Fujii Osamu, Tsujino Kayoko, Soejima Toshinori, Yoden Eisaku, Ichimiya Yukako, Sugimura Kazuro
Department of Radiation Oncology, Hyogo Medical Center for Adults, 13-70 Kitaojicho, Akashi 673-8558, Japan.
Radiat Med. 2006 Jun;24(5):345-50. doi: 10.1007/s11604-006-0039-9.
The purpose of this study was to evaluate white matter (WM) abnormalities induced by WBRT.
Twenty-four patients (11 men and 13 women; age range 38-74 years, median 60 years) who survived for more than 1 year after completion of WBRT (radiation dose range 30-40 Gy, median 35 Gy) at our institution between January 2000 and June 2003 were followed up with magnetic resonance (MR) scans for 11-51 months (median 19 months). We evaluated WM changes attributable to WBRT as grade 0-6 and assessed possible contributing factors by statistical analysis.
WM changes were found in 20 patients: Eight were assessed as grade 2, three as grade 3, and nine as grade 5. In total, 12 patients developed grade 3 or higher WM changes. Age (<60 vs > or =60 years), sex, radiation dose (< or =35 vs >35 Gy), chemotherapy (with CDDP vs without CDDP), biologically effective dose (< or =120 vs >120 Gy1), and head width (<16.3 vs > or =16.3 cm) were found not to be relevant to the incidence or severity of the WM changes.
Long-term survivors who have under-gone WBRT may have a higher incidence of WM abnormalities.
本研究旨在评估全脑放疗（WBRT）所致的白质（WM）异常。
2000年1月至2003年6月期间，在我院完成WBRT（放疗剂量范围30 - 40 Gy，中位剂量35 Gy）后存活超过1年的24例患者（11例男性和13例女性；年龄范围38 - 74岁，中位年龄60岁）接受了11 - 51个月（中位19个月）的磁共振（MR）扫描随访。我们将归因于WBRT的WM变化评估为0 - 6级，并通过统计分析评估可能的影响因素。
20例患者发现有WM变化：8例评估为2级，3例为3级，9例为5级。总共有12例患者出现3级或更高级别的WM变化。年龄（<60岁与≥60岁）、性别、放疗剂量（≤35 Gy与>35 Gy）、化疗（使用顺铂与未使用顺铂）、生物有效剂量（≤120 Gy1与>120 Gy1）以及头宽（<16.3 cm与≥16.3 cm）与WM变化的发生率或严重程度无关。
接受过WBRT的长期存活者可能有更高的WM异常发生率。
