Sakai N, Nakatani K, Shirakami S, Araki Y, Iamo Y, Nishimura Y, Andoh T, Yamada H, Yanagawa S
Department of Neurosurgery, Gifu University School of Medicine, Japan.
No To Shinkei. 1990 Feb;42(2):161-6.
Delayed effects of radiation therapy (RT) on twenty patients with germ-cell tumors, including 17 cases of germinoma, were evaluated with special reference to cerebral blood flow (CBF). All patients except for one of germinoma had craniotomy to verify the tumor histology, then RT followed with a total dose of 39.6 to 60 Gy for each patient. A follow-up study with CT scans and MRI proved not any recurrence of the tumors during the past 14-year period between June, 1975 and April, 1989. On the other hand, CBF was measured by 133Xe inhalation 1 to 14 years after RT. 40% of all patients were below critical values of CBF with higher frequency in the younger. Statistically, the post-irradiated changes of CBF were not related to a total administered dose, grading of brain atrophy, or physical mental developments, but closely related to irradiated volume dose (product of absorbed dose and field, rad.cm3) only for the age ranging from 8 to 15 years at RT. These results suggested that late effects of RT on CBF were more strongly depend upon absorbed dose and field of irradiation to brain in children than in adolescents.
对20例生殖细胞肿瘤患者(包括17例生殖细胞瘤)放射治疗(RT)的迟发效应进行了评估,特别参考了脑血流量(CBF)。除1例生殖细胞瘤患者外,所有患者均接受开颅手术以核实肿瘤组织学,然后进行RT,每位患者的总剂量为39.6至60 Gy。在1975年6月至1989年4月的过去14年期间,通过CT扫描和MRI进行的随访研究未发现肿瘤复发。另一方面,在RT后1至14年通过吸入133Xe测量CBF。所有患者中有40%低于CBF的临界值,且在较年轻患者中频率更高。从统计学上看,放疗后CBF的变化与总给药剂量、脑萎缩分级或身心发育无关,但仅对于RT时年龄在8至15岁的患者,与照射体积剂量(吸收剂量与照射野的乘积,rad.cm3)密切相关。这些结果表明,RT对CBF的迟发效应在儿童中比在青少年中更强烈地取决于对脑的吸收剂量和照射野。