Department of Radiation Oncology, Kyung Hee University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2010 Dec;25(12):1742-7. doi: 10.3346/jkms.2010.25.12.1742. Epub 2010 Nov 24.
Bleeding into joint space is critical to develop hemophilic arthropathy. To reduce the frequency of bleeding in the ankle joint of children with hemophilic arthropathy, low dose external beam irradiation was performed for 37 patients. Among them, 35 patients followed-up for longer than 1 yr (median 87 months) were enrolled for analysis. The average number of bleedings per month was 3.6 during one year prior to radiation therapy. After radiation therapy, it was decreased to 2.1 during the first year, after then it was maintained in the range of 1.0 to 1.5 until the tenth year. The bleeding frequency was reduced to 42% at the first year and it was maintained in the range of 58% to 73% from the second to the tenth year. Especially the patients who had 3 or more bleedings per month, and who had MRI score more than 3 showed significant decreases. During the follow-up period, growth disturbances and secondary malignancies were not found. External beam radiotherapy can be considered for the hemophilic patients with surgical or isotope therapies are not amenable.
关节内出血是导致血友病性关节病的关键因素。为了减少儿童血友病性关节病踝关节出血的频率，对 37 名患者进行了低剂量外照射治疗。其中，35 名患者随访时间超过 1 年（中位数为 87 个月），进行了分析。在放射治疗前的 1 年中，每月出血次数平均为 3.6 次。放射治疗后，第一年减少到 2.1 次，之后在 1.0 到 1.5 次之间维持，直到第十年。出血频率在第一年降低到 42%，从第二年到第十年维持在 58%到 73%的范围内。特别是那些每月出血 3 次以上，MRI 评分大于 3 的患者，出血明显减少。在随访期间，未发现生长障碍和继发性恶性肿瘤。对于不适合手术或同位素治疗的血友病患者，可以考虑外照射治疗。
