• Hiroshi Igaki, Katsuyuki Karasawa, Hisashi Sakamaki, Hiroshi Saito, Keiichi Nakagawa, Kuni Ohtomo, and Yoshiaki Tanaka.
• Department of Radiation Oncology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan. igaki-tky@umin.ac.jp
• Strahlenther Onkol. 2005 Nov 1; 181 (11): 704-8.

PurposeA retrospective analysis was conducted on the outcome of total-body irradiation (TBI) followed by bone marrow transplantation (BMT) on leukemia patients. Also studied was the risk of renal dysfunction after TBI/BMT with or without the use of selective renal shielding blocks.Patients And MethodsThe cases of 109 leukemia patients who received TBI as a component of the conditioning regimen for their BMT were reviewed. They received 12 Gy of TBI in six fractions over 3 consecutive days. Doses to eyes and lungs were reduced to 7 Gy and 8 Gy, respectively, by customized organ shielding blocks. After March 1999, renal shielding blocks were used to constrain the renal dose to 10 Gy. The patients were followed for a median period of 16.6 months (range: 0.3-180.1 months).ResultsThe 2-year and 5-year overall survival rates were 55.4% and 43.2%, respectively. Renal dysfunction-free rates were different between those with and without renal shielding blocks: 100% and 78.5%, respectively, at 2 years. Overall survivals were not significantly different among these patients: 60.4% and 52.9%, respectively, at 2 years in patients with and without renal shielding blocks (p = 0.53).ConclusionThe use of selective renal shielding blocks provided evidence for reducing radiation-induced renal toxicities without decreasing the overall survival rate.

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