{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:41:47Z","timestamp":1789170107389,"version":"build-2803163510"},"reference-count":60,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T00:00:00Z","timestamp":1647907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Johann Wolfgang Goethe-Universit\u00e4t, Frankfurt am Main"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Strahlenther Onkol"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Total body irradiation (TBI) is a\u00a0common part of the myelo- and immuno-ablative conditioning regimen prior to an allogeneic hematopoietic stem cell transplantation (allo-HSCT). Due to concerns regarding acute and long-term complications, there is currently a\u00a0decline in otherwise successfully established TBI-based conditioning regimens. Here we present an analysis of patient and treatment data with focus on survival and long-term toxicity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients with hematologic diseases who received TBI as part of their conditioning regimen prior to allo-HSCT at Frankfurt University Hospital between 1997 and 2015 were identified and retrospectively analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In all, 285 patients with a\u00a0median age of 45\u00a0years were identified. Median radiotherapy dose applied was 10.5\u202fGy. Overall survival at\u00a01, 2, 5, and 10\u00a0years was 72.6, 64.6, 54.4, and 51.6%, respectively. Median follow-up of patients alive was 102 months. The cumulative incidence of secondary malignancies was 12.3% (<jats:italic>n<\/jats:italic>\u202f=\u200935), with hematologic malignancies and skin cancer predominating. A\u00a0TBI dose \u2265\u202f8\u202fGy resulted in significantly improved event-free (<jats:italic>p<\/jats:italic>\u202f=\u20090.030) and overall survival (<jats:italic>p<\/jats:italic>\u202f=\u20090.025), whereas a\u00a0total dose \u2264\u202f8\u202fGy and acute myeloid leukemia (AML) diagnosis were associated with significantly increased rates of secondary malignancies (<jats:italic>p<\/jats:italic>\u202f=\u20090.003, <jats:italic>p<\/jats:italic>\u202f=\u20090.048) in univariate analysis. No significant correlation was observed between impaired renal or pulmonary function and TBI dose.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>TBI remains an effective and well-established treatment, associated with distinct late-toxicity. However, in the present study we cannot confirm a\u00a0dose\u2013response relationship in intermediate dose ranges. Survival, occurrence of secondary malignancies, and late toxicities appear to be subject to substantial confounding in this context.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00066-022-01914-5","type":"journal-article","created":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T17:05:21Z","timestamp":1647968721000},"page":"547-557","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Twenty years of experience of a\u00a0tertiary cancer center in total body irradiation with focus on oncological outcome and secondary malignancies"],"prefix":"10.1007","volume":"198","author":[{"given":"Katharina","family":"Sieker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Fleischmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Trommel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulla","family":"Ramm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Licher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gesine","family":"Bug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert","family":"Serve","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"R\u00f6del","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Balermpas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,22]]},"reference":[{"key":"1914_CR1","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.critrevonc.2018.01.011","volume":"123","author":"A Paix","year":"2018","unstructured":"Paix\u00a0A, Antoni\u00a0D, Waissi\u00a0W, Ledoux\u00a0M\u2011P, Bilger\u00a0K, Fornecker\u00a0L et al (2018) Total body irradiation in allogeneic bone marrow transplantation conditioning regimens: a review. 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