Pilecki B, Kopiec P, Zajusz A, Podworski H, Szelc S, Składowski K, Maciejewski B
Center for Oncology, Maria Sklodowska-Curie, Memorial Institute, Gliwice, Poland.
Neoplasma. 1991;38(6):609-15.
A case of Burkitt-type lymphoma treated by accelerated hyperfractionated irradiation combined with the COP chemotherapy is presented. The effectiveness of treatment was evaluated on the basis of the growth curve and the radiobiological aspects are discussed. During the treatment, the initial volume doubling time (Td) of 15 days was shortened to 4.5 days suggesting accelerated tumor growth. From dose response curve estimated for clinical data taken from literature, an effDo of 1.37 Gy was calculated. Surviving fraction after 58 Gy given in the twice-a-day regimen (b. i. d.) was 10(-19) suggesting local tumor control. However, only partial remission was observed. This nonradical effect may likely result in accelerated repopulation of surviving tumor clonogenic cells. This suggests that such a fast growing tumor as Burkitt-type lymphoma (Tpot = 1 day) should be irradiated using three instead two fractions per day combined with adjuvant or concomitant chemotherapy with a short intervals between cycles.
本文报告1例采用加速超分割放疗联合COP化疗治疗的伯基特型淋巴瘤病例。根据生长曲线评估治疗效果，并讨论放射生物学方面的问题。治疗期间，初始体积倍增时间（Td）从15天缩短至4.5天，提示肿瘤生长加速。根据从文献中获取的临床数据估算的剂量反应曲线，计算出等效剂量（effDo）为1.37 Gy。在每日两次（b.i.d.）的方案中给予58 Gy后的存活分数为10^(-19)，提示局部肿瘤得到控制。然而，仅观察到部分缓解。这种非根治性效果可能导致存活的肿瘤克隆形成细胞加速再增殖。这表明，对于像伯基特型淋巴瘤（增殖时间Tpot = 1天）这样生长迅速的肿瘤，应采用每天三次而非两次分割放疗，并联合辅助或同步化疗，且周期之间间隔较短。
