Awwad H K, Burgers J M
Clin Radiol. 1976 Oct;27(4):443-8. doi: 10.1016/s0009-9260(76)80106-7.
The clinical results of 26 tongue and 31 bladder radium implants were analysed in terms of proposed dose specification parameters that describe the dose-time-volume relationships of the implant. Tongue cases that recurred within two years were mostly those with a relatively short treatment time and in which a relatively large dose reduction factor had to be applied. The dose-time factor did not differ significantly in the groups of bladder implants having different clinical results. A higher incidence of necrosis was noted in bladder cases. This was associated with a significantly higher mean dose and a somewhat greater degree of dose inhomogeneity. Recurrences were generally linked with greater mean dose, target volume and dose inhomogeneity. These unfavourable dose-volume relationships were frequently associated with poor distribution of needles. The reported experimental and clinical findings pertinent to the differential sparing of normal tissues associated with protraction of continuous irradiation are outlined. In the light of these, it is felt that the results of tongue implants could have been improved by omission of the dose-time adjustment factor for treatment time of 3-10 days without undue risk of necrosis. However, bladder results could have been improved by attainment of a better implantation technique while keeping the treatment time within 6-8 days in view of the lower tolerance.
根据描述植入剂量-时间-体积关系的建议剂量规范参数，分析了26例舌部镭植入和31例膀胱镭植入的临床结果。两年内复发的舌部病例大多是治疗时间相对较短且必须应用相对较大剂量降低因子的病例。在具有不同临床结果的膀胱植入组中，剂量-时间因子没有显著差异。膀胱病例中坏死的发生率较高。这与显著更高的平均剂量和一定程度上更大的剂量不均匀性有关。复发通常与更高的平均剂量、靶体积和剂量不均匀性有关。这些不利的剂量-体积关系经常与针的分布不佳有关。概述了与连续照射延长相关的正常组织差异 sparing 相关的报告实验和临床发现。鉴于这些，有人认为，在没有坏死过度风险的情况下，通过省略3至10天治疗时间的剂量-时间调整因子，舌部植入的结果可能会得到改善。然而，鉴于较低的耐受性，通过获得更好的植入技术并将治疗时间保持在6至8天内，膀胱植入的结果可能会得到改善。
