Eichhorn H J
Strahlenther Onkol. 1988 Aug;164(8):457-65.
A survey of literature shows that systemic radiotherapy, given as low dose total body irradiation, offers the same healing results in malignant systemic diseases as tumor chemotherapy. Single high dose half body doses are even effective against less sensitive organ cancers. The problem involved is the tolerance of the lung (fatal radiopneumonitis). The considerations made about the mode of action of ionizing radiation and cytostatic combinations result in clinical assays aiming at the establishment of a systemic radiotherapy based on sequential half body irradiation as an alternative to palliative or adjuvant cytostatic therapy. The advantage of this treatment would lie in the negligible subjective side effects, the great saving of time, and the moderate expense. The most important target of these pilot studies was in increase the pulmonary tolerance. 78 patients with small cell bronchial carcinomas, divided into four groups, are treated by different half body irradiation modalities: interruption of the single dose for 5 hours, small superfractionated additional doses conserving the principle of the high single dose.
the possibility to increase the tolerance dose of the lung by 33% and, at the same time, to spare the bone marrow is demonstrated. No (negative) influence of the different irradiation modalities on the different irradiation modalities on the primary tumor is found (by histological examination). The median survival times of the irradiation series are 56 to 64 weeks (for "LD" patients) which lies within the scope of modern chemotherapy results. These pilot studies confirm the efficacy of sequential half body irradiations in systemic tumor therapy. The author give some recommendations how to extend this method.
文献调查显示,全身放疗作为低剂量全身照射,在恶性全身性疾病中的治疗效果与肿瘤化疗相同。单次高剂量半身照射甚至对敏感性较低的器官癌症有效。所涉及的问题是肺的耐受性(致命性放射性肺炎)。对电离辐射和细胞抑制剂联合作用方式的考虑导致了临床研究,旨在建立一种基于序贯半身照射的全身放疗方法,作为姑息性或辅助性细胞抑制剂治疗的替代方案。这种治疗方法的优点在于主观副作用可忽略不计、节省大量时间且费用适中。这些初步研究的最重要目标是提高肺的耐受性。78例小细胞支气管癌患者被分为四组,采用不同的半身照射方式进行治疗:单次剂量中断5小时、小剂量超分割附加剂量并保留高单次剂量原则。
证明了将肺的耐受剂量提高33%并同时保护骨髓的可能性。未发现不同照射方式对原发性肿瘤有(负面)影响(通过组织学检查)。照射系列的中位生存时间为56至64周(“LD”患者),处于现代化疗结果范围内。这些初步研究证实了序贯半身照射在全身肿瘤治疗中的疗效。作者给出了一些关于如何扩展该方法的建议。