Heyd R, Strassmann G, Donnerstag F, Martin T, Zamboglou N
Strahlenklinik, Städtische Kliniken Offenbach.
Rontgenpraxis. 2000;53(2):51-61.
The use of radiotherapy in the treatment of Langerhans' cell histiocytosis was first reported in the literature in 1930 and has been proven as effective in numerous studies. We present the results of two female adults with eosinophilic granuloma of bone who underwent conventionally fractionated radiation therapy with total doses of 7 x 1.8 Gy and 7 x 2.0 Gy in four different sites. After observation periods raging from three months to six years local control of the disease was achieved in all treated locations. A review of 18 previously published studies include a total of 310 sites of eosinophilic granuloma of bone in 216 patients. It was demonstrated in 13 studies that the patients had complete relief of symptoms. An average of 94.3% had local control of the symptoms. Furthermore, in 12 studies for a total of 344 cases with involvement of other organs local control was reported in an average of 64.8% (range: 14.3-100%). Based on our own observations and on the literature review we conclude that low dose radiation therapy plays an important role in the management of localised Langerhans' cell histiocytosis. In order to minimise the risk of radiation induced neoplasms an accurate and precise radiation technique is required.
放射疗法用于治疗朗格汉斯细胞组织细胞增多症最早于1930年在文献中报道，并且在众多研究中已被证明有效。我们展示了两名患有骨嗜酸性肉芽肿的成年女性的治疗结果，她们在四个不同部位接受了总剂量为7×1.8 Gy和7×2.0 Gy的常规分割放射治疗。经过三个月至六年的观察期，所有治疗部位的疾病均实现了局部控制。对18项先前发表的研究进行回顾，这些研究共纳入了216例患者的310处骨嗜酸性肉芽肿病灶。13项研究表明患者症状完全缓解。平均94.3%的患者症状得到局部控制。此外，在12项共涉及344例其他器官受累病例的研究中，平均64.8%（范围：14.3 - 100%）的病例报告实现了局部控制。基于我们自己的观察以及文献回顾，我们得出结论，低剂量放射疗法在局限性朗格汉斯细胞组织细胞增多症的治疗中发挥着重要作用。为了将放射诱发肿瘤的风险降至最低，需要精确的放射技术。
