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

Publication ,  Journal Article
Deeg, HJ; Flournoy, N; Sullivan, KM; Sheehan, K; Buckner, CD; Sanders, JE; Storb, R; Witherspoon, RP; Thomas, ED
Published in: Int J Radiat Oncol Biol Phys
July 1984

We examined 277 patients, who have been followed for 1 to 12 years after marrow transplantation, for cataract development. In preparation for transplantation, 96 patients with aplastic anemia were conditioned with chemotherapy only, usually cyclophosphamide 50 mg/kg X 4 intravenously, 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), usually at increments of 2 to 2.25 Gy/day for 6 to 7 days for cumulative doses of 12 to 15.75 Gy. 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, and 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 (p less than 0.00005), suggesting a significant sparing effect with use of TBI dose fractionation. Addition significant risk factors included the chronic use of steroids posttransplant (highly associated with the presence of chronic graft-versus-host disease), and the diagnoses of acute lymphoblastic or chronic myelogenous leukemia.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

July 1984

Volume

10

Issue

7

Start / End Page

957 / 964

Location

United States

Related Subject Headings

  • Whole-Body Irradiation
  • Risk
  • Radiotherapy Dosage
  • Preoperative Care
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Leukemia
  • Infant
  • Humans
 

Citation

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Chicago
ICMJE
MLA
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Deeg, H. J., Flournoy, N., Sullivan, K. M., Sheehan, K., Buckner, C. D., Sanders, J. E., … Thomas, E. D. (1984). Cataracts after total body irradiation and marrow transplantation: a sparing effect of dose fractionation. Int J Radiat Oncol Biol Phys, 10(7), 957–964. https://doi.org/10.1016/0360-3016(84)90163-9
Deeg, H. J., N. Flournoy, K. M. Sullivan, K. Sheehan, C. D. Buckner, J. E. Sanders, R. Storb, R. P. Witherspoon, and E. D. Thomas. “Cataracts after total body irradiation and marrow transplantation: a sparing effect of dose fractionation.Int J Radiat Oncol Biol Phys 10, no. 7 (July 1984): 957–64. https://doi.org/10.1016/0360-3016(84)90163-9.
Deeg HJ, Flournoy N, Sullivan KM, Sheehan K, Buckner CD, Sanders JE, et al. Cataracts after total body irradiation and marrow transplantation: a sparing effect of dose fractionation. Int J Radiat Oncol Biol Phys. 1984 Jul;10(7):957–64.
Deeg, H. J., et al. “Cataracts after total body irradiation and marrow transplantation: a sparing effect of dose fractionation.Int J Radiat Oncol Biol Phys, vol. 10, no. 7, July 1984, pp. 957–64. Pubmed, doi:10.1016/0360-3016(84)90163-9.
Deeg HJ, Flournoy N, Sullivan KM, Sheehan K, Buckner CD, Sanders JE, Storb R, Witherspoon RP, Thomas ED. Cataracts after total body irradiation and marrow transplantation: a sparing effect of dose fractionation. Int J Radiat Oncol Biol Phys. 1984 Jul;10(7):957–964.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

ISSN

0360-3016

Publication Date

July 1984

Volume

10

Issue

7

Start / End Page

957 / 964

Location

United States

Related Subject Headings

  • Whole-Body Irradiation
  • Risk
  • Radiotherapy Dosage
  • Preoperative Care
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Leukemia
  • Infant
  • Humans