低剂量脾脏照射治疗症状性充血性脾肿大：5例报告并文献资料分析
Low-dose splenic irradiation in symptomatic congestive splenomegaly: report of five cases with literature data.
作者信息
Bruns Frank, Bremer Michael, Dettmer Arne, Janssen Stefan
机构信息
Department of Radiation Oncology, Hannover Medical School, 30625 Hannover, Germany.
出版信息
Radiat Oncol. 2014 Mar 27;9:86. doi: 10.1186/1748-717X-9-86.
BACKGROUND
To show effectiveness of low-dose splenic irradiation in symptomatic congestive splenomegaly.
METHODS
Five patients were referred to our department for symptomatic congestive splenomegaly within three years. Primary diseases were autoimmune hepatitis with liver cirrhosis (n=2), cystic fibrosis (n=1), granulomatous liver disease (n=1) and Werlhof disease with liver cirrhosis (n=1). Mean age was 54 years (range: 36-67). Patients received splenic irradiation with a total dose of 3 Gy (single dose: 0.5 Gy). One patient was re-irradiated after long-term failure with the same treatment schedule.
RESULTS
In four patients long term relief of splenic pain could be observed during the follow-up time of median 20 (range: 2-36) months. Four patients showed haematological response after irradiation with an increase of erythrocytes, leucocytes and/or platelets. A slightly decrease in spleen size was found in two patients.
CONCLUSIONS
Low-dose splenic irradiation in symptomatic congestive splenomegaly is feasible and perhaps as effective as in lympho-and myeloproliferative malignancies regarding pain relief and haematological response.
背景
为了证明低剂量脾脏照射对有症状的充血性脾肿大的有效性。
方法
三年内，五名有症状的充血性脾肿大患者被转诊至我科。原发性疾病包括自身免疫性肝炎伴肝硬化（n = 2）、囊性纤维化（n = 1）、肉芽肿性肝病（n = 1）和韦尔霍夫病伴肝硬化（n = 1）。平均年龄为54岁（范围：36 - 67岁）。患者接受了总剂量为3 Gy（单次剂量：0.5 Gy）的脾脏照射。一名患者在长期治疗失败后按照相同治疗方案再次接受照射。
结果
在中位随访时间20个月（范围：2 - 36个月）内，观察到四名患者的脾脏疼痛得到长期缓解。四名患者照射后出现血液学反应，红细胞、白细胞和/或血小板增加。两名患者的脾脏大小略有减小。
结论
低剂量脾脏照射治疗有症状的充血性脾肿大是可行的，在缓解疼痛和血液学反应方面可能与淋巴细胞和骨髓增殖性恶性肿瘤的治疗效果相当。
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