Ohtomo K, Shuman W P, Griffin B R, Teefey S A, Larnmore G E, Moss A A
Department of Radiation Oncology, University of Washington Hospital, Seattle.
Radiat Med. 1988 May-Jun;6(3):130-4.
Sixty-nine chest CT studies of 36 patients with lung cancer were obtained at various times (21 to 649 days) following completion of fast neutron radiotherapy. Multiple scans (2 to 7) were available in 16 cases. Fractionated neutron radiotherapy was delivered over four to seven weeks to a total dose of 60 to 67 Gy photon equivalent. Parenchymal change within the lung was noted in 43% by 12 weeks, in 91% between 12 and 24 weeks, and in 100% after 24 weeks. Three different patterns of lung parenchymal change were evident. Ectatic air-filled bronchi were observed in more than 50% after 24 weeks. Mediastinal shift and thoracic shrinkage were demonstrated in six and three cases, respectively. Serial CT scans revealed that lung parenchymal changes usually became stable or shrunk after 36 weeks. The possible effect of chemotherapy (mitomycin-C, vinblastin and cis-platinum), in 19 of these patients is also discussed.
对36例肺癌患者在快中子放射治疗结束后的不同时间（21至649天）进行了69次胸部CT检查。16例患者可获得多次扫描（2至7次）。分次中子放射治疗在4至7周内进行，总剂量为60至67 Gy光子等效剂量。12周时肺部实质改变的比例为43%，12至24周时为91%，24周后为100%。明显出现了三种不同类型的肺实质改变。24周后超过50%的患者观察到扩张的含气支气管。分别有6例和3例出现纵隔移位和胸廓缩小。连续CT扫描显示，肺实质改变通常在36周后趋于稳定或缩小。还讨论了其中19例患者接受化疗（丝裂霉素-C、长春碱和顺铂）的可能效果。
