytological parameters were followed up in broncho-alveolar lavage fluid and in lung homogenate from albino rats, exposed to single whole-body ionizing irradiation with 4, 8, and 15 Gy. Infectious complications were ruled out by addition of 2 g/l tetracycline in the drinking water before and after irradiation. Dose-dependent increase in the number of cells and lactatedehydrogenase and acid phosphate activities in the broncho-alveolar lavage fluid was observed on the first day and a tendency toward decrease in the period between the 5th and 15th day. These parameters are of the definite value as early diagnostic tests in radiation lung injury. These is evidence of inhibition of the antioxidative protective system in this organ - a dose-dependent decrease in the enzymatic activities of superoxyde dismutase and glucose-6-phosphatedehydrogenase and in the content of nonprotein sulfhydryl groups in the pulmonary homogenate

  16. Studies on the effects of whole-body gamma irradiation on chickens infected with Eimeria tenella

    International Nuclear Information System (INIS)

    Whole-body exposure of one- and three-week-old White Leghorn cockerels to 600 R gamma radiation (Cesium-137) 24 hours before oral inoculation with 500, 2500, 5000, or 50,000 Eimeria tenella oocysts produced a pattern of mortality differing markedly from nonirradiated, infected (NRI) control birds. When oocyst dosage was held constant (2500) and radiation exposure increased (250, 450, 600, 800, or 1000 R) a gradual increase in mortality rate with higher radiation dosages was observed among both one- and three-week-old birds. Birds irradiated 24 hours or more before inoculation were less able to survive infection than were those irradiated one hour before and one, two, three, or four days after inoculation. (U.S.)

  17. Effect of whole-body irradiation by fast neutrons on mouse tissues. Pt. 2

    International Nuclear Information System (INIS)

    Male Swiss albino mice were exposed to whole-body irradiation by fast neutrons of 14 MeV average energy. Two single doses of 7 or 14 rem were used, corresponding to a fluence of 1.27x108 and 2.54x108 n/cm2, respectively. Two enzymes were assessed in testicular tissue, acid phosphatase activity to measure the changes in lysosomal function and succinic dehydrogenase activity to test mitochondrial functions and energy production. Lysosomal affection was revealed by statistically significant increase of ACP activity in all cell types of testicular tissue with either of the two doses used. Although SDH was characterised by relatively low activity in most of the testicular tissues, decrease in enzyme activity was clear. Complete absence of activity was sometimes noted. The magnitude of response was dose dependent and there was a tendency to return to pre-irradiation levels of both enzymes with time. (orig.)

  18. Elucidation of aspects of murine skeletal muscle regeneration using local and whole body irradiation

    International Nuclear Information System (INIS)

    To investigate the role of proliferating local and emigrating circulatory leucocytes in skeletal muscle regeneration in mice, their bone marrow was ablated with whole body irradiation and compared with the effects of local irradiation. Results indicate that (1) the sealing of damaged myofibres is a function of local cells and not dependent on the presence of infiltrating leucocytes; (2) the formation of sarcoplasmic projections at the ends of damaged myofibres is dependent on leucocyte infiltration; (3) nuclei in the sarcoplasmic projections are probably derived from fusion of muscle precursor cells; (4) most muscle precursor cells in vivo replicate at least once before fusion; and (5) both replication and fusion of muscle precursors can occur in the absence of infiltrating leucocytes. (author)

  19. The influence on rabbit platelet aggregation following γ ray whole-body-irradiation with 400 rads

    International Nuclear Information System (INIS)

    In this paper, using the method of turbidmetric technique, changes of rabbit platelet aggregation are observed following γ ray whole-body irradiation with 400 rads. The results indicated that the function of blood platelet aggregation was risen from the first to the fifth day after irradiation, but reduced at the seventh day and markedly at the tenth. It is believed that the early elevation of platelet aggregation may result in increase of adherence and coagulation, and enhance microcirculation disturbances. In addition, a large number of platelets and coagulation factors were consumed, and it might be one of the causes of hemorrhage syndrome after exposure. Dueing early therapy of radiation injury, therefore, it is of benefit for improving the repair of radiation injury to inhibit platelet aggregation

  20. Whole Body Microwave Irradiation for Improved Dacarbazine Therapeutical Action in Cutaneous Melanoma Mouse Model

    International Nuclear Information System (INIS)

    A cutaneous melanoma mouse model was used to test the efficacy of a new therapeutical approach that uses low doses of cytostatics in conjunction with mild whole body microwave exposure of 2.45 GHz in order to enhance cytostatics anti tumoral effect. Materials and Methods. A microwave exposure system for C57BL/6 mouse whole body microwave irradiation was designed; groups of 40 mice (males and females) bearing experimental tumours were subjected to a combined therapy comprising low doses of dacarbazine in combination with mild whole body irradiation. Clinical parameters and serum cytokine testing using xMAP technology were performed. Results. The group that was subjected to combined therapy, microwave and cytostatic, had the best clinical evolution in terms of overall survival, tumour volume, and metastatic potential. At day 14 the untreated group had 100% mortality, while in the combined therapy group 40% of mice were surviving. Quantifying serum IL-1β, IL-6, IL-10, IL-12 (p70), IFN-γ, GM-CSF, TNF-α, MIP-1α, MCP-1, and KC during tumorigenesis and therapy found that the combined experimental therapy decreases all the inflammatory cytokines, except chemokine MCP-1 that was found increased, suggesting an increase of the anti-tumoral immune response triggered by the combined therapy. The overall metastatic process is decreased in the combined therapy group.

  1. Partial body irradiation of small laboratory animals with an industrial X-ray tube

    Energy Technology Data Exchange (ETDEWEB)

    Frenzel, Thorsten; Kruell, Andreas [Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany). Bereich Strahlentherapie; Grohmann, Carsten; Schumacher, Udo [Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany). Inst. fuer Anatomie und Experimentelle Morphologie

    2014-07-01

    Dedicated precise small laboratory animal irradiation sources are needed for basic cancer research and to meet this need expensive high precision radiation devices have been developed. To avoid such expenses a cost efficient way is presented to construct a device for partial body irradiation of small laboratory animals by adding specific components to an industrial X-ray tube. A custom made radiation field tube was added to an industrial 200 kV X-ray tube. A light field display as well as a monitor ionization chamber were implemented. The field size can rapidly be changed by individual inserts of MCP96 that are used for secondary collimation of the beam. Depth dose curves and cross sectional profiles were determined with the use of a custom made water phantom. More components like positioning lasers, a custom made treatment couch, and a commercial isoflurane anesthesia unit were added to complete the system. With the accessories described secondary small field sizes down to 10 by 10 mm{sup 2} (secondary collimator size) could be achieved. The dosimetry of the beam was constructed like those for conventional stereotactical clinical linear accelerators. The water phantom created showed an accuracy of 1 mm and was well suited for all measurements. With the anesthesia unit attached to the custom made treatment couch the system is ideal for the radiation treatment of small laboratory animals like mice. It was feasible to shrink the field size of an industrial X-ray tube from whole animal irradiation to precise partial body irradiation of small laboratory animals. Even smaller secondary collimator sizes than 10 by 10 mm{sup 2} are feasible with adequate secondary collimator inserts. Our custom made water phantom was well suited for the basic dosimetry of the X-ray tube.

  2. Partial body irradiation of small laboratory animals with an industrial X-ray tube

    International Nuclear Information System (INIS)

    Dedicated precise small laboratory animal irradiation sources are needed for basic cancer research and to meet this need expensive high precision radiation devices have been developed. To avoid such expenses a cost efficient way is presented to construct a device for partial body irradiation of small laboratory animals by adding specific components to an industrial X-ray tube. A custom made radiation field tube was added to an industrial 200 kV X-ray tube. A light field display as well as a monitor ionization chamber were implemented. The field size can rapidly be changed by individual inserts of MCP96 that are used for secondary collimation of the beam. Depth dose curves and cross sectional profiles were determined with the use of a custom made water phantom. More components like positioning lasers, a custom made treatment couch, and a commercial isoflurane anesthesia unit were added to complete the system. With the accessories described secondary small field sizes down to 10 by 10 mm2 (secondary collimator size) could be achieved. The dosimetry of the beam was constructed like those for conventional stereotactical clinical linear accelerators. The water phantom created showed an accuracy of 1 mm and was well suited for all measurements. With the anesthesia unit attached to the custom made treatment couch the system is ideal for the radiation treatment of small laboratory animals like mice. It was feasible to shrink the field size of an industrial X-ray tube from whole animal irradiation to precise partial body irradiation of small laboratory animals. Even smaller secondary collimator sizes than 10 by 10 mm2 are feasible with adequate secondary collimator inserts. Our custom made water phantom was well suited for the basic dosimetry of the X-ray tube.

  3. Antimutagenic and redox regulatory activities of curcumin in whole body γ - irradiated mice

    International Nuclear Information System (INIS)

    the aim of the current study is understanding the redox regulatory activity ( pro- and anti-oxidant properties) and mutagenic burden following whole body -irradiation with special reference to its control by curcumin in mice. the antimutagenic effects of curcumin; diferuloylmethane ( C21 H20 O6) were evaluated in vitro using chromosomal aberration assay in male mice,induced after-exposure to 3 Gy γ-rays that is a known mutagenic and carcinogenic agent, when curcumin was given at a dose of 400 mmol/kg body wt through gastric intubation for 5 following days either before-, after-or both before and after-exposure, the incidence of aberrant cells and aberration types (mostly chromatids, breaks and fragments) reduced with curcumin dosage as compared to irradiated group. the cellular biochemical changes were estimated using liver tissue damage marker enzymes: alkaline phosphatase (ALP) and γ -glutamyl transferase (GGT), pro-oxidant: xanthine oxidase (XO), lipid per oxidative indices: thiobarbituric acid reactive substances (TBARS) and hydroperoxide (HP. the non-enzymatic antioxidant : glutathione (GSH) and the enzymatic antioxidants: superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx). TBARS ,HP,XO and liver marker enzymes were increased significantly , whereas the levels of GSH and the enzymatic antioxidants were significantly depleted in -irradiated groups. curcumin-treatment either before-, after-or both before and after -irradiation has attenuated the liver toxic effects of radiation obvious by reducing the levels of tbars and HP and diminished the increases of the activity of XO and liver marker enzymes. it has also re sued the depletion of the non enzymatic -and the enzymatic-antioxidant status.conclusion:curcumin has anti-oxidant potential against -rays-induced chromosomal mutations and redox imbalance regulatory status

  4. Enhancement of survival and limitation of inflammatory response in total body irradiated mice treated with cytokines

    International Nuclear Information System (INIS)

    Full text: Inflammatory reaction is a classical feature of radiation exposure and radiation pneumonitis is a dose-limiting complication in the treatment of haematological disorders treated with total body irradiation. Vascular injury is often considered to be a primary determinant of tissue dysfunction and is likely responsible for the chronic and progressive nature of delayed radiation injury. In the present study, we evaluated the influence of anti-inflammatory cytokines (IL-4, IL-11) in association with thrombopoietin (TPO) on the 30-day mouse survival as well as on systemic and lung inflammatory response and on microvascular permeability. Mice were total body irradiated with the supra lethal dose of 10 Gy (137Cs). TPO alone allowed the survival of 45% of the mice although 90% of mice treated with IL-4/TPO or IL-11/TPO survived. TPO, alone or in association, significantly decreased the over-production of the chemokine KC observed in the plasma of irradiated mice 10 to 18 days following exposure, with a higher efficacy for TPO when associated with IL-4 or IL-11. No major effect of treatments was seen on the radiation-induced lung endothelial cell activation, as illustrated by the lack of efficacy of the treatment on PECAM-1 and P-Selectin over-expression with immunohistochemistry. However, both combined-cytokine treatment limited the radiation-induced vascular leakage for 70 kD-Dextran across the mesenteric venules measured in irradiated mice four days after exposure. The efficacy of treatment with cytokines on the 30-day survival of mice might result from limitation of endothelial cell damage. In addition cytokine treatment reduced the radiation-induced vascular hyperpermeability which could result in limitation of systemic inflammatory reaction

  5. Catecholamine levels in sheep hypothalamus, hypophysis and adrenals following whole-body gamma irradiation

    International Nuclear Information System (INIS)

    Changes were studied in the levels of catecholamines and L-DOPA in the control system of the reproduction cycle (hypothalamus, hypophysis) and in the adrenal glands of sheep after whole-body irradiation with 60Co at a total dose of 6.7 Gy for seven days. The output of the radiation source was 0.039 Gy/h. The catecholamines (noradrenaline, dopamine and adrenaline) and L-DOPA were determined after separation from the tissues by the method of spectral fluorometry. After whole-body exposure to gamma radiation, noradrenaline dropped in the hypothalamus in comparison with the control group, most significantly in the rostral (by 74.2%) and caudal (by 40%) parts. A similar drop was also observed in dopamine, the concentrations of which decreased in the rostral hypothalamus by 60%. Adrenaline showed a drop in the hypothalamus, most significant in the caudal region (by 62%). Consequently, the level of the precursor of the synthesis of catecholamines and L-DOPA changed and showed in the studied regions of the hypothalamus significantly lower levels than in the control group. As regards the hypophysis, after irradiation no significant changes in the levels of noradrenaline and adrenaline were recorded, however, dopamine and L-DOPA dropped significantly (P<0.01). The exposure to gamma radiation also causes a decrease in the concentrations of catecholamines and L-DOPA in the adrenal glands of sheep, most significantly in noradrenaline (by 61%). It was thus found that whole-body irradiation of sheep with a dose of 6.7 Gy results in a significant decrease in the level of catecholamines in the hypothalamus, hypophysis and adrenal glands, which is probably in relation to the failure of synthesis and degradation of catecholamines and to the total organism injury

  6. Experimental Models Combining TBI, Hemorrhagic Shock, and Hypoxemia.

    Science.gov (United States)

    Leung, Lai Yee; Deng-Bryant, Ying; Shear, Deborah; Tortella, Frank

    2016-01-01

    Animal models of traumatic brain injury (TBI) provide important tools for studying the pathobiology of brain trauma and for evaluating therapeutic or diagnostic targets. Incorporation of additional insults such as hemorrhagic shock (HS) and/or hypoxemia (HX) into these models more closely recreates clinical scenarios as TBI often occurs in conjunction with these systemic insults (i.e., polytrauma). We have developed a rat model of polytrauma that combines penetrating TBI, HS and HX. Following brain trauma, HX was induced by reducing the inspired oxygen while HS was induced by withdrawing blood to lower the mean arterial pressure. The physiological, histological, and behavioral aspects of this animal model have been characterized and have demonstrated exacerbating effects of systemic insults on penetrating TBI. As such, this model may facilitate the use of simultaneous assessments of multiple mechanisms and provide a platform for testing novel diagnostic and therapeutic targets. PMID:27604733

  7. The Utility of Cerebral Blood Flow Assessment in TBI.

    Science.gov (United States)

    Akbik, Omar S; Carlson, Andrew P; Krasberg, Mark; Yonas, Howard

    2016-08-01

    Over the past few decades, intracranial monitoring technologies focused on treating and preempting secondary injury after traumatic brain injury (TBI) have experienced considerable growth. A physiological measure fundamental to the management of these patients is cerebral blood flow (CBF), which may be determined directly or indirectly. Direct measurement has proven difficult previously; however, invasive and non-invasive CBF monitors are now available. This article reviews the history of CBF measurements in TBI as well as the role of CBF in pathologies associated with TBI, such as cerebral autoregulation, hyperemia, and cortical spreading depression. The limitations of various CBF monitors are reviewed in order to better understand their role in TBI management. PMID:27315250

  8. Changes in plasma apolipoproteins following whole-body irradiation in rabbit

    Energy Technology Data Exchange (ETDEWEB)

    Feliste, R. (INSERM, Toulouse, France); Dousset, N.; Carton, M.; Douste-Blazy, L.

    1981-09-01

    Male New Zealand white rabbits were whole-body-irradiated with a linear electron accelerator at 800 rad (LD/sub 50/ in 30 days). This treatment induced a pronounced hypertriglyceridemia. The apoprotein composition of very low density lipoproteins (VLDL, d < 1.006 g/ml) and high-density lipoproteins (HDL, d = 1.063 - 1.21 g/ml) from irradiated rabbits was studied and compared to those of normal rabbits. Significant changes were observed in both very low density apolipoproteins and high-density apolipoproteins. (1) In the VLDL fraction from irradiated rabbits, there appeared in high proportion two apolipoproteins with electrophoretic mobility in urea/polyacrylamide gels similar to apoA-I and A-II but which were distinctly different in their apparent molecular weights, their isoelectric points, and their amino acid composition from these latter proteins. These proteins had apparent molecular weights of about 10,000. They focused into three bands with pI values of 6.1, 6.4, and 6.6. Their amino acid composition was characterized by a very low content of threonine and serine and a high content of aspartic acid, glycine, alanine, and arginine. In addition, a marked increase of an apolipoprotein with an apparent molecular weight of about 43,000 and with an amino acid composition similar to rat apoA-IV was also observed in rabbit VLDL after irradiation. Apolipoprotein C constituents with slowmobility decreased significantly. (2) The irradiated rabbit HDL apolipoproteins showed an important increase of the proteins with molecular weight 10,000 and isoelectric points 6.1, 6.4, and 6.6. Compared to normal rabbit HDL apolipoproteins, a significant decrease of apoA-IV occurred. These modifications were also observed with lower radiation doses (200 and 400 rad).

  9. Idiopathic interstitial pneumonia following bone marrow transplantation: the relationship with total body irradiation

    International Nuclear Information System (INIS)

    Interstitial pneumonia is a frequent and often fatal complication of allogenic bone marrow transplantation. Thirty to 40 percent of such cases are of unknown etiology and have been labelled as cases of idiopathic interstitial pneumonia. Idiopathic cases are more commonly associated with the use of total body irradiation; their occurrence appears to be independent of immunosupression or graft versus host disease. Evidence is presented from the literature suggesting that the development of idiopathic interstitial pneumonia is related to the absolute absorbed dose of radiation to lung. The similarity of idiopathic pneumonia to radiation pneumonitis seen in a different clinical setting is described

  10. Recovery from Hematopoietic Injury by Modulating Prostaglandin E2 Signaling Post-Irradiation

    OpenAIRE

    Hoggatt, Jonathan; Singh, Pratibha; Stilger, Kayla N.; Plett, P. Artur; Sampson, Carol H.; Chua, Hui Lin; Orschell, Christie M.; Pelus, Louis M.

    2012-01-01

    While high dose total body irradiation (TBI) is used therapeutically, the proliferation of nuclear weapons, increasing use of nuclear power, and worldwide radical terrorism underscore the need to develop countermeasures to a radiological mass casualty event. The hematopoietic syndrome of the acute radiation syndrome (HS-ARS) results from severe compromise to the hematopoietic system, including lymphocytopenia, neutropenia, thrombocytopenia, and possible death from infection and/or hemorrhage....

  11. The influence of whole body 60Co-irradiation on distribution of 67Ga in tumor-bearing mice

    International Nuclear Information System (INIS)

    Since the initial findings that 67Ga has a preferential affinity for soft tissue tumors, in humans numerous suggestions have been advanced for the basic mechanism involved. The effects produced by whole-body X-irradiation on the excretion and tissue distribution of 67Ga have been reported by Swartzendruber and others. Bradley and coworkers have shown that these irradiation effects were associated with an increase in serum iron. The present investigation was undertaken in order to study the relationships between the change in the serum iron concentration and 67Ga accumulation in the tumor and soft tissues in mice bearing Ehrlich's ascites tumor. The following results were obtained. (1) The serum iron concentration was significantly decreased between 3 and 6 hours after 10 Gy (1,000 rad) dose of whole-body 60Co-irradiation. Subsequently, the serum iron levels were slowly elevated. (2) The uptake of 67Ga in the tumor and soft tissues was increased if the serum iron concentration was decreased by whole-body 60Co-irradiation during the early phase. On the contrary, if the serum iron concentration was high, the uptake of 67Ga in the tumor was decreased. (3) The excretion of 67Ga from the body was delayed if the serum iron concentration was decreased by whole-body 60Co-irradiation. However, if the serum iron concentration was high, the excretion of 67Ga from the body significantly increased. (author)

  12. Optimization of monoclonal antibody production in mouse ascites by single whole-body irradiation

    International Nuclear Information System (INIS)

    Hybridoma cells injected intraperitoneally into mice induce formation of ascites tumors producing ascites fluid with high levels of monoclonal antibodies. Several parameters affect the growth of the immunoglobulin-producing tumors in vivo. In 10 different hybridomas the average ascites tumor formation rate could be increased from 32% (n = 338 mice) to 77% (n = 112 mice) by only one whole-body irradiation of paraffin-pretreated Balb/c mice. Production of monoclonal antibodies was better in males because of the significantly (p < 0.01) increased volume of ascites fluid. From the increased tumor formation rate in irradiated mice it is suggested that in non-irradiated recipients the tumor growth rate was lowered by immunological reactions against hybridoma cells provoked by cell surface neoantigens revealed by cell fusion and/or tumor-associated antigens of the myeloma parent cells as well as by altered antigen pattern caused by possible mutations in the myeloma cell line and/or Balb/c/K strain. (author)

  13. The behaviour of the endocrinological parameters cortisol, testosterone, growth hormone and prolactin after UVA and UVB whole-body irradiation

    International Nuclear Information System (INIS)

    With two groups, each with 8 healthy subjects UV whole-body irradiation was carried out with uniformly 30 J/cm2 UVA or respectively UVB at the level of the individual minimal erythema dose. Every subject received serial irradiations once a day for four days. The determination of the serum hormone level was accomplished by means of radioimmunoassays. The results show a weakly significant decline of cortisol 4 and 24 hours after 2 serial UVB irradiations. 3,5 and 7 days after the end of the irradiation series the cortisol values have increased, but by the seventh day statistically only weakly significant. With UVA irradiation there was also a weakly significant increase in cortisol levels three days after the end of the irradiation series. The serum levels of the other hormones showed no statistically significant changes. (orig./MG)

  14. Midplane dose determination and verification of calculated doses in total body irradiation

    Directory of Open Access Journals (Sweden)

    Özlem ÖZDEMİR

    2014-06-01

    Full Text Available OBJECTIVES To compare calculated and measured doses for different regions of anthropomorphic phantom and patients using ion chamber and thermoluminescence dosimetry (TLD for total body irradiation. METHODS Measurements were done for lateral fields with 6 MV, gantry 82º, 40x40 cm2 field and 400 cm source-axis distance (SAD. Entrance-exit and midline doses were measured on anthropomorphic phantom by TLD and entrance-exit doses were measured by TLD and ion chamber on patients. RESULTS For anthropomorphic phantom measurements differences between calculated and measured entrance-exit doses of head, neck, shoulder, lung and thick pelvis were 0.8%, 2.7%, 26.4%, 4.4% and 4.9% and for midline doses were 1.6%, 1.6%, 6.3%, -1.4% and 7.4% respectively. For patients; TLD differences were within -4.13% ile 6.7%, -3.3% ile 3.9%, 5.1% ile 16.6%, -7.8% ile 2.4%, and 3.6% ile 7.1% respectively. For thick pelvis measurements with ion chamber differences were within %0.1-1.9. CONCLUSION Total body irradiation is being applied in limit values in our clinic.

  15. Dose calculation method with 60-cobalt gamma rays in total body irradiation

    CERN Document Server

    Scaff, L A M

    2001-01-01

    Physical factors associated to total body irradiation using sup 6 sup 0 Co gamma rays beams, were studied in order to develop a calculation method of the dose distribution that could be reproduced in any radiotherapy center with good precision. The method is based on considering total body irradiation as a large and irregular field with heterogeneities. To calculate doses, or doses rates, of each area of interest (head, thorax, thigh, etc.), scattered radiation is determined. It was observed that if dismagnified fields were considered to calculate the scattered radiation, the resulting values could be applied on a projection to the real size to obtain the values for dose rate calculations. In a parallel work it was determined the variation of the dose rate in the air, for the distance of treatment, and for points out of the central axis. This confirm that the use of the inverse square law is not valid. An attenuation curve for a broad beam was also determined in order to allow the use of absorbers. In this wo...

  16. Diagnosis of Partial Body Radiation Exposure in Mice Using Peripheral Blood Gene Expression Profiles

    OpenAIRE

    Meadows, Sarah K.; Dressman, Holly K.; Daher, Pamela; Himburg, Heather; Russell, J. Lauren; Doan, Phuong; Chao, Nelson J.; Lucas, Joseph; Nevins, Joseph R.; Chute, John P

    2010-01-01

    In the event of a terrorist-mediated attack in the United States using radiological or improvised nuclear weapons, it is expected that hundreds of thousands of people could be exposed to life-threatening levels of ionizing radiation. We have recently shown that genome-wide expression analysis of the peripheral blood (PB) can generate gene expression profiles that can predict radiation exposure and distinguish the dose level of exposure following total body irradiation (TBI). However, in the e...

  17. Protective Effect Of Avocado Oil Against Biochemical And Histological Changes In Whole Body Gamma Irradiation In Albino Rats

    International Nuclear Information System (INIS)

    Avocado oil, extracted from the pulp of the fruit, is rich in poly-unsaturated fatty acids, linoleic, linolenic, oleic acids and the monounsaturated fatty acid. It also contains B-sitosterol, B-carotene, lecithin, minerals and vitamins A, C, D and E. Avocado oil lowers the blood levels of serum lipids and has antioxidant properties as a free radical scavenger. Male albino rats were divided into 5 groups. 1- Control group: rats not subjected to any treatment, 2- Avocado treated group: rats received avocado oil (0.1 ml/kg/day) via intraperitoneal injection during 21 days, 3- Irradiated group: rats were whole body gamma irradiated with 7 Gy, 4- Avocado + irradiated group: rats received avocado oil for 21 days then exposed to whole body gamma irradiation with 7 Gy and 5- Radiation + avocado group: rats were exposed to 7 Gy whole body gamma irradiation then received avocado oil for 21 days. Avocado oil (0.1 ml/kg/day) was given to rats, receiving a standard diet, for 21 days before exposure to 7 Gy whole body gamma irradiation then the treatment was continued for 10 days after irradiation. Several investigations were carried out such as superoxide dismutase (SOD), malondialdehyde (MDA), reduced glutathione (GSH), catalase (CAT), lipid profile and blood sugar. High significant increase in MDA was observed and treatment with avocado before irradiation caused significant increase in GSH, CAT and SOD and significant decrease in MDA as compared to the irradiated groups. The results also showed that treatment with avocado oil significantly diminished the radiation-induced alterations observed in the levels of lipid profile and glucose. The results demonstrated that whole body gamma irradiated rats showed significant increase in alanine aminotransferase (ALT), aspartate amino-transferase (AST), alkaline phosphatase (ALP) and glucose. By studying the lipid profile, significant increases in cholesterol, triglycerides and LDL-C levels were recorded while significant decrease was

  18. Lung autophagic response following exposure of mice to whole body irradiation, with and without amifostine

    Energy Technology Data Exchange (ETDEWEB)

    Zois, Christos E. [Department of Radiotherapy - Oncology, Democritus University of Thrace, Alexandroupolis 68100 (Greece); Giatromanolaki, Alexandra [Department of Pathology, Democritus University of Thrace, Alexandroupolis (Greece); Kainulainen, Heikki [Department of Biology of Physical Activity, University of Jyvaeskylae (Finland); Botaitis, Sotirios [Department of Experimental Surgery, Democritus University of Thrace, Alexandroupolis (Greece); Torvinen, Sira [Department of Biology of Physical Activity, University of Jyvaeskylae (Finland); Simopoulos, Constantinos [Department of Experimental Surgery, Democritus University of Thrace, Alexandroupolis (Greece); Kortsaris, Alexandros [Department of Biochemistry, Democritus University of Thrace, Alexandroupolis (Greece); Sivridis, Efthimios [Department of Pathology, Democritus University of Thrace, Alexandroupolis (Greece); Koukourakis, Michael I., E-mail: targ@her.forthnet.gr [Department of Radiotherapy - Oncology, Democritus University of Thrace, Alexandroupolis 68100 (Greece)

    2011-01-07

    Research highlights: {yields} We investigated the effect 6 Gy of WBI on the autophagic machinery of normal mouse lung. {yields} Irradiation induces dysfunction of the autophagic machinery in normal lung, characterized by decreased transcription of the LC3A/Beclin-1 mRNA and accumulation of the LC3A, and p62 proteins. {yields} The membrane bound LC3A-II protein levels increased in the cytosolic fraction (not in the pellet), contrasting the patterns noted after starvation-induced autophagy. {yields} Administration of amifostine, reversed all the LC3A and p62 findings, suggesting protection of the normal autophagic function. -- Abstract: Purpose: The effect of ionizing irradiation on the autophagic response of normal tissues is largely unexplored. Abnormal autophagic function may interfere the protein quality control leading to cell degeneration and dysfunction. This study investigates its effect on the autophagic machinery of normal mouse lung. Methods and materials: Mice were exposed to 6 Gy of whole body {gamma}-radiation and sacrificed at various time points. The expression of MAP1LC3A/LC3A/Atg8, beclin-1, p62/sequestosome-1 and of the Bnip3 proteins was analyzed. Results: Following irradiation, the LC3A-I and LC3A-II protein levels increased significantly at 72 h and 7 days. Strikingly, LC3A-II protein was increased (5.6-fold at 7 days; p < 0.001) only in the cytosolic fraction, but remained unchanged in the membrane fraction. The p62 protein, was significantly increased in both supernatant and pellet fraction (p < 0.001), suggesting an autophagosome turnover deregulation. These findings contrast the patterns of starvation-induced autophagy up-regulation. Beclin-1 levels remained unchanged. The Bnip3 protein was significantly increased at 8 h, but it sharply decreased at 72 h (p < 0.05). Administration of amifostine (200 mg/kg), 30 min before irradiation, reversed all the LC3A and p62 findings on blots, suggesting restoration of the normal autophagic function

  19. Lung autophagic response following exposure of mice to whole body irradiation, with and without amifostine

    International Nuclear Information System (INIS)

    Research highlights: → We investigated the effect 6 Gy of WBI on the autophagic machinery of normal mouse lung. → Irradiation induces dysfunction of the autophagic machinery in normal lung, characterized by decreased transcription of the LC3A/Beclin-1 mRNA and accumulation of the LC3A, and p62 proteins. → The membrane bound LC3A-II protein levels increased in the cytosolic fraction (not in the pellet), contrasting the patterns noted after starvation-induced autophagy. → Administration of amifostine, reversed all the LC3A and p62 findings, suggesting protection of the normal autophagic function. -- Abstract: Purpose: The effect of ionizing irradiation on the autophagic response of normal tissues is largely unexplored. Abnormal autophagic function may interfere the protein quality control leading to cell degeneration and dysfunction. This study investigates its effect on the autophagic machinery of normal mouse lung. Methods and materials: Mice were exposed to 6 Gy of whole body γ-radiation and sacrificed at various time points. The expression of MAP1LC3A/LC3A/Atg8, beclin-1, p62/sequestosome-1 and of the Bnip3 proteins was analyzed. Results: Following irradiation, the LC3A-I and LC3A-II protein levels increased significantly at 72 h and 7 days. Strikingly, LC3A-II protein was increased (5.6-fold at 7 days; p < 0.001) only in the cytosolic fraction, but remained unchanged in the membrane fraction. The p62 protein, was significantly increased in both supernatant and pellet fraction (p < 0.001), suggesting an autophagosome turnover deregulation. These findings contrast the patterns of starvation-induced autophagy up-regulation. Beclin-1 levels remained unchanged. The Bnip3 protein was significantly increased at 8 h, but it sharply decreased at 72 h (p < 0.05). Administration of amifostine (200 mg/kg), 30 min before irradiation, reversed all the LC3A and p62 findings on blots, suggesting restoration of the normal autophagic function. The LC3A and Beclin1 m

  20. Anti-tumor immunological mechanisms of low dose whole-body irradiation in the protocol of tumor generadiotherapy

    International Nuclear Information System (INIS)

    Objective: To investigate the immunologic enhancement of low dose whole-body irradiation in mice bearing Lewis lung carcinoma (LLC) under recombinant plasmid pEgr-IL18-B7.1 gene-radiotherapy. Methods: LLC cells were implanted subcutaneously in the right-hind leg of C57BL/6J mice. The pEgr-IL18- B7.1 recombinant plasmids mediated by polyethylenimine were injected locally into tumors of the mice with gene- radiotherapy, and then the tumors received different therapeutic regimens containing local irradiation with 2 Gy and whole-body irradiation with 0.075 Gy, respectively. Cytotoxic activity of CTL and NK were detected with isotope labeling of 3H-TdR. The secretion activities of TNF-α and IFN-γ were detected with ELISA. The anti-tumor immunological effects of low dose whole-body irradiation in protocol of gene-radiotherapy on the tumor-bearing mice were observed. Results: Compared with conventional repeated high dose local irradiation, single high dose local irradiation in combination with repeated low dose whole-body irradiation could enhance the cytotoxic activity of CTL and NK, and increase the secretion of TNF-α and IFN-γ under pEgr-IL18-B7.1 gene-radiotherapy. Conclusions: Low dose whole-body irradiation superimposed upon a local high dose could significantly enhance the anti-tumor effect in the protocol of gene-radiotherapy through promoting the cytotoxic activity of CTL and NK, and up-regulating the expression of TNF-α and IFN-γ. (authors)

  1. Bronchial neuroendocrine elements in late post-radiation stage in humans after total body irradiation

    International Nuclear Information System (INIS)

    It is not known how long-term total body irradiation affects the neuroendocrine cells (Nc) and peptidergic innervation in the bronchial wall. This study examined, by immunohistochemical and radioimmunoassay (RIA) techniques, the distribution of NC and neuropeptide-containing nerve fibres in the large bronchi of Chernobyl nuclear accident cleanup workers displaying pulmonary fibrosis and metaplastic epithelium. Bronchial mucous and submucous layers from 16 Chernobyl patients and 6 control subjects were examined by conventional light microscopy and immunohistochemical techniques for determination of protein gene product 9.5 (PGP), chromogranin A, chromogranin A and B (CAB), calcitonin gene-related peptide (CGRP), calcitonin, vasoactive intestinal peptide (VIP), gastrin-releasing peptide (GRP), helospectin I, neuropeptide Y (NPY), pituitary adenylate cyclase activating peptide (PACAP), serotonin (5-hydroxyltryptamine, 5-HT), and substance P (SP). Additionally, bronchial biopsies from 6 Chernobyl cleanup workers and 3 control patients were examined by RIA for VIP and NPY/peptideYY-Ievels. The Chernobyl patients were examined 10 years after exposure during the cleanup works in the Chernobyl Atomic Electric Power Station. PGP immunoreactive nerve fibres appeared to be more frequent in the bronchial wall after long term irradiation as compared with controls. However, no specific alterations in the amounts of NPY-, PACAP-, helospectin-, SP- and CGRP-immunoreactive nerve fibres were seen in bronchi of control and Chernobyl patients. 5-HT -immunoreactive NC appeared to be more numerous in normal bronchial epithelium adjacent to metaplastic epithelium, in which numerous CAB- immunoreactive NC were seen in Chernobyl patients. RIA for VIP and NPY/PYY showed individual variations in the levels of these peptides in the bronchial tissue. In two cases (one Chernobyl patient and one control patient) there was a high concentration of VIP in parallel with a high concentration of NPY

  2. Electronic compensation technique to deliver a total body dose

    Science.gov (United States)

    Lakeman, Tara E.

    Purpose: Total body irradiation (TBI) uses large parallel-opposed radiation fields to suppress the patient's immune system and eradicate the residual cancer cells in preparation of recipient for bone marrow transplant. The manual placement of lead compensators has been conventionally used to compensate for the varying thickness throughout the body in large-field TBI. The goal of this study is to pursue utilizing the modern electronic compensation technique to more accurately and efficiently deliver dose to patients in need of TBI. Method: Treatment plans utilizing the electronic compensation to deliver a total body dose were created retrospectively for patients for whom CT data had been previously acquired. Each treatment plan includes two pair of parallel opposed fields. One pair of large fields is used to encompass the majority of the patient's anatomy. The other pair are very small open fields focused only on the thin bottom portion of the patient's anatomy, which requires much less radiation than the rest of the body to reach 100% of the prescribed dose. A desirable fluence pattern was manually painted within each of the larger fields for each patient to provide a more uniform distribution. Results: Dose-volume histograms (DVH) were calculated for evaluating the electronic compensation technique. In the electronically compensated plans, the maximum body doses calculated from the DVH were reduced from the conventionally-compensated plans by an average of 15%, indicating a more uniform dose. The mean body doses calculated from the electronically compensated DVH remained comparable to that of the conventionally-compensated plans, indicating an accurate delivery of the prescription dose using electronic compensation. All calculated monitor units were within clinically acceptable limits. Conclusion: Electronic compensation technique for TBI will not increase the beam on time beyond clinically acceptable limits while it can substantially reduce the compensator setup

  3. Effect of black pepper (piper nigrum) on body weight and some serum lipid fractions in whole body gamma irradiated albino rats

    International Nuclear Information System (INIS)

    Two experiments were conducted to determine effect of sublethal body gamma irradiation (6.0 Gy as a single dose) on body weight and some serum lipid fractions in female and male rats. The beneficial efficacy of intragastric administration of black pepper (in two doses of 160 and 320 mg/kg bw) was also investigated. The results obtained revealed that the sublethal irradiated rats showed a drastic loss in body weight reached 39.5% less than the normal males and significant alterations in serum triglycerides, cholesterol, high density lipoprotein (HDL-cholesterol) and low density lipoprotein (LDL-cholesterol) levels, 5 weeks post exposure to gamma irradiation in female and male rats. Black pepper showed a beneficial effect on these significant changes in lipid fractions in irradiated female and male rats. Treatment with the two doses of black pepper up to 14 weeks, 5 days/week, showed a slight effect on body gain and fluctuations in the lipid fractions at 5.10 and 14 weeks for both sexes

  4. Effects of 8 Gy whole body irradiation on number and functions of small intestinal intraepithelial lymphocytes (IELs)

    International Nuclear Information System (INIS)

    Objective: To explore the characteristics of intestinal mucosal immunity after radiation injury. Methods: Number, proliferation activity, cytotoxicity of IEL as well as the TNF-α and TGF-β concentrations in supernatant of cultured IELs were studied using freshly isolated IELs from whole small intestine of Kunming strain mice whole-body irradiated with 8 Gy 60Co rays. Results: The proliferation activity, cytotoxicity as well as the number of IELs in small intestinal mucosa were significantly decreased from 8h and reached the lowest level at 72 h post-irradiation. The TNF-α and TGF-β concentrations in supernatant of cultured IELs isolated from irradiated mice elevated at 8h and reached the peak values at 72h. Conclusion: The decrease in number and important factions of IELs might be one of the reasons which damage the intestinal mucosal immunity barrier after whole body irradiation

  5. A technique for delivery of total body irradiation for bone marrow transplantation in adults and adolescents

    International Nuclear Information System (INIS)

    With the increasing use of bone marrow transplantation for cancer, total body irradiation is becoming a more commonplace procedure in many of the larger centers across the country. The technical difficulties in delivering homogenous doses of radiation to the whole body are significant and involve many factors such as creation of a homogeneous, flat beam of radiation, and dealing with variations in patient thickness and tissue homogeneity, particularly in the lung. In addition, techniques must be used to safely and efficiently deal with patients who are usually very ill and require long treatment times. Although there is often an advantage in terms of dosimetry to using an AP/PA treatment technique, many institutions use parallel opposed lateral beams because of equipment and facility limitations. A technique has been devised that enables total body irradation to be given by an AP/PA technique using equipment available in many radiotherapy departments. Patients are supported in an upright position during treatment by means of a modified harness attached to the ceiling of the treatment room. Lung compensators are fixed to individually fitted vests, allowing the patient moderate amounts of movement during treatment while maintaining the position of the compensator relative to the lungs. Thermoluminiscent dosimeter (TLD) dose measurements in a phantom indicate that this system can deliver accurate and homogeneous doses to lung tissue, while allowing a good degree of patient comfort and safety during the long treatment times that are required

  6. Effect of liposome entrapped Cu/Zn bovine superoxide dismutase in rat after total body (neutron-gamma) irradiation

    International Nuclear Information System (INIS)

    Our purpose was, to study in rat the effects of (neutron-gamma) exposure and of LIPSOD treatment (liposomal Cu/Zn super-oxide dismutase) on cognitive functions. Our data demonstrate that whole-body irradiation induces in Sprague-Dawley rats some cognitive dysfunction. Treatment using LIPSOD corrects in a significantly way this trend. Moreover, in sham-irradiated rats, this treatment shows an inhibitory effect. (authors)

  7. Whole body UVA irradiation lowers systemic blood pressure by release of nitric oxide from intracutaneous photolabile nitric oxide derivates

    OpenAIRE

    Opländer, C.; Volkmar, C.M.; Paunel-Görgülü, A; van Faassen, E.E.H.; Heiss, C

    2009-01-01

    Rationale: Human skin contains photolabile nitric oxide derivates like nitrite and S-nitroso thiols, which after UVA irradiation, decompose and lead to the formation of vasoactive NO. Objective: Here, we investigated whether whole body UVA irradiation influences the blood pressure of healthy volunteers because of cutaneous nonenzymatic NO formation. Methods and Results: As detected by chemoluminescence detection or by electron paramagnetic resonance spectroscopy in vitro with human skin speci...

  8. Influence of immunization on serum γ-globulin levels of calves following whole-body X irradiation

    International Nuclear Information System (INIS)

    Calves aged 2.5 to 4 months were whole-body X irradiated with mean lethal doses between 1.2 and 1.7 Gy. The effect of different immunization procedures on the irradiation-induced reaction of the serum gamma globulin levels was studied. Immunization 14 and 21 days before irradiation resulted in obvious stimulation gamma globulin production. After parenteral antigen administration the nearly 2 weeks lasting increase of the gamma globulin level rose in the irradiated animals but declined in the sham-irradiated calves. After a lethal dosis of 1.7 Gy there was a decrease of the gamma globulins 3 weeks post irradiation, at the climax of the radiation syndrome. When 1.5 Gy were used the increase of the gamma globulin concentration was observed also after oral administration of the antigen. The response of the irradiated animals in the secondary reaction of the antibody production was most lear after boosting with homologous bacteria. The stimulating effect of the irradiation on the serum globulin levels after immunization prior to irradiation has been attributed to the reaction of the immunoglobulin-producing system to the release of tissue proteins and antigens, respectively

  9. Influence of whole body irradiation on BCG contact suppression of a rat sarcoma and tumour-specific immunity

    International Nuclear Information System (INIS)

    An assessment has been made of the influence of host immunosuppression on Bacillus Calmette Guerin (BCG) contact suppression of a syngenetically transplanted, highly immunogenic, 3-methylcholanthrene-induced rat sarcoma. Experiments have been carried out with transplanted cells derived from solid tissue and from an in vitro culture line, the latter excluding the possibility of transfer to immunosuppressed rats of lymphoid cells present in preparations from solid tissue. Normal or whole-body γ-irradiated (450 rad 24 hours before injection) rats were injected s.c. with mixtures of tumour cells and BCG organisms, and some of the animals received a simultaneous challenge of tumour cells alone at a contralateral subcutaneous site. Whole-body irradiation did not abrogate the local suppressive effect of BCG injected in admixture with sarcoma cells, whereas in contrast the development of tumour-specific host immunity, normally occurring concomitantly with rejection of mixed inocula, was totally abrogated by whole-body irradiation. (U.K.)

  10. Neuro-immune response and sleep studies after whole body irradiation with high-LET particles

    Energy Technology Data Exchange (ETDEWEB)

    Marquette, C.; Bertho, J.M.; Wysoki, J.; Maubert, C.; Gerbin, R.; Aigueperse, J. [IRSN, F-92260 Fontenay Aux Roses, (France); Mathieu, J.; Galonnier, M.; Clarencon, D. [CRSSA, Dept Radiobiol and Radiopathol, F-38700 La Tronche, (France); Balanzat, E. [CEA, DSM, CIRIL, Ganil, Caen, (France)

    2009-07-01

    In order to investigate the biological effects of galactic rays on astronaut cerebral functions after space flight, mice were exposed to different heavy ions (HZE) in whole-body conditions at doses comparable to the galactic flux: {sup 12}C, {sup 16}O and {sup 20}Ne (95 MeV/u, at 42-76 mGy). Animals were also exposed to 42 mGy of {sup 60}Co radiation for comparison with HZE. The neuro-immune response, evaluated by interleukin-I (IL-1) measurement, showed that this cytokine was produced 3 h after irradiation by {sup 16}O or {sup 60}Co. In contrast, neither {sup 12}C (56.7 mGy) nor {sup 20}Ne (76 mGy) induced IL-1 production. However, immunohistochemical staining of {sup 12}C-irradiated mouse brain tissue showed 2 months later a marked inflammatory reaction in the hippocampus and a diffuse response in parenchyma. Sleep studies were realized before and after exposure to 42 mGy of {sup 16}O and 76 mGy of {sup 20}Ne: only the {sup 20}Ne radiation displayed a small effect. A slight decrease in paradoxical sleep, corresponding to a reduction in the number of episodes of paradoxical sleep, was manifested between 8 and 22 days after exposure. Exposure to {sup 12}C and {sup 16}O induced no changes either in cellularity of spleen or thymus, or in caspase 3 activity (as much as four months after irradiation). Taken together, these data indicate that the CNS could be sensitive to heavy ions and that responses to HZE impact depend on the nature of the particle, the dose threshold and the time delay to develop biological processes. Differences in responses to different HZE highlight the complex biological phenomena to which astronauts are submitted during space flight. (authors)

  11. Neuro-immune response and sleep studies after whole body irradiation with high-LET particles

    International Nuclear Information System (INIS)

    In order to investigate the biological effects of galactic rays on astronaut cerebral functions after space flight, mice were exposed to different heavy ions (HZE) in whole-body conditions at doses comparable to the galactic flux: 12C, 16O and 20Ne (95 MeV/u, at 42-76 mGy). Animals were also exposed to 42 mGy of 60Co radiation for comparison with HZE. The neuro-immune response, evaluated by interleukin-I (IL-1) measurement, showed that this cytokine was produced 3 h after irradiation by 16O or 60Co. In contrast, neither 12C (56.7 mGy) nor 20Ne (76 mGy) induced IL-1 production. However, immunohistochemical staining of 12C-irradiated mouse brain tissue showed 2 months later a marked inflammatory reaction in the hippocampus and a diffuse response in parenchyma. Sleep studies were realized before and after exposure to 42 mGy of 16O and 76 mGy of 20Ne: only the 20Ne radiation displayed a small effect. A slight decrease in paradoxical sleep, corresponding to a reduction in the number of episodes of paradoxical sleep, was manifested between 8 and 22 days after exposure. Exposure to 12C and 16O induced no changes either in cellularity of spleen or thymus, or in caspase 3 activity (as much as four months after irradiation). Taken together, these data indicate that the CNS could be sensitive to heavy ions and that responses to HZE impact depend on the nature of the particle, the dose threshold and the time delay to develop biological processes. Differences in responses to different HZE highlight the complex biological phenomena to which astronauts are submitted during space flight. (authors)

  12. Stimulation of hematopoietic stem cells by interferon inducer in nonhuman primates receiving fractionated total body irradiation

    International Nuclear Information System (INIS)

    Interferon response and hematopoietic stem cells (spleen colony forming units-CFU-S) were studied in rhesus monkeys subjected to fractionated total body irradiation (FTBI). An interferon inducer, a nuclease resistant complex of polyinosinic-polycytidylic acid with poly-L-lysine and carboxmethylcellulose[-poly(ICLC)] was used. Poly(ICLC) at 3.75 mg/m2 was given I.V. to 7 monkeys, 5 of which, starting 24 hours later, received 50 rad of 4 MV X rays twice a week for 2.5 weeks (total of 250 rad). Another group of 4 monkeys received FTBI only. Although the initial interferon response was similar in both groups treated with poly(ICLC)-800 international units (IU), the animals receiving FTBI showed reduced interferon levels after 100 rad. These animals, however, did not develop the hyporesponsiveness to subsequent poly(ICLC) injections that was observed in non-irradiated monkeys. Stabile interferon response (30-100 IU) in the FTBI group paralleled the prolonged persistence of the drug in their serum. Bone marrow (BM) aspirates from animals receiving FTBI and poly(ICLC) contained more CFU-S per 106 nucleated cells than those treated with poly(ICLC) alone or FTBI alone. FTBI with and without poly(ICLC) led to thrombocytopenia and leukopenia. Lower white blood cell (WBC) count was found in irradiated animals treated with poly(ICLC). Partial alopecia was observed in animals receiving poly(ICLC). Two animals--one in the poly(ICLC) and FTBI group and the other receiving FTBI alone, died with thrombocytopenia and leukopenia

  13. Stimulation of hematopoietic stem cells by interferon inducer in nonhuman primates receiving fractionated total body irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Lvovsky, E.A. (George Washington Univ. Medical Center, Washington, DC); Levine, P.H.; Bengali, Z.; Leiseca, S.A.; Cicmanec, J.L.; Robinson, J.E.; Bautro, N.; Levy, H.B.; Scott, R.M.

    1982-10-01

    Interferon response and hematopoietic stem cells (spleen colony forming units--CFU-S) were studied in rhesus monkeys subjected to fractionated total body irradiation (FTBI). An interferon inducer, a nuclease resistant complex of polyinosinic-polycytidylic acid with poly-L-lysine and carboxmethylcellulose(-poly(ICLC)) was used. Poly(ICLC) at 3.75 mg/m/sup 2/ was given I.V. to 7 monkeys, 5 of which, starting 24 hours later, received 50 rad of 4 MV X rays twice a week at 2.5 weeks (total of 250 rad). Another group of 4 monkeys received FTBI only. Although the initial interferon response was similar in both groups treated wih poly(ICLC)--800 international units (IU), the animals that receiving FTBI showed reduced interferon levels after 100 rad. These animals, however, did not develop the hyporesponsiveness to subsequent poly(ICLC) injections that was observed in non-irradiated monkeys. Stabile interferon response (30-100 IU) in the FTBI group paralleled the prolonged persistence of the drug in their serum. Bone marrow (BM) aspirates from animals receiving FTBI and poly(ICLC) contained more CFU-S per 10/sup 6/ nucleated cells than those treated with poly(ICLC) along or FTBI with and without poly(ICLC) lead to thrombocytopenia and leukopenia. Lower white blood cell (WBC) count was found in irradiated animals treated with poly(ICLC). Partial alopecia was observed in animals receiving poly(ICLC). Two animals--one in the poly(ICLC) and FTBI group and the other receiving FTBI along, died with thrombocytopenia and leukopenia.

  14. Catecholamines levels in hypothalamus, pineal and adrenal glands after whole body irradiation and hormone stimulations

    International Nuclear Information System (INIS)

    Effect of the exposure of the whole body to continuous radiation and of the administration of serum gonadotropin (SG) and Folistiman (FSH) was studied as exerted on the concentration of catecholamines (epinephrine and norepinephrine (NE)) in the hypothalamus, epiphysis and adrenal glands of ewes during the aneostric period with synchronized oestrus. The ewes were were exposed to continuous radiation of 60Co (on a total dose 2.48 Gy) for five days. The radiation was provided at the rate 0.020 Gy per hour. Protracted exposure to gamma radiation and hormonal stimulation with SG reduces the concentration of NE in whole hypothalamus of sheep. A decrease of norepinephrine concentrations, statistically significant in the caudal (p < 0.01) and medial hypothalamus were recorded in the ewes after hormonal stimulation with SG without irradiation. (authors)

  15. Allogeneic bone marrow transplantation in adults after fractionated body irradiation and high dose cyclophosphamide

    International Nuclear Information System (INIS)

    The authors present short and long-term results of allogeneic bone marrow transplantation after hyper-fractionated total body irradiation and high dose cyclophosphamide in ten patients treated for leukaemia during th period 1985-89. Three patients died from complications connected to the transplantation, while seven are living free from leukaemia 18 to 59 months after transplantation. Two patients need treatment for chronic graft versus host disease. Allogeneic bone marrow transplantation is expensive and risky. Close cooperation between clinicians and laboratory specialists is essential. The treatment increases long term survival and probably cures certain patients with leukaemia. Some of the patients will need treatment for chronic graft versus host disease and other late sequelae. 19 refs., 2 tabs

  16. Incidence of cataracts in rhesus monkeys treated with whole-body irradiation

    International Nuclear Information System (INIS)

    The incidence of cataract formation was investigated in rhesus monkeys exposed to different doses of whole-body irradiation. Application of 850 to 900 rad (8.5 to 9 Gy) caused cataracts in 17% of the monkeys within 3 years after treatment; after 10 to 15 years, incidence increased to 100%. Young lenses showed a significantly lower incidence than adult lenses, although no differences in the stage of cataractogenesis could be demonstrated. Sex differences did not play a role in incidence and severity of cataracts. Lower doses (400 rad or 4 Gy) did not cause cataracts. In view of the close similarity between monkeys and humans, these results indicate that a single dose of 850 to 900 rad, sometimes employed in the treatment of acute myeloid leukemia in children, carries a strong risk of cataract development

  17. Proton-beam irradiated epithelioid cell melanoma of the ciliary body

    International Nuclear Information System (INIS)

    A malignant ciliary body melanoma received proton-beam irradiation. After an apparent failure of the tumor to respond, the eye was enucleated. A predominantly epithelioid cell tumor appeared viable by light microscopy, and a low degree of mitotic activity persisted, despite therapy. The tumor cells, however, displayed degenerative changes ultrastructurally, presumably results of the radiotherapy. These consisted of numerous cytoskeletal filaments, lipid vacuoles, prominent phagolysosomes, and nuclear convolutions and fragmentations. The mitochondria were fewer in number in the present tumor than typically encountered in epithelioid cells. A rare leptomeric structure was discovered, probably an organizational modification of the cytoplasmic filaments. The tumor's capillaries showed radiation-induced changes in terms of thickened basement membranes and perivascular fibrin deposition. The foregoing features are indicative of cellular and metabolic injury from the radiotherapy, but these were evidently not sufficiently injurious to sterilize the tumor

  18. Effects of chronic whole-body gamma irradiation on cell mediated immunity

    International Nuclear Information System (INIS)

    The whole blood lymphocyte stimulation test has been used to estimate the effects of chronic, whole-body, gamma irradiation in the dog. At lower dose levels, 0.07 and 0.33 R/day to cumulative dose of about 50 and 250 R, there was no change in cell mediated immunity. Dogs at high dose levels were affected. Dogs which succumbed to aplastic anemia at high doses had reduced immunological responses. Dogs which survived these high doses showed a temporary depression. When aplastic anemia was initially noted, there was a differential response to PHA and Con-A stimulation. The response to the former mitogen was profoundly reduced, but Con-A stimulated cells were unaffected, indicative of the development of radioresistant cell lines. As the dogs progressed toward aplastic anemia, all T lympocytes were negatively affected

  19. Changes in rat plasma fibrinolytic factors during long term follow up after whole body irradiation

    International Nuclear Information System (INIS)

    Rats were whole body irradiated with a dose of 7.0 Gy and then bled at different times after exposure, from 1 day to 12 months; in their plasma the activity of plasmin, the level of plasminogen, the activity of plasminogen activator as well as α2-antiplasmin and α2-macroglobulin were determined. In comparison to control values obtained in parallel determinations it was found that during the acute phase of radiation disease (up to 30 days after irradiation) the activity of plasmin and the level of plasminogen underwent fluctuation: at the beginning there was an increase, followed by a decrease at later time intervals. There was also a distinct decrease (over 50%) in the activity of plasminogen activator. During the 2 to 4 weeks after exposure the activity of inhibitors was somewhat decreased, especially that of α2-macroglobulin. At later periods the level of plasminogen and the activity of plasminogen activator returned to normal but that of plasmin underwent fluctuation again, reaching a significant decrease in activity 6 and 12 months after exposure. At these time points also some decrease in activity of inhibitors was observed, especially in that of α2-macroglobulin. 11 refs., 1 fig., 2 tabs. (author)

  20. Stability of the translocation frequency following whole-body irradiation measured in rhesus monkeys

    Science.gov (United States)

    Lucas, J. N.; Hill, F. S.; Burk, C. E.; Cox, A. B.; Straume, T.

    1996-01-01

    Chromosome translocations are persistent indicators of prior exposure to ionizing radiation and the development of 'chromosome painting' to efficiently detect translocations has resulted in a powerful biological dosimetry tool for radiation dose reconstruction. However, the actual stability of the translocation frequency with time after exposure must be measured before it can be used reliably to obtain doses for individuals exposed years or decades previously. Human chromosome painting probes were used here to measure reciprocal translocation frequencies in cells from two tissues of 8 rhesus monkeys (Macaca mulatta) irradiated almost three decades previously. Six of the monkeys were exposed in 1965 to whole-body (fully penetrating) radiation and two were unexposed controls. The primates were irradiated as juveniles to single doses of 0.56, 1.13, 2.00, or 2.25 Gy. Blood lymphocytes (and skin fibroblasts from one individual) were obtained for cytogenetic analysis in 1993, near the end of the animals' lifespans. Results show identical dose-response relationships 28 y after exposure in vivo and immediately after exposure in vitro. Because chromosome aberrations are induced with identical frequencies in vivo and in vitro, these results demonstrate that the translocation frequencies induced in 1965 have not changed significantly during the almost three decades since exposure. Finally, our emerging biodosimetry data for individual radiation workers are now confirming the utility of reciprocal translocations measured by FISH in radiation dose reconstruction.

  1. Effect of whole body neutron irradiation on certain enzyme activities in different brain areas in mice

    International Nuclear Information System (INIS)

    Male swiss albino mice were exposed to whole-body irradiation by fast neutrons of 14 MeV average energy. Two single doses of 0.08 sievert and 0.16 sievert were used, corresponding to fluences of 1.27 X 108 and 2.54 X 108 n/cm2 respectively. Two enzymes were assessed in different layers of the cerebrum and cerebellum of mouse brain. Changes in the activities of acid phosphatase (ACP) and succinic dehydrogenase (SDH) were taken to measure alterations in lysosomal and mitochondrial functions respectively. The degrees of lysosomal affection in different layers of the cerebrum were not uniform, while changes in A activity were very prominent in certain layers (e.g. external pyramidal layer, polymorphous cells layer and white matter), they were practically absent in others (e.g. internal pyramidal layer). Stronger effect was noted in the tissue layers of the cerebellum. The activity of SDH decreased as result of fast neutron irradiation. The response was more apparent for this enzyme than for ACP. This indicates more liability for a decrease in energy metabolism with consequent effect on behavioural and physiological functions under central nervous system control. 4 figs., 4 tabs

  2. The influences of a whole body irradiation on the host immune system in mice

    International Nuclear Information System (INIS)

    The influence of a whole body irradiation in mice was studied. Marked depression of the absolute lymphocyte count in the spleen and the peripheral blood was observed within 24 hour, with 300 rad. The count began to recover on day 4 in the spleen and completely recovered in about 4 weeks in the spleen and the peripheral blood. Incorporation of [3H]-TdR in the splenolymphocytes was reduced on day 1 postirradiation, however, the rate of [3H]-TdR-labeled cells per number of splenolymphocytes increased temporarily on day 1 and 4 postirradiation and, later, recovered quickly. Labeling index was enhanced only on day 4 postirradiation. In the case of the relative radiosensitivity of B lymphocytes, measured by antibody formation against SRBC, plaque-forming capacities were observed when antigens were injected into mice before or after irradiation. The capacities were extremely suppressed in each experimental groups. Cytotoxic activities against VX2-carcinoma cells were examined by microcytotoxicity assay. The activities increased more than 3 fold, both before immunization and on day 15 postirradiation, suggesting that B lymphocytes in antibody formation against SRBC were more radiosensitive than cytotoxic T lymphocytes against xenogeneic cells. Transfusion of splenolymphocyted labeled with [3H]-TdR was observed on day 4, which appeared to compensate for that of [51Cr]-labeled one. When [51Cr] labeled T lymphocytes were transfused intravenously, trapping and negative trapping of the lymphocytes were observed in spleen and in peripheral blood, respectively. (Ueda, J.)

  3. Sesamol attenuates genotoxicity in bone marrow cells of whole-body γ-irradiated mice.

    Science.gov (United States)

    Kumar, Arun; Selvan, Tamizh G; Tripathi, Akanchha M; Choudhary, Sandeep; Khan, Shahanshah; Adhikari, Jawahar S; Chaudhury, Nabo K

    2015-09-01

    Ionising radiation causes free radical-mediated damage in cellular DNA. This damage is manifested as chromosomal aberrations and micronuclei (MN) in proliferating cells. Sesamol, present in sesame seeds, has the potential to scavenge free radicals; therefore, it can reduce radiation-induced cytogenetic damage in cells. The aim of this study was to investigate the radioprotective potential of sesamol in bone marrow cells of mice and related haematopoietic system against radiation-induced genotoxicity. A comparative study with melatonin was designed for assessing the radioprotective potential of sesamol. C57BL/6 mice were administered intraperitoneally with either sesamol or melatonin (10 and 20mg/kg body weight) 30 min prior to 2-Gy whole-body irradiation (WBI) and sacrificed after 24h. Total chromosomal aberrations (TCA), MN and cell cycle analyses were performed using bone marrow cells. The comet assay was performed on bone marrow cells, splenocytes and lymphocytes. Blood was drawn to study haematological parameters. Prophylactic doses of sesamol (10 and 20mg/kg) in irradiated mice reduced TCA and micronucleated polychromatic erythrocyte frequency in bone marrow cells by 57% and 50%, respectively, in comparison with radiation-only groups. Sesamol-reduced radiation-induced apoptosis and facilitated cell proliferation. In the comet assay, sesamol (20mg/kg) treatment reduced radiation-induced comets (% DNA in tail) compared with radiation only (P < 0.05). Sesamol also increased granulocyte populations in peripheral blood similar to melatonin. Overall, the radioprotective efficacy of sesamol was found to be similar to that of melatonin. Sesamol treatment also showed recovery of relative spleen weight at 24h of WBI. The results strongly suggest the radioprotective efficacy of sesamol in the haematopoietic system of mice. PMID:25863274

  4. Chondrosarcoma arising within a radiation-induced osteochondroma several years following childhood total body irradiation: Case report

    International Nuclear Information System (INIS)

    Malignant degeneration arising in radiation-induced osteochondromas is extremely rare. We report a case of a 34-year-old man with a chondrosarcoma arising from an osteochondroma of the left posterior eighth rib that developed following total body irradiation received as part of the conditioning regimen prior to bone marrow transplantation at age 8. To our knowledge, this is only the fourth reported case of a chondrosarcoma arising within a radiation-induced osteochondroma and the first case occurring following childhood total body irradiation. (orig.)

  5. Radionuclide imaging of myocardial infarction using Tc-99m TBI

    International Nuclear Information System (INIS)

    The cationic complex Tc-99m t-butylisonitrile (TBI) concentrates in the myocardial tissue of several animal species. Its myocardial distribution is proportional to blood flow both in zones of ischemia and in normal myocardium at rest. Planar, tomographic, and gated myocardial images have been obtained using Tc-99m TBI in the human. The authors investigated the potential application of Tc-99m TBI imaging to detect and localize myocardial infarction. Four subjects without clinical evidence of cardiovascular disease and five patients with ECG evidence of previous myocardial infarction were studied. Tc-99m TBI (10mCi) was injected intravenously with the patient in a resting state with planar imaging in the anterior, 30 and 70 degree LAO projections beginning one hr after injection. The distribution of the tracer was homogeneous throughout the left ventricular wall in the normal subjects. Regional perfusion defects were present in 4/5 of the patients with myocardial infarction. Location of the defects corresponded to the location of the infarct using ECG criteria (2 inferoposterior and 2 anterior). The patient in whom the Tc-99m TBI image appeared normal had sustained a subendocardial myocardial infarct which could not be localized by ECG; the other 4 pts had transmural infarcts. Anterior and 30 degree LAO images were of excellent quality in all cases; there was overlap of the liver on the inferior wall of the left ventricle on the 70 degree LAO views. The authors conclude that accurate perfusion imaging may be possible using Tc-99m TBI in patients with transmural myocardial infarction

  6. Radionuclide imaging of myocardial infarction using Tc-99m TBI

    Energy Technology Data Exchange (ETDEWEB)

    Holman, B.L.; Campbell, S.; Kirshenbaum, J.M.; Lister-James, J.; Jones, A.G.; Davison, A.; Antman, E.

    1985-05-01

    The cationic complex Tc-99m t-butylisonitrile (TBI) concentrates in the myocardial tissue of several animal species. Its myocardial distribution is proportional to blood flow both in zones of ischemia and in normal myocardium at rest. Planar, tomographic, and gated myocardial images have been obtained using Tc-99m TBI in the human. The authors investigated the potential application of Tc-99m TBI imaging to detect and localize myocardial infarction. Four subjects without clinical evidence of cardiovascular disease and five patients with ECG evidence of previous myocardial infarction were studied. Tc-99m TBI (10mCi) was injected intravenously with the patient in a resting state with planar imaging in the anterior, 30 and 70 degree LAO projections beginning one hr after injection. The distribution of the tracer was homogeneous throughout the left ventricular wall in the normal subjects. Regional perfusion defects were present in 4/5 of the patients with myocardial infarction. Location of the defects corresponded to the location of the infarct using ECG criteria (2 inferoposterior and 2 anterior). The patient in whom the Tc-99m TBI image appeared normal had sustained a subendocardial myocardial infarct which could not be localized by ECG; the other 4 pts had transmural infarcts. Anterior and 30 degree LAO images were of excellent quality in all cases; there was overlap of the liver on the inferior wall of the left ventricle on the 70 degree LAO views. The authors conclude that accurate perfusion imaging may be possible using Tc-99m TBI in patients with transmural myocardial infarction.

  7. Caffeine and Aspirin Protecting Albino Rats A gainst Biochemical and Histological Disorders Induced by Whole Body Gamma Irradiation

    International Nuclear Information System (INIS)

    Caffeine is an alkaloid (purine derivative) that contains flavonoids, where as aspirin, natural component of mammalian tissue ( acetylsalicylic acid) is one of the most commonly used non steroidal anti - inflammatory , and it is a necessary factor in the utilization of long - chain fatty acids to produce energy. Furthermore, it has been shown to protect cells from per oxidative stress. Th e objective of the present study is to evaluate the efficacy of caffeine (1,3,7 - trimethyl xanthine) 80 mg/kg b.wt. a nd aspirin ( acetylsalicylic acid) in the amelioration of the physiological and histological changes in stomach and intestine of rats exposed to gamma irradiation . Male albino rats were divided into 8 groups. 1 - Control group: rats not subject to any treatment, 2 - Caffeine group: rats received caffeine ( 80 ml/Kg body weight )via intraperitoneal injection for 21 days, 3 - Aspirin group: rats received aspirin (150 mg / kg body) via intraperitoneal injection for 21 days , 4 - Caffeine + Aspirin group: rats received caffeine a nd aspirin treatment, 5 - Radiation groups: rats were whole body gamma irradiated at 8 Gy , 6 - Caffeine + Radiation group: rats received caffeine for 21 days before whole body gamma irradiation at 8 Gy, 7 - Aspirin + Radiation group: rats received aspirin during 21 days before w hole body gamma irradiation , 8 - Caffeine + Aspirin + Radiation group: rats received caffeine parallel to aspirin for 21 days before whole body gamma irradiation. Animals were sacrificed 24 hrs post irradiation. The results demonstrated that rats exposed to whole body gamma irradiation showed a significant increase in alanine amino transferase (AL ) , aspartate amino transferase ( AST), and alkaline phosphatase (ALP) activities, and a significant decrease in total protein indicating liver injury. A significant increase in urea, creatinine, Na+,and K+ were recorded indicating kidney damage. Alteration of liver and kidney functions was accompanied by a significant

  8. Clinical Effect of Total Body Irradiation and Hematopoietic Stem Cell Transplantation for Refractory and Relapsed Childhood Leukemia%含全身照射方案的造血干细胞移植对难治性白血病的疗效

    Institute of Scientific and Technical Information of China (English)

    陈点点; 郭智; 冯超英; 路娜; 王雅棣

    2013-01-01

    Objective To explore the efficacy and feasibility of allogeneic hematopoietic stem cell transplantation ( allo-HSCT) and total body irradiation (TBI) for refractory and relapsed leukemia. Methods 20 patients with refractory and relapsed leukemia who received allo -HSCT were examined. Bone marrow combined with peripheral blood HSCT was used . All patients were treated with standardized conditioning regimen consisting of cytarabine , busulfan, fludarabine and TBI ,etc. Body irradiation used 6MV-X irradiation. Graft-versus-host disease ( GVHD) prophylaxis used classic cyclosporin A , methotrexate ,anti-thymocyte immu-noglobulin and CD25 monoclonal antibody. Complications and disease-free survival after transplantation of patients were observed . Results All of the patients were engrafted and had 100% donor hematological cell after transplantation by cytogenetic evidence analysis. Patients have mild symptoms such as nausea ,vomiting,parotid swelling,no case of interstitial pneumonia after TBI. The median follow up time was 12.5 months (6 ~36 months).8 cases had experience of GVHD ,2 died of acute GVHD ,2 died of infection and 6 died of relapse. The rest 10 patients were alive in free situation and the disease -free survival rates at 2 years were 50%. Conclusion Hematopoietic stem cell transplantation combined with total body irradiation program is safe and effective treatment for refractory and relapsed leukemia. It can be widely used in clinical as a key technology for salvage therapy .%目的 探讨含全身照射(TBI) 预处理方案的造血干细胞移植(allo-HSCT)对难治性白血病的疗效和安全性.方法 采用含TBI预处理方案的allo-HSCT治疗20例难治性白血病患者,采用骨髓加外周血干细胞联合移植,预处理方案包括阿糖胞苷、氟达拉滨及TBI等,全身照射采用6MV-X照射,移植物抗宿主病(GVHD) 预防采用经典环孢菌素A(CSA) 和氨甲蝶呤(MTX)及抗胸腺细胞免疫球蛋白(ATG)、CD25单克隆抗体,

  9. Gene Expression Changes in Mouse Intestinal Tissue Following Whole-Body Proton or Gamma-Irradiation

    Science.gov (United States)

    Purgason, Ashley; Zhang, Ye; Mangala, Lingegowda; Nie, Ying; Gridley, Daila; Hamilton, Stanley R.; Seidel, Derek V.; Wu, Honglu

    2014-01-01

    Crew members face potential consequences following exposure to the space radiation environment including acute radiation syndrome and cancer. The space radiation environment is ample with protons, and numerous studies have been devoted to the understanding of the health consequences of proton exposures. In this project, C57BL/6 mice underwent whole-body exposure to 250 MeV of protons at doses of 0, 0.1, 0.5, 2 and 6 Gy and the gastrointestinal (GI) tract of each animal was dissected four hours post-irradiation. Standard H&E staining methods to screen for morphologic changes in the tissue showed an increase in apoptotic lesions for even the lowest dose of 0.1 Gy, and the percentage of apoptotic cells increased with increasing dose. Results of gene expression changes showed consistent up- or down- regulation, up to 10 fold, of a number of genes across exposure doses that may play a role in proton-induced oxidative stress including Gpx2. A separate study in C57BL/6 mice using the same four hour time point but whole-body gamma-irradiation showed damage to the small intestine with lesions appearing at the smallest dose of 0.05 Gy and increasing with increasing absorbed dose. Expressions of genes associated with oxidative stress processes were analyzed at four hours and twenty-four hours after exposure to gamma rays. We saw a much greater number of genes with significant up- or down-regulation twenty-four hours post-exposure as compared to the four hour time point. At both four hours and twenty-four hours post-exposure, Duox1 and Mpo underwent up-regulation for the highest dose of 6 Gy. Both protons and gamma rays lead to significant variation in gene expressions and these changes may provide insight into the mechanism of injury seen in the GI tract following radiation exposure. We have also completed experiments using a BALB/c mouse model undergoing whole-body exposure to protons. Doses of 0, 0.1, 1 and 2 Gy were used and results will be compared to the work mentioned

  10. Biochemical and histological changes in whole body gamma-irradiated rats feed on wheat, barely and corn bran

    International Nuclear Information System (INIS)

    The present work aims to study the effect of adding 3 different of dietary fibers (wheat, barley or corn bran) to normal balanced diet on liver function, blood, cholesterol, triglycerides and blood glucose level to counteract their elevation in whole body gamma irradiation rats. The experimental diets (balanced diet + fibre additive) were fed for 4 weeks. Samples (blood and tissue) were collected at intervals of times 7, 14 and 28 days post exposure to single dose (7 Gy) gamma irradiation. The control group consumed a fibre diet for 4 weeks, but not irradiated. The minimum aspartate amino-transferase (AST) and alanine aminotransferase (ALT) activities and the lowest blood total cholestrol, triglycerides and blood glucose were observed in rats (irradiated and non-irradiated rats) fed on wheat bran experimental diet (barley or corn bran). It could be concluded that wheat fibers were more effective, as compared with other fibers contained in balanced diet, in improving the investigated parameters observed after whole body gamma irradiation exposure

  11. Protective Effects of Ibuprofen and L-Carnitine Against Whole Body Gamma Irradiation-Induced Duodenal Mucosal Injury

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    Meryem Akpolat

    2011-03-01

    Full Text Available Objective: Ibuprofen and L-carnitine have been demonstrated to provide radioprotective activity to the hamster against whole body sublethal irradiation. The purpose of this study is to test those antioxidant drugs, each of which has the capacity of inhibiting mucosal injury, as topical radioprotectants for the intestine. Material and Methods: The male hamsters were divided into the following four groups (n=6: group 1: control group, received saline, 1 ml/100 g by gavage, as placebo. Group 2: irradiated-control group, received whole body irradiation of 8 Gy as a single dose plus physiological saline. The animals in groups 3 and 4 were given a daily dose of 10 mg/kg of ibuprofen and 50 mg/kg of L-carnitine for 15 days respectively, before irradiation with a single dose of 8 Gy. Twenty-four hours after radiation exposure, the hamsters were sacrificed and samples were taken from the duodenum, and the histopatological determinations were carried out. Results: Morphologically, examination of the gamma irradiated duodenum revealed the presence of shortening and thickening of villi and flattening of enterocytes, massive subepithelial lifting. Pretreatment of ibuprofen and L-carnitine with irradiation reduced these histopathological changes. Conclusion: Ibuprofen and L-carnitine administrated by the oral route may be a good radioprotector against small intestinal damage in patients undergoing radiotherapy.

  12. Comparison of /sup 32/P therapy and sequential hemibody irradiation (HBI) for bony metastases as methods of whole body irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Aziz, H.; Choi, K.; Sohn, C.; Yaes, R.; Rotman, M.

    1986-06-01

    We report a retrospective study of 15 patients with prostate carcinoma and diffuse bone metastases treated with sodium /sup 32/P for palliation of pain at Downstate Medical Center and Kings County Hospital from 1973 to 1978. The response rates, duration of response, and toxicities are compared with those of other series of patients treated with /sup 32/P and with sequential hemibody irradiation. The response rates and duration of response are similar with both modalities ranging from 58 to 95% with a duration of 3.3 to 6 months with /sup 32/P and from 75 to 86% with a median duration of 5.5 months with hemibody irradiation. There are significant differences in the patterns of response and in the toxicities of the two treatment methods. Both methods cause significant bone marrow depression. Acute radiation syndrome, radiation pneumonitis, and alopecia are seen with sequential hemibody irradiation and not with /sup 32/P, but their incidence can be reduced by careful treatment planning. Hemibody irradiation can provide pain relief within 24 to 48 h, while /sup 32/P may produce an initial exacerbation of pain. Lower hemibody irradiation alone is less toxic than either upper hemibody irradiation or /sup 32/P treatment.

  13. Comparison of 32P therapy and sequential hemibody irradiation (HBI) for bony metastases as methods of whole body irradiation

    International Nuclear Information System (INIS)

    We report a retrospective study of 15 patients with prostate carcinoma and diffuse bone metastases treated with sodium 32P for palliation of pain at Downstate Medical Center and Kings County Hospital from 1973 to 1978. The response rates, duration of response, and toxicities are compared with those of other series of patients treated with 32P and with sequential hemibody irradiation. The response rates and duration of response are similar with both modalities ranging from 58 to 95% with a duration of 3.3 to 6 months with 32P and from 75 to 86% with a median duration of 5.5 months with hemibody irradiation. There are significant differences in the patterns of response and in the toxicities of the two treatment methods. Both methods cause significant bone marrow depression. Acute radiation syndrome, radiation pneumonitis, and alopecia are seen with sequential hemibody irradiation and not with 32P, but their incidence can be reduced by careful treatment planning. Hemibody irradiation can provide pain relief within 24 to 48 h, while 32P may produce an initial exacerbation of pain. Lower hemibody irradiation alone is less toxic than either upper hemibody irradiation or 32P treatment

  14. Coverage and temperature driven isomerization of TBI on Au(111)

    Energy Technology Data Exchange (ETDEWEB)

    Gahl, Cornelius; Brete, Daniel; Carley, Robert; Schmidt, Roland [Max-Born-Institut, Max-Born-Str. 2a, 12489 Berlin (Germany); McNellis, Erik R.; Mielke, Johannes; Grill, Leonhard [Fritz-Haber-Institut, MPG, Faradayweg 4-6, 14195 Berlin (Germany); Reuter, Karsten [Fritz-Haber-Institut, MPG, Faradayweg 4-6, 14195 Berlin (Germany); Technische Universitaet Muenchen, Lichtenbergstr. 4, 85747 Garching (Germany); Tegeder, Petra [Freie Universitaet Berlin, Arnimallee 14, 14195 Berlin (Germany); Weinelt, Martin [Max-Born-Institut, Max-Born-Str. 2a, 12489 Berlin (Germany); Freie Universitaet Berlin, Arnimallee 14, 14195 Berlin (Germany)

    2011-07-01

    Tetra-tert-butyl azobenzene (TBA) is one of the few examples of molecular switches which have been successfully photoisomerized after adsorption on a metal surface. We have now studied the corresponding imine, N-(3,5-di-tert-butylbenzylidene)-3,5-di-tert-butylaniline, referred to as TBI, by core-level spectroscopy, STM and dispersion corrected DFT. Although isomerization of TBI/Au(111) could not be optically induced, the molecules can run through a complete thermally driven isomerisation cycle. At 210 K TBI adsorbs in trans-conformation. Upon annealing to 320 K a bilayer of trans-TBI is transformed into a densely packed cis-monolayer. Further heating to 420 K results in desorption of half of the molecules leaving a close-packed trans-monolayer. Experiment and theory result in a consistent picture of the molecular adsorption geometry for both isomers as well as the lateral layer structures. The isomerization reaction is governed by the activation energy as well as the interplay of adsorption energies (cistrans).

  15. Reduced-intensity conditioning regimen using low-dose total body irradiation before allogeneic transplant for hematologic malignancies: Experience from the European Group for Blood and Marrow Transplantation

    International Nuclear Information System (INIS)

    Purpose: The high rate of toxicity is the limitation of myelobalative regimens before allogeneic transplantation. A reduced intensity regimen can allow engraftment of stem cells and subsequent transfer of immune cells for the induction of a graft-vs.-tumor reaction. Methods and Materials: The data from 130 patients (80 males and 50 females) treated between 1998 and 2003 for various hematologic malignancies were analyzed. The median patient age was 50 years (range, 3-72 years). Allogeneic transplantation using peripheral blood or bone marrow, or both, was performed in 104 (82%), 22 (17%), and 4 (3%) patients, respectively, from HLA identical sibling donors (n = 93, 72%), matched unrelated donors (n = 23, 18%), mismatched related donors (4%), or mismatched unrelated donors (6%). Total body irradiation (TBI) at a dose of 2 Gy delivered in one fraction was given to 101 patients (78%), and a total dose of 4-6 Gy was given in 29 (22%) patients. The median dose rate was 14.3 cGy/min (range, 6-16.4). Results: After a median follow-up period of 20 months (range, 1-62 months), engraftment was obtained in 122 patients (94%). Acute graft-vs.-host disease of Grade 2 or worse was observed in 37% of patients. Multivariate analysis showed three favorable independent factors for event-free survival: HLA identical sibling donor (p < 0.0001; relative risk [RR], 0.15), complete remission (p < 0.0001; RR, 3.08), and female donor to male patient (p = 0.006; RR 2.43). For relapse, the two favorable prognostic factors were complete remission (p < 0.0001, RR 0.11) and HLA identical sibling donor (p = 0.0007; RR 3.59). Conclusions: In this multicenter study, we confirmed high rates of engraftment and chimerism after the reduced intensity regimen. Our results are comparable to those previously reported. Radiation parameters seem to have no impact on outcome. However, the lack of a statistically significant difference in terms of dose rate may have been due, in part, to the small population

  16. Cataracts after total body irradiation and bone marrow transplantation in patients with acute leukemia in complete remission: a study of the european group for blood and marrow transplantation

    International Nuclear Information System (INIS)

    Purpose: Advances in bone marrow transplantation (BMT) have consistently improved long-term survival. Therefore, evaluation of late complications such as cataracts is of paramount importance. Methods and Materials: We analyzed data of 2149 patients from the EBMT registry. A cohort of 1063 patients were evaluable for survival and ophthalmologic status after transplant for acute leukemia (AL) in first or second complete remission. Conditioning therapy included either single-dose total body irradiation (STBI) or fractionated TBI (FTBI) grouped in different dose rates (low: LDR ≤ 0.04 Gy/min; high: HDR > 0.04 Gy/min). Results: The overall 10-year estimated cataract incidence (ECI) was 50%. It was 60% in the STBI group, 43% in the FTBI group ≤ 6 fractions, and 7% in the FTBI group > 6 fractions (p -4). It was significantly lower (30%) in the LDR than in the HDR groups (59%; p -4). Patients receiving heparin for veno-occlusive disease prophylaxis had fewer cataracts than those who did not (10-year ECI: 33% vs. 53%, respectively; p = 0.04). The 10-year ECI was 65% in the allogeneic vs. 46% in the autologous BMT patients (p = 0.0018). Factors independently associated with an increased risk of cataract were an older age (> 23 years), higher dose rate (> 0.04 Gy/min), allogeneic BMT, and steroid administration (> 100 days). The use of FTBI was associated with a decreased risk of cataract. Heparin administration was a protective factor in patients receiving STBI. In terms of cataract surgery, the unfavorable factors for requiring surgery were: age > 23 yr, STBI, dose rate > 0.04 Gy/min, chronic graft-vs.-host disease (cGvHD), and absence of heparin administration. Among the patients who required cataract surgery (111 out of 257), secondary posterior capsular opacification was observed in 15.7%. Conclusion: High dose rate and STBI are the main risk factors for cataract development and the need for surgery, and the administration of heparin has a protective role in

  17. The effects of whole-body irradiation on the serum levels and kinetics of thyroid hormones in rats

    International Nuclear Information System (INIS)

    The effects of a single whole-body dose of X-rays on the serum levels and kinetics of thyroid hormones in rats were studied. The influence of radiation-induced anorexia was monitored by using pair fed control groups. A dose of 800 rad caused a reduction in T4 levels and 750 rad had a similar effect on T3; in each case the control group showed a smaller reduction. The kinetic results indicated that, in the control groups, the early reduction in hormone concentrations was caused by decreased production, whereas, in the irradiated groups, it was caused by a change in the distribution of the hormone; however the continuing reduction in hormone levels in the irradiated rats appeared to result from decreased production. The results suggest that the thyroid system may play an active part in the early metabolic changes which follow whole-body irradiation. (author)

  18. Impairment of adrenal Gland in albino rat embryo in response to polytrin contamination and/or whole body gamma irradiation

    International Nuclear Information System (INIS)

    In the present work, investigations have been carried out in view of evaluation of the biological hazard exerted on adrenal gland of albino rat embryos subjected to the pesticide polytrin and whole body gamma irradiation either individually or in succession. Histological and histochemical studies showed in general, vacuolation, karyolysis, pyknotic nuclei and increased signs of necrosis in adrenal tissue exposed to irradiation. Pesticide treatment resulted in severe degeneration in between zona glomerulosa and fasciculata accompanied by intercellular degeneration. Combined effect of polytrin together with gamma irradiation showed to exert more intensive degeneration in tissue cells with affected chromatin material as compared with the effect of either polytrin or irradiation when applied individually. The histochemical investigations revealed decreased alkaline phosphatase activity in all treated groups. 14 figs

  19. Suppression of delayed-type hypersensitivity to oxazolone in whole-body-irradiated mice and protection by WR-2721

    International Nuclear Information System (INIS)

    The effect of whole-body irradiation on cellular immunity, as measured in vivo by delayed-type hypersensitivity (DTH) to oxazolone, was determined in CD2F1 mice. DTH, determined by changes in ear swelling after challenge with oxazolone, was significantly depressed in irradiated mice (500-900 rad of 60Co) in a dose-dependent fashion when animals were irradiated after sensitization and before challenge with oxazolone. Administration of WR-2721 30 min before irradiation (2 days after sensitization) resulted in protection against suppression of DTH, which was dependent on drug and radiation dose. An effective dose of WR-2721 provided an approximate dose-modifying factor of 1.3. The data suggest that WR-2721 interacts with cells involved in that DTH response and that WR-2721 may be useful in protecting against radiation-induced decrements in cell-mediated immunity

  20. Zinc cystein as an enhancer to natural antioxidant defense mechanism (s) in whole body gamma irradiated rats

    International Nuclear Information System (INIS)

    Malonaldehyde (MDA), reduced glutathione (GSH) levels and superoxide dismutase (SOD) activity in liver and blood, were measured in whole body gamma irradiated rats with a dose of 6.5 Gy before and after administration of zinc cystein. Zinc cystein (Zn/cyst) was administrated intraperitoneally at a concentration of 30 mg/kg, b.w. 30 min pre-irradiation and measurements were done at 24 and 72 hr after irradiation. These results were compared with non-irradiated. These results were compared with non-irradiated, non Zn/cyst treated group (control group). After irradiation, the activity of SOD and the level of GSH in both liver and blood were decreased, while in Zn/cyst protected groups this decrease was less but did not reach to that of control group level till the end of the experimental period. On the other hand, MDA markedly increased after irradiation. Nevertheless, and in protected group with Z0/cyst reveled less increase. It can be concluded that pre-treatment with Zn/cyst protects rats against sublethal effect of radiation, by improving the natural antioxidant mechanism (s)

  1. Comparison of therapeutic effects between pulsed and continuous wave 810-nm wavelength laser irradiation for traumatic brain injury in mice.

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    Takahiro Ando

    Full Text Available BACKGROUND AND OBJECTIVE: Transcranial low-level laser therapy (LLLT using near-infrared light can efficiently penetrate through the scalp and skull and could allow non-invasive treatment for traumatic brain injury (TBI. In the present study, we compared the therapeutic effect using 810-nm wavelength laser light in continuous and pulsed wave modes in a mouse model of TBI. STUDY DESIGN/MATERIALS AND METHODS: TBI was induced by a controlled cortical-impact device and 4-hours post-TBI 1-group received a sham treatment and 3-groups received a single exposure to transcranial LLLT, either continuous wave or pulsed at 10-Hz or 100-Hz with a 50% duty cycle. An 810-nm Ga-Al-As diode laser delivered a spot with diameter of 1-cm onto the injured head with a power density of 50-mW/cm(2 for 12-minutes giving a fluence of 36-J/cm(2. Neurological severity score (NSS and body weight were measured up to 4 weeks. Mice were sacrificed at 2, 15 and 28 days post-TBI and the lesion size was histologically analyzed. The quantity of ATP production in the brain tissue was determined immediately after laser irradiation. We examined the role of LLLT on the psychological state of the mice at 1 day and 4 weeks after TBI using tail suspension test and forced swim test. RESULTS: The 810-nm laser pulsed at 10-Hz was the most effective judged by improvement in NSS and body weight although the other laser regimens were also effective. The brain lesion volume of mice treated with 10-Hz pulsed-laser irradiation was significantly lower than control group at 15-days and 4-weeks post-TBI. Moreover, we found an antidepressant effect of LLLT at 4-weeks as shown by forced swim and tail suspension tests. CONCLUSION: The therapeutic effect of LLLT for TBI with an 810-nm laser was more effective at 10-Hz pulse frequency than at CW and 100-Hz. This finding may provide a new insight into biological mechanisms of LLLT.

  2. Dosimetric analysis for photon and electron beams in Whole body irradiation

    International Nuclear Information System (INIS)

    To initiate the Whole body irradiation as an alternative for the treatment of the hematological diseases, leukemia and assistant for the osseous marrow transplantation, it may be taken account the application of International Protocols about control and quality assurance. It is established the intercomparison by the different dosimetric methods: cylindrical ionization chambers and parallel plane, radiographic emulsion film, semiconductor diodes (Mosfet transistors) and TLD-100 thermoluminescent crystals, obtained measurements for 140 x 140 cm2 fields and large distances 340 cm respect conventional fields in Radiotherapy. The in vitro dosimetry was realized at the Universal Anthropomorphic puppet Alderson Rando basically with the cylindrical crystals (1 mm diameter) of TLD-100 lithium fluoride. It was obtained the dose value with a 0.6 cm3 cylindrical ionization chamber and the Farmer electrometer for Whole body irradiation (ICT) with photons for electrons and were obtained values with the Markus plane parallel camera. Knowing the dose rate value to the source-surface distance DFS= 80 cm, it was calibrated the crystals with the reference radiation beam of 60 Co for obtaining the response curve: Dose vs. Tl lecture. It was characterized the 10 % of the total population for 300 crystals for applying the statistics corresponding. The luminescence curve obtained of Gaussian form was considered satisfactory by its stability during the pre-anneal lecture and anneal process, getting the main peak lecture at 300 Centigrade according to assigned parameters at lecture equipment TLD Harshaw model 4500. The results indicate the functional dependence with the distance DFS= 340 cm for the following depth PPD, the relations TMR and TPR, the TAR is not calculated by the increment of the dispersion in air. The penumbra increment indicates an increase of the radiation field respect of luminous field. The dispersion angle q1 respect at the field central axis was determined and was

  3. Effect of a whole-body gamma irradiation on glycemia and ATP blood level in rats

    International Nuclear Information System (INIS)

    An attempt was made to establish possible correlations, during gamma irradiation, between glucose and ATP. The variations in their blood levels were studied, using specific enzymatic methods. The results obtained after a low dose irradiation (150 roentgens) demonstrated an increase of glycemia during the hours following the irradiation and a parallel decrease of ATP blood level

  4. Influence of whole-body irradiation on immune reactions after antitetanus vaccination

    International Nuclear Information System (INIS)

    The effect of gamma irradiation (450, 550 and 650 rads) on the circulating antibodies resulting from the injection of antitetanus vaccine in rabbits, were studied for different time interval between irradiation and antigen injection. An analysis of the results obtained exhibited that the increase in antibodies formation appeared only one weak after the beginning of irradiation and for a dose of 650 rads

  5. Effects of a granulocyte colony stimulating factor, Neulasta, in mini pigs exposed to total body proton irradiation

    Science.gov (United States)

    Sanzari, Jenine K.; Krigsfeld, Gabriel S.; Shuman, Anne L.; Diener, Antonia K.; Lin, Liyong; Mai, Wilfried; Kennedy, Ann R.

    2015-04-01

    Astronauts could be exposed to solar particle event (SPE) radiation, which is comprised mostly of proton radiation. Proton radiation is also a treatment option for certain cancers. Both astronauts and clinical patients exposed to ionizing radiation are at risk for loss of white blood cells (WBCs), which are the body's main defense against infection. In this report, the effect of Neulasta treatment, a granulocyte colony stimulating factor, after proton radiation exposure is discussed. Mini pigs exposed to total body proton irradiation at a dose of 2 Gy received 4 treatments of either Neulasta or saline injections. Peripheral blood cell counts and thromboelastography parameters were recorded up to 30 days post-irradiation. Neulasta significantly improved WBC loss, specifically neutrophils, in irradiated animals by approximately 60% three days after the first injection, compared to the saline treated, irradiated animals. Blood cell counts quickly decreased after the last Neulasta injection, suggesting a transient effect on WBC stimulation. Statistically significant changes in hemostasis parameters were observed after proton radiation exposure in both the saline and Neulasta treated irradiated groups, as well as internal organ complications such as pulmonary changes. In conclusion, Neulasta treatment temporarily alleviates proton radiation-induced WBC loss, but has no effect on altered hemostatic responses.

  6. Effects of low dose total body irradiation (LDTBI) and recombinant human interleukin-2 in mice

    International Nuclear Information System (INIS)

    10-16-week-old female BALB/c mice received low dose total body irradiation (LDTBI) in one fraction immediately before the beginning of treatment with recombinant human interleukin-2 (rIL-2). LDTBI prevented in a dose-dependent manner the weight increase of the spleen, liver and lungs induced by fluid extravasation provoked by rIL-2 injections. It also limited the increase of the number of mononuclear cells in the spleen induced after in vivo treatment with rIL-2. Immunofluorescence analysis of spleen cells revealed that LDTBI decreased the relative sIgM+ cell number in spleen, while the relative numbers of Lyt-1+, Thy-1+ and L3T4+ cells were increased, indicating that a T and/or NK population, radioresistant to LDTBI, could still proliferate under rIL-2 stimulation in vivo. Such lymphocytes were capable of in vitro lysis of YAC cells in a 4-hour 51Cr release assay, as well as lymphokine-activated killer (LAK) cells obtained in mice treated with rIL-2 alone. Thus, LDTBI given prior to rIL-2, yet preserving the cytotoxic capacity of the LAK cells activated by rIL-2, could prevent the vascular leak syndrome toxicity induced by rIL-2 injection. (author). tabs., figs

  7. Acute effects of whole-body proton irradiation on the immune system of the mouse

    Science.gov (United States)

    Kajioka, E. H.; Andres, M. L.; Li, J.; Mao, X. W.; Moyers, M. F.; Nelson, G. A.; Slater, J. M.; Gridley, D. S.

    2000-01-01

    The acute effects of proton whole-body irradiation on the distribution and function of leukocyte populations in the spleen and blood were examined and compared to the effects of photons derived from a (60)Co gamma-ray source. Adult female C57BL/6 mice were exposed to a single dose (3 Gy at 0.4 Gy/min) of protons at spread-out Bragg peak (SOBP), protons at the distal entry (E) region, or gamma rays and killed humanely at six different times thereafter. Specific differences were noted in the results, thereby suggesting that the kinetics of the response may be variable. However, the lack of significant differences in most assays at most times suggests that the RBE for both entry and peak regions of the Bragg curve was essentially 1.0 under the conditions of this study. The greatest immunodepression was observed at 4 days postexposure. Flow cytometry and mitogenic stimulation analyses of the spleen and peripheral blood demonstrated that lymphocyte populations differ in radiosensitivity, with B (CD19(+)) cells being most sensitive, T (CD3(+)) cells being moderately sensitive, and natural killer (NK1.1(+)) cells being most resistant. B lymphocytes showed the most rapid recovery. Comparison of the T-lymphocyte subsets showed that CD4(+) T helper/inducer cells were more radiosensitive than the CD8(+) T cytotoxic/suppressor cells. These findings should have an impact on future studies designed to maximize protection of normal tissue during and after proton-radiation exposure.

  8. Fractionated half body irradiation for palliation of multiple symptomatic bone metastases from solid tumors

    International Nuclear Information System (INIS)

    This was a phase I-II nonrandomized study that explored the toxicity and response of fractionated half-body irradiation (F-HBI) in patients with multiple symptomatic osseous metastases. The patients had no premedication and received 10 Gy in 5 fractions with a dose rate of 15 cGy/min. At the Cancer Institute Hospital, 9 patients were treated by this technique (1 upper and lower F-HBI, 6 upper F-HBI, 2 lower F-HBI). All patients were female and had adenocarcinomas (8 breast and 1 lung). Adverse effects were myelosuppression, vomiting and partial alopecia. But hematologic toxicity was treated with blood transfusion or G-CSF. All toxicity was transient, and no pneumonitis nor radiation-related deaths occurred. When given as palliation, F-HBI was found to relieve pain in 80% of the patients. In 10% of the patients the pain relief was complete. The mean time to achieve pain relief in responders after F-HBI was 9 days. The pain relief was long-lasting and continued without need of reirradiation for 40% of the remaining patient's life. This treatment modality appears to be well tolerated and effective in patients with multiple symptomatic osseous metastases. The optimal indications, dose and fractionation for F-HBI should be further explored in randomized trials. (author)

  9. Fractionated half body irradiation for palliation of multiple symptomatic bone metastases from solid tumors

    Energy Technology Data Exchange (ETDEWEB)

    Sekiguchi, Kenji; Hayashi, Shinya; Sunagawa, Yoshimitsu; Sougawa, Mitsuharu; Nakazawa, Masanori; Yamashita, Takashi (Japanese Foundation for Cancer Research, Tokyo (Japan). Hospital)

    1992-06-01

    This was a phase I-II nonrandomized study that explored the toxicity and response of fractionated half-body irradiation (F-HBI) in patients with multiple symptomatic osseous metastases. The patients had no premedication and received 10 Gy in 5 fractions with a dose rate of 15 cGy/min. At the Cancer Institute Hospital, 9 patients were treated by this technique (1 upper and lower F-HBI, 6 upper F-HBI, 2 lower F-HBI). All patients were female and had adenocarcinomas (8 breast and 1 lung). Adverse effects were myelosuppression, vomiting and partial alopecia. But hematologic toxicity was treated with blood transfusion or G-CSF. All toxicity was transient, and no pneumonitis nor radiation-related deaths occurred. When given as palliation, F-HBI was found to relieve pain in 80% of the patients. In 10% of the patients the pain relief was complete. The mean time to achieve pain relief in responders after F-HBI was 9 days. The pain relief was long-lasting and continued without need of reirradiation for 40% of the remaining patient's life. This treatment modality appears to be well tolerated and effective in patients with multiple symptomatic osseous metastases. The optimal indications, dose and fractionation for F-HBI should be further explored in randomized trials. (author).

  10. Calculation of midplane dose for total body irradiation from entrance and exit dose MOSFET measurements.

    Science.gov (United States)

    Satory, P R

    2012-03-01

    This work is the development of a MOSFET based surface in vivo dosimetry system for total body irradiation patients treated with bilateral extended SSD beams using PMMA missing tissue compensators adjacent to the patient. An empirical formula to calculate midplane dose from MOSFET measured entrance and exit doses has been derived. The dependency of surface dose on the air-gap between the spoiler and the surface was investigated by suspending a spoiler above a water phantom, and taking percentage depth dose measurements (PDD). Exit and entrances doses were measured with MOSFETs in conjunction with midplane doses measured with an ion chamber. The entrance and exit doses were combined using an exponential attenuation formula to give an estimate of midplane dose and were compared to the midplane ion chamber measurement for a range of phantom thicknesses. Having a maximum PDD at the surface simplifies the prediction of midplane dose, which is achieved by ensuring that the air gap between the compensator and the surface is less than 10 cm. The comparison of estimated midplane dose and measured midplane dose showed no dependence on phantom thickness and an average correction factor of 0.88 was found. If the missing tissue compensators are kept within 10 cm of the patient then MOSFET measurements of entrance and exit dose can predict the midplane dose for the patient. PMID:22298238

  11. Rates of TBI-related Deaths by Age Group — United States, 2001–2010

    Data.gov (United States)

    U.S. Department of Health & Human Services — Changes in the rates of TBI-related deaths vary depending on age. For persons 44 years of age and younger, TBI-related deaths decreased between the periods of...

  12. Hippophae leaf extract (SBL-1) countered radiation induced dysbiosis in jejunum of total body 60Cobalt gamma - irradiated mice

    International Nuclear Information System (INIS)

    Single dose of SBL-1 administered at the rate 30 mg/kg body weight (b.w.) 30 min prior to whole body 60Co-gamma-irradiation at lethal dose (10 Gy), rendered >90% survival in comparison to zero survival in the non-SBL-1 treated 60Co-gamma-irradiated (10 Gy) mice population (J Herbs Spices Med Plants, 2009; 15(2): 203-215). Present study investigated the effect of SBL-1 on jejunal microbiota in lethally irradiated mice. Study was performed with inbred Swiss albino Strain 'A' male mice (age 9 weeks) weighing 28±2 g. The animals were maintained under controlled environment at 26±2℃; 12 h light/dark cycle and offered standard animal food (Golden feed, Delhi) as well as tap water ad libitum. Metagenomic DNA was extracted, purified and quantified from jejunum of the mice. Universal primers (27f and 1492r) were used to amplify the 16S rRNA DNA from the metagenomic DNA. Amplicons were sequenced, vector contamination and chimeras were removed. The sequences (GenBank Accession No: KF681283 to KF681351) were taxonomically classified by using Sequence Match program, Ribosomal Database Project as well as by nucleotide-BLAST (E-value: 10, database: 16S rRNA gene sequences, Bacteria and Archea). Phylogenetic Tree was prepared using MEGA 5.2 package, using maximum likelihood algorithm after sequence alignment by MUSCLE. Thermus aquaticus was used as out-group to construct rooted tree. Branch stability was assessed by bootstrap analysis. Untreated animals and the animals treated with SBL-1 had 100% Lactobacillus; 60Co gamma-irradiated animals had 55% Cohaesibacter (Alphaproteobacteria); 27% Mycoplasma (Tenericutes) and only 18% Lactobacillus; animals treated with SBL-1 prior to irradiation had 89% Lactobacillus and 11% Clostridium. This study demonstrated that treatment with SBL-1 at radioprotective doses before total body irradiation with lethal dose (10 Gy) countered the jejunal dysbiosis. (author)

  13. The nucleic acids as early indicators of the recovery of patients subjected to total body irradiation for bone marrow transplant

    International Nuclear Information System (INIS)

    The possibility to use the concentration of nucleic acids as an early indicator for the recovery of individuals exposed to high radiation was valued in 30 patients subjected to a dose of 10 Gy (cobalt 60) in two or three sessions of total body irradiation for bone marrow transplants. The determination of the concentration of the nucleic acids was carried out prior to the irradiation, and later in different periods until the patients discharge. The behaviour of indicate such as alpha amylase serics transaminases, glicemics, alkaline phosphatase and others was also studied

  14. Arginine-esterase activity of kallikrein in the sera of whole-body irradiated rats and guinea-pigs

    International Nuclear Information System (INIS)

    In whole-body irradiated rats (800 R=LDsub(50/30)) and guinea pigs (300 R=LDsub(50/30)) changes were investigated in the arginine esterase activity of kallikrein in native serum as well as in serum exposed to contact with a clay suspension. From the values obtained the activity of prekallikrein was calculated. While in the rat serum significant changes in the arginine esterase activity of kallikrein were found, in the guinea pig serum the kallikrein activity did not change markedly. The activity of prekallikrein immediately after irradiation assumes a similar course in both types of laboratory animals while during later intervals a reverse pattern was observed. (author)

  15. Initial developmental process of a VA semistructured clinical interview for TBI identification

    OpenAIRE

    Heather G . Belanger, PhD; Rodney D. Vanderploeg, PhD; Shirley Groer, PhD

    2012-01-01

    Identification of a remote traumatic brain injury (TBI), particularly mild TBI, is a challenge. The acknowledged standard for determining a history of prior TBI is self-report elicited through a structured or in-depth clinical interview. In April 2007, the Veterans Health Administration (VHA) mandated that the four-section TBI Clinical Reminder screening instrument be completed on all individuals returning from deployment in the Operation Iraqi Freedom/Operation Enduring Freedom theaters of o...

  16. Stem cell factor enhances the survival of murine intestinal stem cells after photon irradiation

    International Nuclear Information System (INIS)

    Recombinant rat stem cell factor (SCF) has been shown to decrease lethality in mice exposed to total-body irradiation (TBI) in the lower range of lethality through radioprotection of hematopoietic stem cells and acceleration of bone marrow repopulation. This study evaluates the effect of SCF on the survival of the intestinal mucosal stem cell after TBI. This non-hematopoietic cell is clinically relevant. Gastrointestinal toxicity is common during and after abdominal and pelvic radiation therapy and limits the radiation dose in these regions. As observed with bone marrow, the administration of SCF to mice prior to TBI enhanced the survival of mouse duodenal crypt stem cells. The maximum enhancement of survival was seen when 100 μ/kg of SCF was given intraperitoneally 8 h before irradiation. This regimen increased the survival of duodenal crypt stem cells after 12.0 Gy TBI from 22.5 ± 0.7 per duodenal cross section for controls to 30.0 ± 1.7 after treatment with SCF (P=0.03). The TBI dose producing 50% mortality of 6 days (LD50/6) was increased from 14.9 Gy for control mice to 19.0 Gy for mice treated with SCF (dose modification factor = 1.28). These findings demonstrate that SCF (dose modification factor = 1.28). These findings demonstrate that SCF has radioprotective effects on a non-hematopoietic stem cell population and suggest that SCF may be of clinical value in preventing radiation injury to the intestine. 29 refs., 4 figs

  17. Acute whole body UVA irradiation combined with nitrate ingestion enhances time trial performance in trained cyclists.

    Science.gov (United States)

    Muggeridge, David J; Sculthorpe, Nicholas; Grace, Fergal M; Willis, Gareth; Thornhill, Laurence; Weller, Richard B; James, Philip E; Easton, Chris

    2015-08-01

    Dietary nitrate supplementation has been shown to increase nitric oxide (NO) metabolites, reduce blood pressure (BP) and enhance exercise performance. Acute exposure to ultraviolet (UV)-A light also increases NO bioavailability and reduces BP. We conducted a randomized, counterbalanced placebo-controlled trial to determine the effects of UV-A light alone and in combination with nitrate on the responses to sub-maximal steady-state exercise and time trial (TT) performance. Nine cyclists (VO2max 53.1 ± 4.4 ml/kg/min) completed five performance trials comprising 10 min submaximal steady-state cycling followed by a 16.1 km TT. Following a familiarization the final four trials were preceded, in random order, by either (1) Nitrate gels (NIT) + UV-A, (2) Placebo (PLA) + UV-A, (3) NIT + Sham light (SHAM) and (4) PLA + SHAM (control). The NIT gels (2 × 60 ml gels, ~8.1 mmol nitrate) or a low-nitrate PLA were ingested 2.5 h prior to the trial. The light exposure consisted of 20 J/cm(2) whole body irradiation with either UV-A or SHAM light. Plasma nitrite was measured pre- and post-irradiation and VO2 was measured continuously during steady-state exercise. Plasma nitrite was higher for NIT + SHAM (geometric mean (95% CI), 332 (292-377) nM; P = 0.029) and NIT + UV-A (456 (312-666) nM; P = 0.014) compared to PLA + SHAM (215 (167-277) nM). Differences between PLA + SHAM and PLA + UV-A (282 (248-356) nM) were small and non-significant. During steady-state exercise VO2 was reduced following NIT + UVA (P = 0.034) and tended to be lower in NIT + SHAM (P = 0.086) but not PLA + UV-A (P = 0.381) compared to PLA + SHAM. Performance in the TT was significantly faster following NIT + UV-A (mean ± SD 1447 ± 41 s P = 0.005; d = 0.47), but not PLA + UV-A (1450 ± 40 s; d = 0.41) or NIT + SHAM (1455 ± 47 s; d = 0.28) compared to PLA + SHAM (1469 ± 52 s). These findings demonstrate that exposure to UV-A light alone does not alter the physiological responses to exercise or improve

  18. Biochemical changes in mice brain synaptosomes after whole body, low dose gamma-irradiation of various intensities

    International Nuclear Information System (INIS)

    Some characteristics of mice brain nerve-endings' lipid phase were studied (total lipids, total and individual phospholipids and cholesterol contents, their ratios, lipid peroxidation level, rigidity index) after single low dose, whole body gamma-irradiation (15 cGy) with dose intensities of 0.01, 0.25, 9.0 cGy/min. Some markedly expressed alterations were found out in those parameters. Brain membranes functioning also changed significantly as it was judged by membrane-bound acetylcholinesterase activity. All the changes revealed complicated dependence both on dose intensity and on time period after irradiation. The ranges of the observed changes suppose CNS state to have been modified by low dose irradiation including CNS sensibility to external psycho-and neurotropic factors. 25 refs., 2 figs., 1 tab

  19. A dislocation dynamics study of the transition from homogeneous to heterogeneous deformation in irradiated body-centered cubic iron

    International Nuclear Information System (INIS)

    Low temperature irradiation of crystalline materials is known to result in hardening and loss of ductility, which limits the usefulness of candidate materials in harsh nuclear environments. In body-centered cubic (bcc) metals, this mechanical property degradation is caused by the interaction of in-grown dislocations with irradiation defects, particularly small dislocation loops resulting from the microstructural evolution of displacement cascades. In this paper, we perform dislocation dynamics simulations of bcc Fe containing various concentrations of dislocation loops produced by irradiation in an attempt to gain insight into the processes that lead to hardening and embrittlement. We find that a transition from homogenous to highly localized deformation occurs at a critical loop density. Above it, plastic flow proceeds heterogeneously, creating defect-free channels in its wake. We find that channel initiation and size are mediated by loop coalescence resulting from elastic interactions with moving dislocations.

  20. Multicolor flow cytometry analysis of blood cell subsets in patients given total body irradiation before bone marrow transplantation

    International Nuclear Information System (INIS)

    Bone marrow transplantation has often been closely linked with accidental or intentional therapeutical irradiation. In both situations, study of the radiosensitivity of human blood cell subsets is of interest. Using one-color flow cytometry analysis of B lymphocytes, T cell subsets, and natural killer cells, we previously reported that lymphocyte subsets exhibit equal radiosensitivity. Taking advantage of recent developments in the knowledge of leukocyte differentiation antigens and flow cytometry technology we undertook a study of blood cell subsets to search for rare populations exhibiting different radiosensitivity. Thirty patients, who were delivered a 12 Gy fractionated total body irradiation as part of their conditioning regimen before transplantation for malignant disorders, were studied using multicolor flow cytometry. T and B lymphocytes showed a sharp, radiation-induced decrease, with the B lymphocytes (cluster of differentiation (CD) 19+) being the most sensitive. When analyzed by multicolor flow cytometry all major lymphocyte subsets appeared equally sensitive to the in vivo irradiation. Therefore, all major lymphocyte subsets sharing the helper phenotype (naive or memory) and the cytotoxic phenotype appeared equally sensitive to in vivo whole body irradiation. In parallel, the CD34+ cell subset remained basically unchanged after whole body irradiation. Finally, the CD3-, 56+, 16+ natural killer cell subset was relatively radioresistant (91 and 74% of its initial value, after 2 and 4 Gy, respectively) as compared to other lymphocyte subsets. Our study provides evidence that T and B cell subsets seem to be highly radiosensitive in vivo. The CD34+ progenitor/stem cells and NK cells seem to be more radioresistant. This latter result might provide clues to the understanding of the pathophysiogeny of radiation-induced aplasia and of the engrafment/rejection process following bone marrow transplantation. 20 refs., 3 figs., 1 tab

  1. Multicolor flow cytometry analysis of blood cell subsets in patients given total body irradiation before bone marrow transplantation

    International Nuclear Information System (INIS)

    Purpose: Bone marrow transplantation has often been closely linked with accidental or intentional therapeutical irradiation. In both situations, study of the radiosensitivity of human blood cell subsets is of interest. Using one-color flow cytometry analysis of B lymphocytes, T cell subsets, and natural killer cells, we previously reported that lymphocyte subsets exhibit equal radiosensitivity. Taking advantage of recent developments in the knowledge of leukocyte differentiation antigens and flow cytometry technology we undertook a study of blood cell subsets to search for rare populations exhibiting different radiosensitivity. Methods and Materials: Thirty patients, who were delivered a 12 Gy fractionated total body irradiation as part of their conditioning regimen before transplantation for malignant disorders, were studied using multicolor flow cytometry. Results: T and B lymphocytes showed a sharp, radiation-induced decrease, with the B lymphocytes (cluster of differentiation (CD) 19+) being the most sensitive. When analyzed by multicolor flow cytometry, all major lymphocyte subsets appeared equally sensitive to the in vivo irradiation; that is, CD3+4+45RO+, CD3+4+45RA+, CD3+4+8-, CD3+4-8+. Therefore, all major lymphocyte subsets sharing the helper phenotype (naive or memory) and the cytotoxic phenotype appeared equally sensitive to in vivo whole body irradiation. In parallel, the CD34+ cell subset remained basically unchanged after whole body irradiation. Finally, the CD3-, 56+, 16+ natural killer cell subset was relatively radioresistant (91 and 74% of its initial value, after 2 and 4 Gy, respectively) as compared to other lymphocyte subsets. Conclusion: Our study provides evidence that T and B cell subsets seem to be highly radiosensitive in vivo. The CD34+ progenitor/stem cells and NK cells seem to be more radioresistant. This latter result might provide clues to the understanding of the pathophysiogeny of radiation-induced aplasia and of the engrafment

  2. Impact of Whole Body Irradiation on the Intestinal Microbiome- Considerations for Space Flight

    Science.gov (United States)

    Karouia, Fathi; Santos, Orlando; Valdivia-Silva, Julio E.; Jones, Jeffrey; Greenberger, Joel S.; Epperly, Michael W.

    Human space travelers experience a unique environment that affects homeostasis and physiologic adaptation. Spaceflight-related changes have been reported in the musculo-skeletal, cardiovascular, neurovestibular, endocrine, and immune systems to just name a few. However, to date, radiation exposure is one of the main limiting factors for long duration space exploration missions and especially a mission to Mars. Over the past few years through advances in technology, the characterization of the microbiome has revealed a large and complex community of microorganisms living in symbiosis with the human host. However, heterogeneity of the intestinal microbial spectrum in humans has been associated with a variety of diseases and susceptibility to infectious and toxic agents. Limited information is known about the influence of space environment in general and radiation in particular on the microbiome. Furthermore, multiple spaceflight and simulated microgravity experiments have shown changes in phenotypic microbial characteristics such as microbial growth, morphology, metabolism, genetic transfer, antibiotic and stress susceptibility, and an increase in virulence factors. We now report a study of the bacterial composition of the intestine in C57BL/6NTAC mice and the types of microbes entering the body at two time points after the LD 50/30 dose of total body irradiation using microarray-based assay, G3 PhyloChip 16S rRNA, and bioinformatics methods. Bacteria and archaea taxon richness was determined at the genus level and ranged from 2 to 107 and 0 to 3 respectively. As expected, pre-exposure blood samples exhibited less bacterial and archaeal genus richness compared to all other samples. However, the study shows a significant shift in the mouse gut microbial speciation in several bacterial families, with increases in the Turicibacteraceae and Enterobacteriaceae and decreases in the Lachnospiraceae and Ruminococcaceae families. The findings most relevant to occupational

  3. Neoplasia in beagles that received whole-body irradiation during prenatal or postnatal development

    International Nuclear Information System (INIS)

    Sensitivity to radiation carcinogenesis is being studied in 1680 beagle dogs that received whole-body 60Co gamma radiation exposures during development. Eight treatment groups of 120 dogs each received 0.16 or 0.83 Gy at one of three prenatal (8, 28, or 55 days postcoitus) ages or at one postnatal (2 days postpartum) age. One treatment group of 120 dogs received 0.83 Gy as juveniles at 70 days postpartum, and one treatment group of 240 young adult dogs received 0.83 Gy at 365 days postpartum. Three-hundred-sixty control dogs were sham irradiated. Of the 1680 dogs, 1058 are dead. Approximately 25% of these deaths were related to malignant neoplasia. The age-related incidence of neoplasia is being evaluated. While the incidence of all neoplasms is being studied, particular emphasis is being placed on types of cancer with known susceptibility to induction by radiation such as those of breast, thyroid, and hematopoietic tissues. Neoplasms are classed as (1) incidental, i.e., those found at necropsy in dogs that died of an unrelated cause; (2) mortality independent, i.e., those seen in live dogs and removed surgically, or (3) fatal, i.e., those directly or indirectly responsible for death. Analyses of incidental tumors are done by a prevalence method, whereas analyses of mortality-independent and fatal tumors use an onset-rate or death-rate method. The results of these methods are then combined to give a composite age-related incidence of specific neoplasms. Analyses also are done on disease subgroups to attempt to delineate the effect of intercurrent disease on tumor incidence. The results of such analyses support the concept that age at exposure is an important factor in radiation carcinogenesis. 28 refs., 7 tabs

  4. Changes in levels of tissue-specific aldolases following whole-body x-irradiation of rat

    International Nuclear Information System (INIS)

    Effects of whole-body X-irradiation (600 R) of rat on the levels of tissue-specific forms of fructose-1, 6-biphosphate (FDP) aldolase have been investigated. Aldolase activities of type A from muscle, heart and spleen were relatively more susceptible than those from brain (A-C), liver (B) and kidney (A-B). While aldolase activities from brain and kidney showed losses after exposure of rat to 1000 R, that from liver remained unaffected. Effects on muscle aldolase were most pronounced. In muscle, though aldolase showed reduction in activity with FDP as substrate, no change was observed towards fructose-1-phosphate (F-1-P); consequently FDP/F-1-P activity ratio was reduced. Post-irradiation structural changes in muscle aldolase were suggested by the appearance of an extra band with aldolase activity in the gel electrophoresis pattern of muscle extract of irradiated rat. Incubation of muscle extract of control rat with that from irradiated animal at pH 6.0 resulted in loss of aldolase activity, and the presence of EDTA and -SH agents enhanced the loss. A similar loss of crystalline rabbit muscle aldolase was also seen upon incubation with muscle extract from irradiated rat and iodoacetamide protected against such loss. The results indicated involvement of catheptic enzymes of lysosomal origin in the inactivation of aldolase in rat muscle. Incorporation of DL-[1-14C] leucine into the muscle proteins of rat was inhibited by 80-90% upon administration of cycloheximide or puromycin. (author)

  5. Accelerated recovery of hematopoiesis following sub-lethal whole body irradiation with recombinant murine interleukin-1 (IL-1)

    International Nuclear Information System (INIS)

    This communication reports the results of studies designed to investigate the ability of recombinant murine interleukin-1 (rIL-1) to enhance the recovery of hematopoiesis following administration of sub-lethal whole body irradiation (2 Gy). Mice were administered rIL-1 (100 and 500 units) i.p. Twenty-four hours later these mice were administered 2 Gy radiation. Irradiated control mice were given only phosphate buffered saline (PBS). Animals were then serially sacrificed (on days 1, 2, 4, 7, 9, and 12 following irradiation) and their peripheral blood was analyzed for indices (packed red cell volume, WBC, platelets, and differential). Femoral bone marrow was harvested and assayed for their stem cell content--erythroid (CFU-E, BFU-E), granulocyte-macrophage (CFU-GM), and megakaryocyte (CFU-MEG). Irradiated mice pretreated with rIL-1 demonstrated accelerated hematopoietic recovery as measured by higher WBC, platelets and femoral stem cell content than PBS-treated irradiated controls. These results indicate IL-1 may be an effective radioprotective agent against the hematotoxicity induced by ionizing radiation

  6. Activity of kallikrein and kininases in lung tissue and serum of whole-body irradiated rats

    International Nuclear Information System (INIS)

    The activity of kallikrein, kininase 1 and kininase 2 (Angiotensin converting enzyme, ACE) was assayed using chromogenic substrates in lung tissue preparation (microsomal fraction) and in serum of rats irradiated with a dose of 7.0 Gy of X-rays. Kallikrein and ACE in lung were decreased on the 1, 6 and 28 day while kininase 1 was increased from the 6 day on after irradiation. In serum no significant changes were observed in kallikrein and kininase 1. Significant decrease in ACE activity during two weeks after exposure was noticed. Three weeks after irradiation the activity of all three enzymes was significantly lower than in controls. The changes observed are interpreted as contributing to a diminished removal of kinins from irradiated animals and thus favouring vasodilating effect of irradiation. 22 refs. (author)

  7. Effects of local and whole body irradiation on the appearance of osteoblasts during wound healing in tooth extraction sockets in rats

    International Nuclear Information System (INIS)

    Irradiation before tooth extraction delays wound healing in the alveolar socket. This study examined the influences of local and whole body irradiation before tooth extraction on appearance of osteoblasts in the alveolar bone of rat maxillary first molars because bone formation is observed at the initial phase of wound healing. Several osteoblasts were generated 3 days after tooth extraction, and the number of cells increased day by day. Morphological studies showed there were little differences between local irradiation and non-irradiated controls. In contrast, the extraction wound in the whole body irradiation group showed delayed healing, and there was poor granulation tissue and very few osteoblasts at the bottom of the socket. An ultrastructural study showed that the osteoblasts in the extraction socket of whole body irradiation rats were smaller, and had poorly developed organelles. Injection of bone marrow cells to whole body-irradiated animals immediately after tooth extraction partially restored the number of osteoblasts. New periosteal bone formations outside of sockets showed little delay in the whole body irradiation group. These findings suggest that bone formation in the wound healing of extraction socket requires bone marrow cells from hematopoietic organs such as the bone marrow as well as local sources around the alveolar socket, during the initial phase of wound healing. (author)

  8. Technique and dosimetry for total body irradiation with an 8-MV linear accelerator

    International Nuclear Information System (INIS)

    The aim of the study was to develop a method for calculation of the absorbed dose at an arbitrary point in the patient (adults and children). The method should be accurate but simple to use in clinical routine and it should as far as possible follow the recommendations by ICRU for conventional radiotherapy. An 8-MV linear accelerator is used with a diamond-shaped field and an isocentric technique at a focus-axis distance of 430 cm. The dose rate in an arbitrary point in the patient is calculated from the absorbed dose rate in dose maximum for a phantom size of 30 x 30 x 30 cm3 in the TBI field, an inverse square law factor, the tissue-maximum ratio, an equivalent field size correction factor determined from the patient contour using the Clarkson method, a factor correcting for lack of backscattering material, an off-axis output correction factor, and a factor that corrects for off-axis variations in effective photon beam energy and for oblique beam penetration of the patient. A personal computer is used for the dose calculations. The formula was tested with TLD measurements in a RT Humanoid (adult) phantom and in a Pedo-RT Humanoid (child) phantom. In vivo dose measurements are also presented

  9. Hemi body irradiation: An economical way of palliation of pain in bone metastasis in advanced cancer

    Directory of Open Access Journals (Sweden)

    Santanu Pal

    2014-01-01

    Full Text Available Background: The primary aim of this prospective non-randomized study was to evaluate the effect of hemi-body irradiation (HBI on pain and quality of life in cancer patients with extensive bone metastases. The secondary aim was to evaluate side-effects and cost-effectiveness of the treatment. Materials and Methods: Between March 2008 and December 2010, a total of 23 (male = 14, female = 9, median age = 60 years diagnosed cases of metastatic cancer patients (prostate = 11, breast = 6, and lung = 6 received HBI, which was delivered as lower (n = 7 (dose = 8 Gy, upper (n = 8 (dose = 6 Gy, or sequential HBI (n = 8 with a Telecobalt unit (Theratron 780C. Among them, one lung cancer patient died at 2 months and one prostate cancer patient defaulted after the second follow-up. Thus, 21 patients (male = 13, female = 8, median age = 65 years (prostatic cancer = 10, breast cancer = 6, and lung cancer = 5 were followed up for a minimum of 6 months. Evaluations were performed before and at 2, 4, 8, 16, and 24 weeks after treatment. Pain evaluation was done by Visual Analogue Scale (VAS, Verbal Rating Scale (VRS, Percentage of Pain Relief (PRR, and Global Pain Score (GPS. Toxicity was assessed by CTC v-3 toxicity scores in the medical record. Assessment of oral morphine consumption was done before and after radiation using paired t-test, and correlation analysis was also done with decrease of morphine consumption and reduction of pain score using statistical analysis. Results: Response (control of pain was partial (PR in 67% and complete (CR in 22% of patients. For most patients, the pain control lasted throughout the follow-up period (6 months. From 66.66% patients requiring 13 or more Morphine (10 mg tablets per day prior to HBI, none of the patients required to consume 13 or more Morphine (10 mg tablets per day following HBI, which was correlated with significant reduction in various pain scores (P < 0.05. One way ANOVA with Dunnett′s Multiple Comparison

  10. Biochemical estimation of ovaries after whole body irradiation with low doses of gamma radiation

    International Nuclear Information System (INIS)

    Public concern is being expressed over the effects on men and his environment of exposure to low levels of ionizing radiation from the increasing use of atomic energy in medicine industry and power generation. An evaluation of the toxic effects of gamma radiation on female reproduction was made by biochemical estimations of cytoplasmic and membrane bound, Glycogen, Acid and Alkaline phosphatases and cholesterol in the rat varies after whole body irradiation with the low doses of gamma rays. Female Sprague Dawley rats of 12 weeks were divided randomly into four groups Two groups were exposed to 60Co gamma rays of 0.10 Gy and 0.40 Gy respectively at the dose rate 0.0589 Gy/min. These groups were further exposed to the same respective doses and dose rates each month for two consecutive months i .e. when the animals were 16 and 20 weeks old. Total doses delivered in three fractionated doses to the two groups were therefore 0.30 Gy and 1.20 Gy respectively. The remaining two groups were exposed as above but at the dose rate of 0.00368 Gy/min. This would mean that these animals received the same respective doses i.e 0.30 Gy and 1.20 Gy but at the dose rate 1/16th of the above. A day after the last dose the animals were sacrificed by decapitation, ovaries were extirpated put in normal saline and freed from fat and adhering connective tissues. The cleared ovaries were soaked on a piece of filter paper, weighed, minced and homogenized in known volume ice-cold phosphate - buffer saline (PBS, pH 7.4) and the ovarian homogenate was centrifuged for biochemical estimation. Radiation caused degenerative changes in the ovaries as evidenced by a significant decrease in the concentration of cytoplasmic as well as membrane bound glycogen and cholesterol. AKP activity is associated with follicular atrophy. The growing follicles had less AKP activity than antral follicle. The high concentration of ACP in small antral follicles might limit their ability to respond radiation stimulation

  11. Image-Guided Total-Marrow Irradiation Using Helical Tomotherapy in Patients With Multiple Myeloma and Acute Leukemia Undergoing Hematopoietic Cell Transplantation

    International Nuclear Information System (INIS)

    Purpose: Total-body irradiation (TBI) has an important role in patients undergoing hematopoietic cell transplantation (HCT), but is associated with significant toxicities. Targeted TBI using helical tomotherapy results in reduced doses to normal organs, which predicts for reduced toxicities compared with standard TBI. Methods and Materials: Thirteen patients with multiple myeloma were treated in an autologous tandem transplantation Phase I trial with high-dose melphalan, followed 6 weeks later by total-marrow irradiation (TMI) to skeletal bone. Dose levels were 10, 12, 14, and 16 Gy at 2 Gy daily/twice daily. In a separate allogeneic HCT trial, 8 patients (5 with acute myelogenous leukemia, 1 with acute lymphoblastic leukemia, 1 with non-Hodgkin's lymphoma, and 1 with multiple myeloma) were treated with TMI plus total lymphoid irradiation plus splenic radiotherapy to 12 Gy (1.5 Gy twice daily) combined with fludarabine/melphalan. Results: For the 13 patients in the tandem autologous HCT trial, median age was 54 years (range, 42-66 years). Median organ doses were 15-65% that of the gross target volume dose. Primarily Grades 1-2 acute toxicities were observed. Six patients reported no vomiting; 9 patients, no mucositis; 6 patients, no fatigue; and 8 patients, no diarrhea. For the 8 patients in the allogeneic HCT trial, median age was 52 years (range, 24-61 years). Grades 2-3 nausea, vomiting, mucositis, and diarrhea were observed. In both trials, no Grade 4 nonhematologic toxicity was observed, and all patients underwent successful engraftment. Conclusions: This study shows that TMI using helical tomotherapy is clinically feasible. The reduced acute toxicities observed compare favorably with those seen with standard TBI. Initial results are encouraging and warrant further evaluation as a method to dose escalate with acceptable toxicity or to offer TBI-containing regimens to patients unable to tolerate standard approaches

  12. Effect of 60Co-gamma whole-body irradiation on serum amylase level

    International Nuclear Information System (INIS)

    Changes of serum amylase activity in rats, after several doses of acut 60Co-gamma irradiation as a function of time were investigated. These changes proved to be of no diagnostic value in early radiation damage. (author)

  13. Hepatic catalase activity after whole-body irradiation of the mouse

    International Nuclear Information System (INIS)

    Using biochemical techniques, the effect of irradiation on catalase rate of different tissues is studied. With cytochemistry, the decrease of catalase activity is studied in situ, after exposure to great ionizing radiation doses

  14. Repopulation of murine alveolar macrophage colony-forming cells after whole body irradiation

    International Nuclear Information System (INIS)

    A study was made of the repopulation of alveolar macrophage colony-forming cells (AL-CFC) after a supra lethal irradiation and bone marrow transplantation in mice. The repopulation of both CFU-S (hemopoietic stem cells) and the committed stem cells for both granulocytes and monocytes (GM-CFC) in the femoral bone marrow occurred within 2 weeks. In sharp contrast, the repopulation of AL-CFC in the lung was a very slow process. The number of AL-CFC, which are more resistant to irradiation than both CFU-S and GM-CFC, was reduced to 1% of control values one day after the irradiation and recovered slowly with time. It took almost nine weeks for the number of AL-CFC per mouse to reach normal levels. The number of recoverable alveolar cells in these mice never dropped below 70% of control values and reached the nadir about two weeks after the irradiation. (UK)

  15. Effect of whole-body irradiation by fast neutrons on mouse tissues. Pt. 1

    International Nuclear Information System (INIS)

    Groups of male Swiss albino mice were irradiated by single doses of either 7 rem or 14 rem of fast neutrons with 14 MeV average energy, corresponding to fluences of 1.27x108 n/cm2 and 2.54x108 n/cm2, respectively. The activities of acid phosphatase (ACP) and succinic dehydrogenase (SDH) in kidney, lung and liver were determined at different time point up to seven days after irradiation. Lysosomal affection was represented by statistically significant increase of ACP activity in all cell types of the three tested organs immediately after irradiation with either of the doses used. The effect of SDH was represented by reduction in activity in all three organs. The activities of both enzymes showed tendencies to return to pre-irradiation levels with time in most cell types especially after the 7 rem dose. (orig.)

  16. Busulfan and total body irradiation as antihematopoietic stem cell agents in the preparation of patients with congenital bone marrow disorders for allogenic bone marrow transplantation

    International Nuclear Information System (INIS)

    The capacity of busulfan and total body irradiation to ablate hematopoietic stem cells as preparation for the allogeneic bone marrow transplantation of patients with congenital bone marrow disorders was studied. Fourteen patients received 18 transplants; busulfan was used in the preparatory regimen of eight transplants and total body irradiation in the regimens of six transplants. Sustained hematopoietic ablation was achieved in six of eight patients prepared with busulfan and in all six patients prepared with total body irradiation. Three patients prepared with total body irradiation died with idiopathic interstitial pneumonitis, whereas no patients receiving busulfan developed interstitial pneumonitis. The optimal antihematopoietic stem cell agent to be used for the preparation of patients with congenital bone marrow disorder for bone marrow transplantation is not certain

  17. Effects of whole-body x-irradiation on some aspects of collagen metabolism in the rat

    International Nuclear Information System (INIS)

    Whole-body exposure of adult rats to x rays at sublethal or lethal doses causes a decrease in hydroxyproline levels in urine and skeletal muscle. Similarly, reduction in the excretion of labeled hydroxyproline in urine following intraperitoneal injection of 14C-proline may be attributed to impaired in vivo hydroxylation of proline. Incorporation of administered 14C-proline into 14C-hydroxyproline and its distribution in different metabolic forms of collagen in skeletal muscle and skin are markedly reduced in x-irradiated rats. These suggest impaired hydroxylation of proline. However, in vitro proline hydroxylase activity in liver is not affected by radiation treatment. Decreased endogenous oxygen consumption, as observed in liver homogenates of x-irradiated rats, may be one of the factors which affect in vivo proline hydroxylation

  18. Experimental model of a combined lung lesion by selinon herbicide and external whole-body ionizing irradiation

    International Nuclear Information System (INIS)

    Wistar rats have been treated as follows: acute gamma irradiated with 4 Gy; per os poisoned with selinon 5 times weekly during 4 months at dose 2.2 mg/kg (1/20 LD50) exposed to combined treatment with both factors. The following indices of the bronchoalveolar lavage fluid (BALF) and supernatant from lung homogenate (LH) were determined in dynamics till day 60: in BALF - total cell count; activity of the lactate dehydrogenase, alkaline phosphatase, acid phosphatase, protein content; in LH - activity of superoxide dismutase, catalase, glucose-6-phosphate dehydrogenase, amounts of malonic aldehyde and protein. The results show that chronic oral introduction of selinon at small doses causes toxic lung damage. Whole-body irradiation with 4 Gy ionizing radiation fails to potentiate the biological effects recorded. 2 figs., 4 refs

  19. Effect of whole-body irradiation of mice on the number of background plaque-forming cells

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, R.E.; Lefkovits, I.; Soeederberg, A.

    1983-08-01

    Mice were exposed in whole-body fashion to several doses of radiation and killed at various times thereafter for a determination of the number of background plaque-forming cells (PFCs) as assayed on either sheep erythrocytes or bromelain-treated autologous mouse erythrocytes. Increased numbers of both types of PFC were found in the irradiated groups. These increases were dependent on radiation dose and time after exposure. They did not appear to be caused by a disruption of normal lymphocyte traffic or a switch in immunoglobulin isotype. An increased number of PFCs on bromelain-treated mouse RBCs but not on sheep RBCs were found in irradiated congenitally athymic nude mice. On the basis of this and related observations, background PFCs on bromelain-treated mouse RBCs and on sheep RBCs appear to fall under different forms of homeostatic control.

  20. DNA base damage generated in vivo in hepatic chromatin of mice upon whole body γ-irradiation

    International Nuclear Information System (INIS)

    DNA base lesions in hepatic chromatin formed upon whole-body irradiation of mice were studied. After γ-irradiating (20-470 Gy) and killing animals, chromatin was isolated from their livers and analysed by GC-MS. Five pyrimidine- and five purine-derived DNA lesions were identified and quantified: 5-hydroxy-5-methylhydantoin, 5-hydroxycytosine, 5-(hydroxymethyl) uracil, 4,6-diamino-5-formamidopyrimidine, 7,8-dihydro-8-oxoadenine, 2-hydroxyadenine, 2,6-diamino-4-hydroxy-5-formamidopyrimidine, 7,8-dihydro-8-oxoguanine, thymine glycol and 5,6-dihydroxy-uracil. Except for the latter two, amounts of these compounds were increased significantly over control levels in the dose range of 100-470 Gy. Above 200 Gy, a deviation from linearity was observed, although yields were increased in most cases up to 470 Gy. (Author)

  1. Impact of irradiation and immunosuppressive agents on immune system homeostasis in rhesus macaques.

    Science.gov (United States)

    Meyer, C; Walker, J; Dewane, J; Engelmann, F; Laub, W; Pillai, S; Thomas, Charles R; Messaoudi, I

    2015-09-01

    In this study we examined the effects of non-myeloablative total body irradiation (TBI) in combination with immunosuppressive chemotherapy on immune homeostasis in rhesus macaques. Our results show that the administration of cyclosporin A or tacrolimus without radiotherapy did not result in lymphopenia. The addition of TBI to the regimen resulted in lymphopenia as well as alterations in the memory/naive ratio following reconstitution of lymphocyte populations. Dendritic cell (DC) numbers in whole blood were largely unaffected, while the monocyte population was altered by immunosuppressive treatment. Irradiation also resulted in increased levels of circulating cytokines and chemokines that correlated with T cell proliferative bursts and with the shift towards memory T cells. We also report that anti-thymocyte globulin (ATG) treatment and CD3 immunotoxin administration resulted in a selective and rapid depletion of naive CD4 and CD8 T cells and increased frequency of memory T cells. We also examined the impact of these treatments on reactivation of latent simian varicella virus (SVV) infection as a model of varicella zoster virus (VZV) infection of humans. None of the treatments resulted in overt SVV reactivation; however, select animals had transient increases in SVV-specific T cell responses following immunosuppression, suggestive of subclinical reactivation. Overall, we provide detailed observations into immune modulation by TBI and chemotherapeutic agents in rhesus macaques, an important research model of human disease. PMID:25902927

  2. Radioprotective efficacy of melatonin and sesamol in hematopoietic system of whole body irradiated mice at 2 Gy

    International Nuclear Information System (INIS)

    Hematopoietic system is most sensitive to radiation exposure, its protection and recovery is very critical for survival and quality of life after radiation exposure. Antioxidants have strong capacity to reduce free radicals and have multiple roles in recovery of radiation induced damages in different organs. The objective of the present study was to investigate radioprotective effects of melatonin and sesamol in hematopoietic system of whole body irradiated C57BL/6 mice at therapeutic dose of 2 Gy. Male 7-8 week old C57BL/6 mice were administered intra-peritoneal with melatonin/sesamol (10 and 20 mg/kg body weight) 30 minutes prior to whole body γ-irradiation (2 Gy at dose rate 1 Gy/min) using Cobalt Teletherapy Unit Bhabhatron-II (Panacea Biotech Pvt. Ltd, India). Control (untreated mice), radiation, melatonin alone, sesamol alone and melatonin/sesamol plus radiation groups were sacrificed 24 hours post irradiation. The spleen and bone marrow were extracted and processed for relative organ weight, smears preparation (for micronuclei analysis). The relative spleen weight was observed and expressed in the ratio of weight of spleen (mg) and body weight of mice (gms). Relative spleen weight of radiation groups decreased significantly to control group (p<0.01); melatonin/sesamol (20 mg/kg body weight) plus radiation groups recovered the relative spleen weight (p<0.05). The micro-nucleated polychromatic erythrocytes (mnPCE) were scored in minimum 1000 polychromatic erythrocytes (PCE) under 100X objective for micronuclei assay in bone marrow cells. Normochromatic erythrocytes (NCE) were also scored along with PCE to calculate the PCE/NCE ratio. The results have shown significant increase in frequency of mnPCE (p<0.05) in radiation alone group compared to control; whereas melatonin (20 mg/kg body weight) plus radiation decreased the mnPCE frequency (p<0.05). Further studies for MnPCE in bone marrow of sesamol groups are in progress. The results will have strong

  3. Changes in some sex hormones in the pigs after whole body gamma irradiation

    International Nuclear Information System (INIS)

    Pigs aged 2 months were gamma irradiated at doses of 1.5-3.0 Gy. The control sex markers LH, FSH, PG, 17-estradiol and testosterone were measured by radioimmunoassay. Hormonal analysis of blood is performed on the 30th day after irradiation and continued at fixed intervals until sexual maturity. A histological study of the ovaries was carried out and the quality of ova was examined. During the same terms the development of the testes and the quality of the spermatogenesis of the males were also examined. Results indicate that irradiation up to 1.5 Gy cause short life hormonal changes in both sexes and insignificant changes in the histological structure of the ovary and testis. Doses above 1.5 Gy cause changes in both hormonal and germinative function of the ovary and testis leading up to proved changes in the reproductive ability of the male and female animals. (author)

  4. Growth in children following irradiation for bone marrow transplantation

    International Nuclear Information System (INIS)

    Longitudinal height data from 46 pediatric bone marrow transplant (BMT) patients, including 18 with aplastic anemia (AA), 19 with acute nonlymphoblastic leukemia (ANLL), and 9 with acute lymphoblastic leukemia (ALL), were analyzed to assess growth posttransplantation. Patients were prepared for BMT with high-dose cyclophosphamide followed by 7.5 Gy single-dose irradiation; AA patients received total lymphoid irradiation (TLI), and leukemia patients received total body irradiation (TBI). AA patients demonstrated reduced height posttransplant as reflected in a negative mean standard deviation score. The observed reduction was statistically significant only at 3 years following transplant. In contrast, leukemia patients showed a significant loss in relative height that was first visible at 1 year post-BMT and continued until at least 4 years post-BMT. Mean growth velocities in the leukemia patients were significantly below median for the 3 years following transplant. With a median follow-up of 4 years, antithymocyte globulin plus steroids in combination with methotrexate as graft vs. host prophylaxis was associated with less severe growth suppression than methotrexate alone, while there were no significant associations between growth during the first 2 years following transplant and prepubertal status at transplant (as defined by age), graft vs. host disease, thyroid or gonadal function, or previous therapies received by the leukemia patients. Children undergoing marrow transplantation, particularly those receiving TBI, are at significant risk of subsequent growth suppression

  5. Protective Effect of Exogenous Dehydro-epiandrosterone Sulfate (DHEAS) on Liver Cell Organs of Whole Body y-Irradiated Rats

    International Nuclear Information System (INIS)

    Dehydroepiandrosterone (DHEA) and its sulfate (DHES) are adrenal hormones. They are powerful endogenous antioxidants and are important in protecting the cells from damage. The present work aimed to evaluate the exogenous DHEAS as a protector against the whole body exposure to gamma radiation damages on DNA and RNA content of the nuclear fraction, calcium and acid phosphatase in the mitochondria fraction and glutathione (GSH) and malonaldehyde (MDA) in the cytosol fraction in the liver of male rats. Fifty male albino rats weighing 130-150 g were categorized into the following groups: 1-Control untreated. 2-Exposed to whole body gamma irradiation (6.5 Gy). 3-Received a single oral administration of DHEAS at a dose level of 200 mg/kg b.wt. 4-Administered with DHEAS (200 mg/kg) two h pre-exposure to whole body gamma irradiation (6.5 Gy). Three time intervals were determined for tissue sampling: after one day, one week and two weeks post irradiation (groups 2 and 4) and post administration of DHEAS (group 3). The results showed that: 1- DHEAS has a radioprotective effect on DNA and RNA content decreases in the liver nuclear fraction. 2- It significantly ameliorated the changes in mitochondria Ca21 content and acid phosphatase activity. 3- It improved both GSH and MDA contents in the cytosolic fraction. It could be concluded that, DHEAS showed an obvious protective role against the hazard of gamma radiation on liver cells. Several mechanisms were discussed about its effects. Therefore, more investigations are needed to understand well the role of DHEAS in protecting the animal tissues against ionizing radiation hazard

  6. Effect of whole-body irradiation on the level of blood clotting factors in rats

    International Nuclear Information System (INIS)

    Rats were irradiated with 6.0, 7.0 or 9.5 Gy of X-rays. Blood was collected on the 1,3,7,14 or 30th day after exposure. Fibrinogen, thrombin, prothrombin, factor X and antithrombin 3 levels were determined in blood plasma. In irradiated rats the level of these factors underwent a change which depended to some extent on the radiation dose absorbed. In general, there was a temporary elevation of all factors, lasting longer when the dose applied was higher. 24 refs., 6 tabs. (author)

  7. Enhancement of hemopoietic recovery by indomethacin after sublethal whole-body gamma irradiation

    International Nuclear Information System (INIS)

    The effect of the non-steroid anti-inflammatory drug, indomethacin, a potent prostaglandin synthesis inhibitor, on the recovery of hemopoiesis was investigated in sublethally gamma irradiated mice. Treatment with indomethacin after irradiation was found to increase the granulocyte and lymphocyte counts in peripheral blood. Furthermore, an increased rate of the restitution of bone marrow cellularity and of the spleen weight was observed. Using the method of 125iodo-deoxyuridine uptake in the spleen, the ability of indomethacin to potentiate cell proliferation was demonstrated. (orig.)

  8. Intraesophageal manganese superoxide dismutase-plasmid liposomes ameliorates novel total-body and thoracic radiation sensitivity of NOS1-/- mice.

    Science.gov (United States)

    Rajagopalan, Malolan S; Stone, Brandon; Rwigema, Jean-Claude; Salimi, Umar; Epperly, Michael W; Goff, Julie; Franicola, Darcy; Dixon, Tracy; Cao, Shaonan; Zhang, Xichen; Buchholz, Bettina M; Bauer, Anthony J; Choi, Serah; Bakkenist, Christopher; Wang, Hong; Greenberger, Joel S

    2010-09-01

    The effect of deletion of the nitric oxide synthase 1 gene (NOS1(-/-)) on radiosensitivity was determined. In vitro, long-term cultures of bone marrow stromal cells derived from NOS1(-/-) were more radioresistant than cells from C57BL/6NHsd (wild-type), NOS2(-/-) or NOS3(-/-) mice. Mice from each strain received 20 Gy thoracic irradiation or 9.5 Gy total-body irradiation (TBI), and NOS1(-/-) mice were more sensitive to both. To determine the etiology of radiosensitivity, studies of histopathology, lower esophageal contractility, gastrointestinal transit, blood counts, electrolytes and inflammatory markers were performed; no significant differences between irradiated NOS1(-/-) and control mice were found. Video camera surveillance revealed the cause of death in NOS1(-/-) mice to be grand mal seizures; control mice died with fatigue and listlessness associated with low blood counts after TBI. NOS1(-/-) mice were not sensitive to brain-only irradiation. MnSOD-PL therapy delivered to the esophagus of wild-type and NOS1(-/-) mice resulted in equivalent biochemical levels in both; however, in NOS1(-/-) mice, MnSOD-PL significantly increased survival after both thoracic and total-body irradiation. The mechanism of radiosensitivity of NOS1(-/-) mice and its reversal by MnSOD-PL may be related to the developmental esophageal enteric neuronal innervation abnormalities described in these mice. PMID:20726721

  9. Influence of L-dopa and of thymus fraction on the survival rate of whole-body irradiated mice

    Energy Technology Data Exchange (ETDEWEB)

    Busse, E.; Helmholz, M. (Humboldt-Universitaet, Berlin (German Democratic Republic). Bereich Medizin (Charite))

    1982-06-01

    The survival rate of mice with exposure of the whole body (7 Gy) was hardly changed by one dose as well as several doses of the phosphodiesterase inhibitor amantadine and the interferon inductor measles vaccine. However, the survival rates were increased by one administration of L-dopa or by the long-term therapy using L-dopa at 7 and 9 Gy, resp. The survival rates were also increased at 7 and 9 Gy, resp. if the thymus factor was three times applied to the animals after irradiation. The increased survival rates gained by using L-dopa and thymus factor are correlated with the leukocyte values determined.

  10. The influence of L-dopa and of thymus fraction on the survival rate of whole-body irradiated mice

    International Nuclear Information System (INIS)

    The survival rate of mice with exposure of the whole body (7 Gy) was hardly changed by one dose as well as several doses of the phosphodiesterase inhibitor amantadine and the interferon inductor measles vaccine. However, the survival rates were increased by one administration of L-dopa or by the long-term therapy using L-dopa at 7 and 9 Gy, resp. The survival rates were also increased at 7 and 9 Gy, resp. if the thymus factor was three times applied to the animals after irradiation. The increased survival rates gained by using L-dopa and thymus factor are correlated with the leukocyte values determined. (author)

  11. Effect of low dose whole-body X-irradiation on the efficacy of pEgr-IL18-B7.1 gene-radiotherapy

    International Nuclear Information System (INIS)

    Objective: To observe the therapeutic effect of whole-body irradiation with low dose X-rays in mice bearing Lewis lung carcinoma under recombinant plasmid pEgr-IL18-B7.1 gene-radiotherapy. Methods: The pEgr-IL18-B7.1 recombinant plasmids mediated by polyethylenimine were injected locally into tumors of the mice with gene-radiotherapy, and then the tumors received different therapeutic regimens containing local X-irradiation with 2 Gy and whole-body X-irradiation with 0.075 Gy, respectively. The anti-tumor effects of low dose X-rays in optimizing the protocol of pEgr-IL18-B7.1 gene-radiotherapy on the tumor-bearing mice were observed. Results: As compared with repeated high dose local X-irradiation alone, single high dose local X-irradiation in combination with repeated low dose of whole-body X-irradiation showed more significant inhibition of tumor growth under pEgr-IL18-B7.1 gene-radiotherapy. Conclusions: Low dose whole-body X-irradiation superimposed upon a local high dose could significantly enhance the anti-tumor effect in the protocol of pEgr-IL18-B7.1 gene-radiotherapy. (authors)

  12. Sexual Functioning, Desire, and Satisfaction in Women with TBI and Healthy Controls

    OpenAIRE

    Jenna Strizzi; Laiene Olabarrieta Landa; Monique Pappadis; Silvia Leonor Olivera; Edgar Ricardo Valdivia Tangarife; Inmaculada Fernandez Agis; Paul B. Perrin; Juan Carlos Arango-Lasprilla

    2015-01-01

    Traumatic brain injury (TBI) can substantially alter many areas of a person's life and there has been little research published regarding sexual functioning in women with TBI. Methods. A total of 58 women (29 with TBI and 29 healthy controls) from Neiva, Colombia, participated. There were no statistically significant differences between groups in sociodemographic characteristics. All 58 women completed the Sexual Quality of Life Questionnaire (SQoL), Female Sexual Functioning Index (FSFI), Se...

  13. Acute whole-body irradiation, even at moderate dose, induces alterations in blood-brain-barrier permeability

    International Nuclear Information System (INIS)

    Full text: A radiation-induced blood-brain barrier (BBB) breakdown has been evoked, but clearly demonstrated only at high doses of ionizing radiations. By using two protocols, we have searched an impairment in BBB integrity induced by moderate doses. First, the effects of irradiation on the permeability of striatal BBB to [3H]AIBA and [14C]sucrose were investigated in rats by using brain microdialysis. 32 rats, irradiated at 4.5Gy were serially experimented from 0 to 24 hours, from 24 to 48 hours and at later delays after exposure. 32 sham-irradiated rats served as controls. Second, the entry of pyridostigmine (PYR would not be expected to cross the BBB) into the brain was investigated in mice subjected to (neutron-g) exposure at 0.7Gy or 4Gy. For each dose 120 animals were irradiated and 120 sham-irradiated mice were included. At different delays after exposure, 10 mice were injected with 0.9% NaCl (control) or PYR bromide (0.1 mg/kg). Mice were killed 10min after injection and striatum, cortex and hippocampus were quickly dissected. Penetration of the drug into the brain was examined by measurement of AChE activity. Concerning microdialysis protocol, no late modification of the permeability of BBB was observed. But, in the course of the initial syndrome, we observed a transient increase of the permeability to the two markers, between the third and the 17th hour after exposure. A secondary transient 'opening' of the BBB to [14C] sucrose was noticed about 28 hours following irradiation with no modification of the permeability to [3H]AIBA. Concerning the BBB permeability to PYR, by comparing irradiated-PYR mice to sham-PYR mice, a decrease of AChE activity in the three cerebral areas was noted 48 hours after exposure at 4 Gy ; at 0.7 Gy this decrease is noted in the striatum only. In conclusion, our experiments by using two animal models, two types of radiations, and different tracers show modifications of the BBB permeability after moderate doses whole-body

  14. The influence of whole-body irradiation with combined ultraviolet/infrared light on the spermiogram

    International Nuclear Information System (INIS)

    We irradiated for six weeks two times a week 10 volunteer subjects with a UV/IR-radiation source and evaluated the spermiogram every week. The subjects were divided in 3 groups with various light sensitivities (high, medium, low), in order to achieve a similar erythematous intensity. No relation to the irradiation could be found in any of the spermiogram parameters (sperm density, total sperm number, motility, vitality, ejaculation quantity, fructose, pH value). A direct effect as a result of photochemical changes of the cells of spermatogenesis is not possible because of the limited penetration ability of the used radiation. The temperature increase as a result of the UV/IR irradiation was too small to result in a decrease of spermatozoan concentration, as can be expected by stronger warming of the testicles. An indirect effect of the UV/IR irradiation in the sense of an influence on spermatogenesis via the involuntary nervous system → hypophysis → sexual hormone could not be determined by us. (orig.)

  15. Histostructural changes in pig testes after total-body gamma irradiation

    International Nuclear Information System (INIS)

    The experiments were carried out with male pigs from Cembarow breed. Animals aged 60 days were exposed to 1.5 - 2.5 Gy gamma rays. Samples for histological study were taken after castration 1, 2, 3, 4, 5 and 6 months after irradiation. The testes samples were fixed and prepared by routine histological methods. The following control markers were used to examine the histostructural changes of testes in post-irradiation period: total number of germ cells, diameter of seminiferous tubule, relative number of seminiferous tubules with impaired and normal spermatogenesis and sterile seminiferous tubule. The changes were compared in relation to age and dose. Data obtained from serial cross sections of the seminiferous tubules indicated that in earlier periods after exposure (1-2 months) the number of germ cells decreased in part of the seminiferous tubules, but later some violation of spermatogenesis was observed. The analysis of these changes in relation to the dose indicated that the 2.5 Gy irradiation caused a permanent cytopathogenetic effect on germ cells in pig seminiferous tubules. The results from histological studies of the 2-8 months aged pig testes irradiated at 2.5 Gy indicated depressed spermatogenesis in its morphological state. (author)

  16. Monte Carlo efficiency calibration of a neutron generator-based total-body irradiator

    International Nuclear Information System (INIS)

    Many body composition measurement systems are calibrated against a single-sized reference phantom. Prompt-gamma neutron activation (PGNA) provides the only direct measure of total body nitrogen (TBN), an index of the body's lean tissue mass. In PGNA systems, body size influences neutron flux attenuation, induced gamma signal distribution, and counting efficiency. Thus, calibration based on a single-sized phantom could result in inaccurate TBN values. We used Monte Carlo simulations (MCNP-5; Los Alamos National Laboratory) in order to map a system's response to the range of body weights (65-160 kg) and body fat distributions (25-60%) in obese humans. Calibration curves were constructed to derive body-size correction factors relative to a standard reference phantom, providing customized adjustments to account for differences in body habitus of obese adults. The use of MCNP-generated calibration curves should allow for a better estimate of the true changes in lean tissue mass that many occur during intervention programs focused only on weight loss. (author)

  17. Cellular therapy by mesenchymal stem cells in the gamma radiation-induced multi organ dysfunction syndrome; Therapie cellulaire par cellules souches mesenchymateuses d'une atteinte multi-organes induite par une irradiation gamma: un modele experimental

    Energy Technology Data Exchange (ETDEWEB)

    Francois, S.; Mouiseddine, M.; Semont, A.; Frick, J.; Sache, A.; Thierry, D.; Voisin, P.; Gourmelon, P.; Chapel, A. [Institut de Radioprotection et de Surete Nucleaire (IRSN), Direction de la Radioprotection de l' Homme, 92 6 Fontenay-aux-Roses (France); Gorin, N.C. [Universite Paris -6 Pierre et Marie Curie, Faculte de Medecine Saint-Antoine, Lab. de Therapie Cellulaire et Radioprotection Accidentelle, EA 1638, 75 - Paris (France); Hopital Saint-Antoine, Service d' Hematologie et de Therapie Cellulaire, 75 - Paris (France)

    2007-07-15

    Mesenchymal stem cells (M.S.C.) have been shown to migrate to various tissues. There is little information on the fate and potential therapeutic efficacy of the re infusion of M.S.C. following total body irradiation (T.B.I.). We addressed this question using human M.S.C. (h.M.S.C.) infused to non obese diabetic/severe combined immuno-deficient (N.O.D./S.C.I.D.) mice submitted to T.B.I.. Further, we tested the impact of additional local irradiation (A.L.I.) superimposed to T.B.I., as a model of accidental irradiation. N.O.D./S.C.I.D. mice were transplanted with h.M.S.C.. Group 1 was not irradiated before receiving h.M.S.C. infusion. Group 2 received only T.B.I. at a dose of 3.5 Gy, group 3 received local irradiation to the abdomen at a dose of 4.5 Gy in addition to T.B.I., and group 4 received local irradiation to the leg at 26.5 Gy in addition to T.B.I.. Fifteen days after gamma irradiation, quantitative and spatial distribution of the h.M.S.C. were studied. Histological analysis of mouse tissues confirmed the presence of radio-induced lesions in the irradiated fields. Following their infusion into nonirradiated animals, h.M.S.C. homed at a very low level to various tissues (lung, bone marrow, and muscles) and no significant engraftment was found in other organs. T.B.I. induced an increase of engraftment levels of h.M.S.C. in the brain, heart, bone marrow, and muscles. Abdominal irradiation (A.I.) as compared with leg irradiation (L.I.) increased h.M.S.C. engraftment in the exposed area (the gut, liver, and spleen). Comparison of two local irradiations has shown that (L.I.) as compared with (A.I.) increased h.M.S.C. engraftment in the exposed area. An increase of h.M.S.C. engraftment in organs outside the fields of the A.L.I. was also observed. Conversely, following L.I., h.M.S.C. engraftment was increased in the brain as compared with A.I.. This study shows that engraftment of h.M.S.C. in N.O.D./ S.C.I.D. mice with significantly increased in response to tissue

  18. Effect of intestinal microflora on the survival time of mice exposed to lethal whole-body γ irradiation

    International Nuclear Information System (INIS)

    The effect of intestinal microflora on the survival time of mice exposed to 2-kR whole-body γ irradiation was studied using germfree, monoassociated, and conventionalized ICR mice. The germfree mice were monoassociated with 1 of 11 bacterial strains, which were isolated from the fresh feces of conventional mice, 2 weeks prior to irradiation. All mice died within 3 weeks after irradiation. Monoassociation with Fusobacterium sp., Streptococcus faecalis, Escherichia coli, or Pseudomonas sp. significantly reduced the mean survival time compared to that of germfree mice. In contrast, monoassociation with Clostridium sp., Bifidobacterium pseudolongum, or Lactobacillus acidophilus significantly prolonged the mean survival time compared to that of germfree mice. This suggests that the latter organisms may perform some activity to protect the mice from radiation injury. In this histopathological autopsy examination, the main lesions were hypocellularity in hematopoietic organs and hemorrhage in various organs. Neither karyorrhexis nor desquamation of intestinal mucosal cells was observed in any mice. From these observations, it is suggested that the death of these mice was related to hematopoietic damage. Bacterial invasion into various organs was observed in conventionalized and Pseudomonas-, E. coli-, or S. faecalis-monoassociated mice but not in Clostridium-, B. pseudolongum-, L. acidophilus-, or Fusobacterium-monoassociated mice

  19. Radio-induced neuropathology: from early effects to late sequelae. Rat behavioural and metabolic studies after sublethal total body irradiation

    International Nuclear Information System (INIS)

    The radioresistance dogma of Central Nervous System (CNS) is now obsolete. Recent progress in neuroscience allow us to reconsider the radiation-induced cognitive dysfunctions observed after radiation therapy or after a nuclear accident, and to devise appropriate diagnostic and therapeutic means. We have developed a Rat model to study the effects of total body irradiation at a sublethal dose (4.5 Gy). This leads to impaired learning and memory of a task being acquired during the first month - which is prevented by administration of a radioprotector (amifostine) - while it does not appear to affect retrograde memory. Early, an apoptotic wave occurs in the sub-ventricular zone, 5 to 9 hours after exposure, while neuro-genesis is suppressed. Two days after irradiation, the metabolic study conducted by NMR HRMAS (High Resolution Magic Angle Spinning) suggests the presence of cerebral oedema and the study of brain lipids in liquid NMR confirms the membrane damages (elevated cholesterol and phospholipids). The lipid profile is then normalized while a gliosis appears. Finally, 1 month post-irradiation, the elevation of GABA, an inhibitory neurotransmitter, in 2 separate brain structures, occurs simultaneously with a taurine decrease in the hippocampus that lasts 6 months. Our integrated model allows validating bio-markers measurable in vivo NMR spectroscopy - the next experimental stage - and testing new radiation-protective agents. (author)

  20. The effect of total body irradiation and bone marrow transplantation during childhood and adolescence on growth and endocrine function

    International Nuclear Information System (INIS)

    Seventeen children with acute leukaemia and myeloproliferative disorders were investigated for growth and endocrine dysfunction. All had undergone bone marrow transplantation prepared with cyclophosphamide and single fraction total body irradiation (900-1000 cGy) between 1.5 and 3.8 (mean 2.2) years previously. The majority exhibited growth failure, of multiple aetiology. Ten patients, of whom eight had had previous prophylactic cranial irradiation, had evidence of growth hormone deficiency based on reduced growth hormone reponse to insulin induced hypoglycaemia. Three had evidence of hypothalamic damage. Gonadal failure was common. All four girls of adolescent age (10.6-14.1 years) had ovarian failure requiring sex steroid replacement. Of eight boys of adolescent age (12.3-18.3 years), two had testicular failure requiring sex steroid supplements. Both had had previous testicular irradiation. Five others had compensated gonadal failure; one had normal Leydig cell function. Abnormalities of the TSH response to TRH occurred in 10 patients but only three had overt hypothyroidism. Unlike growth hormone deficiency, gonadal and thyroid dysfunction showed no correlation with previous cranial radiotherapy. (author)