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- Publisher Website: 10.12809/hkjr1615329
- Scopus: eid_2-s2.0-84978191624
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Article: Pneumocystis Jiroveci Infection and Craniospinal Irradiation with Arc Therapy: a Report of Two cases
Title | Pneumocystis Jiroveci Infection and Craniospinal Irradiation with Arc Therapy: a Report of Two cases 肺囊蟲感染及採用圓弧式照射的脊髓放療:兩例病例報告 |
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Authors | |
Keywords | Craniospinal irradiation Intensity-modulated Lymphopenia Pneumocystis jiroveci Radiotherapy |
Issue Date | 2016 |
Publisher | Hong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkjr.org |
Citation | Hong Kong Journal of Radiology, 2016, v. 19 n. 2, p. 126-131 How to Cite? |
Abstract | Tomotherapy, a form of arc therapy, is often preferred to craniospinal irradiation (CSI) because of its better dose homogeneity when planning target volume and minimising organ risk. We report the cases of two young men with central nervous system germ cell tumour who had unnoticed severe and prolonged lymphopenia after completing CSI with tomotherapy. Both developed Pneumocystis jiroveci pneumonia and one died of respiratory failure. We hypothesise that the rapid drop in lymphocyte count may have been in part due to the ‘low dose bath’ of radiation to the whole pulmonary vasculature with consequent killing of the circulating lymphocytes, in addition to low-dose radiation to a high volume of the thymus, thoracic duct, and bone marrow. We therefore suggest close monitoring of lymphocyte count during tomotherapy-CSI and consideration of co-trimoxazole prophylaxis in severe lymphopenic patients. Further large-scale study is required to understand the possible correlation of V1-V5 lung dosimetry with risk of lymphopenia. |
Persistent Identifier | http://hdl.handle.net/10722/229162 |
ISSN | 2023 Impact Factor: 0.2 2023 SCImago Journal Rankings: 0.127 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | So, TH | - |
dc.contributor.author | Ho, PYP | - |
dc.contributor.author | Leung, TW | - |
dc.contributor.author | Kwong, DLW | - |
dc.date.accessioned | 2016-08-23T14:09:22Z | - |
dc.date.available | 2016-08-23T14:09:22Z | - |
dc.date.issued | 2016 | - |
dc.identifier.citation | Hong Kong Journal of Radiology, 2016, v. 19 n. 2, p. 126-131 | - |
dc.identifier.issn | 2223-6619 | - |
dc.identifier.uri | http://hdl.handle.net/10722/229162 | - |
dc.description.abstract | Tomotherapy, a form of arc therapy, is often preferred to craniospinal irradiation (CSI) because of its better dose homogeneity when planning target volume and minimising organ risk. We report the cases of two young men with central nervous system germ cell tumour who had unnoticed severe and prolonged lymphopenia after completing CSI with tomotherapy. Both developed Pneumocystis jiroveci pneumonia and one died of respiratory failure. We hypothesise that the rapid drop in lymphocyte count may have been in part due to the ‘low dose bath’ of radiation to the whole pulmonary vasculature with consequent killing of the circulating lymphocytes, in addition to low-dose radiation to a high volume of the thymus, thoracic duct, and bone marrow. We therefore suggest close monitoring of lymphocyte count during tomotherapy-CSI and consideration of co-trimoxazole prophylaxis in severe lymphopenic patients. Further large-scale study is required to understand the possible correlation of V1-V5 lung dosimetry with risk of lymphopenia. | - |
dc.language | eng | - |
dc.publisher | Hong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkjr.org | - |
dc.relation.ispartof | Hong Kong Journal of Radiology | - |
dc.rights | Hong Kong Journal of Radiology. Copyright © Hong Kong Academy of Medicine Press. | - |
dc.subject | Craniospinal irradiation | - |
dc.subject | Intensity-modulated | - |
dc.subject | Lymphopenia | - |
dc.subject | Pneumocystis jiroveci | - |
dc.subject | Radiotherapy | - |
dc.title | Pneumocystis Jiroveci Infection and Craniospinal Irradiation with Arc Therapy: a Report of Two cases | - |
dc.title | 肺囊蟲感染及採用圓弧式照射的脊髓放療:兩例病例報告 | - |
dc.type | Article | - |
dc.identifier.email | So, TH: sth495@hku.hk | - |
dc.identifier.email | Ho, PYP: pattyho@hku.hk | - |
dc.identifier.email | Leung, TW: ltw920@hkucc.hku.hk | - |
dc.identifier.email | Kwong, DLW: dlwkwong@hku.hk | - |
dc.identifier.authority | So, TH=rp01981 | - |
dc.identifier.authority | Kwong, DLW=rp00414 | - |
dc.identifier.doi | 10.12809/hkjr1615329 | - |
dc.identifier.scopus | eid_2-s2.0-84978191624 | - |
dc.identifier.hkuros | 261636 | - |
dc.identifier.volume | 19 | - |
dc.identifier.issue | 2 | - |
dc.identifier.spage | 126 | - |
dc.identifier.epage | 131 | - |
dc.identifier.isi | WOS:000393054000011 | - |
dc.publisher.place | Hong Kong | - |
dc.identifier.issnl | 2223-6619 | - |