Borgmann Kerstin, Hoeller Ulrike, Nowack Sven, Bernhard Michael, Röper Barbara, Brackrock Sophie, Petersen Cordula, Szymczak Silke, Ziegler Andreas, Feyer Petra, Alberti Winfried, Dikomey Ekkehard
Clinic for Radiotherapy and Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Int J Radiat Oncol Biol Phys. 2008 May 1;71(1):256-64. doi: 10.1016/j.ijrobp.2008.01.007.
We tested whether the chromosomal radiosensitivity of in vitro irradiated lymphocytes could be used to predict the risk of acute reactions after radiotherapy.
Two prospective studies were performed: study A with 51 patients included different tumor sites and study B included 87 breast cancer patients. Acute reaction was assessed using the Radiation Therapy Oncology Group score. In both studies, patients were treated with curative radiotherapy, and the mean tumor dose applied was 55 Gy (40-65) +/- boost with 11 Gy (6-31) in study A and 50.4 Gy +/- boost with 10 Gy in study B. Individual radiosensitivity was determined with lymphocytes irradiated in vitro with X-ray doses of either 3 or 6 Gy and scoring the number of chromosomal deletions.
Acute reactions displayed a typical spectrum with 57% in study A and 53% in study B showing an acute reaction of Grade 2-3. Individual radiosensitivity in both studies was characterized by a substantial variation and the fraction of patients with Grade 2-3 reaction was found to increase with increasing individual radiosensitivity measured at 6 Gy (study A, p = 0.238; study B, p = 0.023). For study B, this fraction increased with breast volume, and the impact of individual radiosensitivity on acute reaction was especially pronounced (p = 0.00025) for lower breast volume. No such clear association with acute reaction was observed when individual radiosensitivity was assessed at 3 Gy.
Individual radiosensitivity determined at 6 Gy seems to be a good predictor for risk of acute effects after curative radiotherapy.
我们测试了体外照射淋巴细胞的染色体放射敏感性是否可用于预测放疗后急性反应的风险。
进行了两项前瞻性研究：研究A纳入了51例不同肿瘤部位的患者，研究B纳入了87例乳腺癌患者。使用放射治疗肿瘤学组评分评估急性反应。在两项研究中，患者均接受根治性放疗，研究A中平均肿瘤剂量为55 Gy（40 - 65），加量11 Gy（6 - 31）；研究B中平均肿瘤剂量为50.4 Gy，加量10 Gy。通过用3或6 Gy的X射线剂量体外照射淋巴细胞并对染色体缺失数量进行评分来确定个体放射敏感性。
急性反应呈现出典型的范围，研究A中57%的患者和研究B中53%的患者出现2 - 3级急性反应。两项研究中的个体放射敏感性均表现出很大差异，并且发现2 - 3级反应患者的比例随着在6 Gy时测量的个体放射敏感性增加而增加（研究A，p = 0.238；研究B，p = 0.023）。对于研究B，该比例随乳房体积增加，并且个体放射敏感性对急性反应的影响在较小乳房体积时尤为明显（p = 0.00025）。当在3 Gy评估个体放射敏感性时，未观察到与急性反应有如此明显的关联。
在6 Gy时确定的个体放射敏感性似乎是根治性放疗后急性效应风险的良好预测指标。
