Warszawski N, Pfreundner L, Bratengeier K, Bohndorf W, Feustel H
Klinik und Poliklinik für Strahlentherapie, Universität Würzburg.
Strahlenther Onkol. 1992 Sep;168(9):552-7.
From September 1989 until March 1992 nine patients with unresectable, though localized carcinoma of the pancreas were treated by a multimodality therapy consisting of palliative surgery, interstitial conformal brachytherapy in high-dose rate mode (HDRBT) with iridium-192 up to 30 Gy and external-beam radiation therapy (EBRT) of about 52 Gy. Four patients simultaneously received two cycles of chemotherapy consisting of 5-FU and Leucovorin. Since high radiation doses are applied which are not tolerated in adjacent healthy tissues, doses to tumor and critical areas need to be known precisely and are to be adjusted before treatment. A three-dimensional imaging system is required. A self developed method combines the data of simulation radiographs and those of CT scans. The prescribed minimum target absorbed dose in HDRBT is adjusted to the target volume sparing organs at risk. The specialized quality assurance is adapted to this method. Differences between measured and calculated doses do not exceed 5%. The addition of isodoses of HDRBT and EBRT on CT scans is demonstrated. Due to patients' selection the treatment concept did not reveal any positive effects on survival. However, excellent palliative results were obtained without severe side-effects.
从1989年9月至1992年3月，对9例无法切除但为局限性胰腺癌患者采用了多模式治疗，包括姑息性手术、采用铱-192的高剂量率模式（HDRBT）的组织间适形近距离放射治疗，剂量达30 Gy，以及约52 Gy的外照射放疗（EBRT）。4例患者同时接受了两个周期由5-氟尿嘧啶和亚叶酸组成的化疗。由于要施加在相邻健康组织中无法耐受的高辐射剂量，因此需要精确了解肿瘤和关键区域的剂量，并在治疗前进行调整。这需要一个三维成像系统。一种自行开发的方法将模拟X线片数据与CT扫描数据相结合。HDRBT中规定的最小靶区吸收剂量根据危及器官的靶区体积进行调整。专门的质量保证适用于此方法。测量剂量与计算剂量之间的差异不超过5%。展示了HDRBT和EBRT等剂量线在CT扫描上的叠加情况。由于患者选择的原因，该治疗方案未显示出对生存有任何积极影响。然而，获得了极佳的姑息治疗效果，且无严重副作用。
