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百日咳的放射治疗:历史评估

Radiotherapy for Pertussis: An Historical Assessment.

作者信息

Calabrese Edward J, Dhawan Gaurav, Kapoor Rachna

机构信息

Environmental Health Sciences, University of Massachusetts, Amherst, MA, USA.

Research Compliance, University of Massachusetts, Mass Venture Center, Hadley, MA, USA.

出版信息

Dose Response. 2017 May 8;15(2):1559325817704760. doi: 10.1177/1559325817704760. eCollection 2017 Apr-Jun.

Abstract

X-ray therapy was used to treat pertussis/whooping cough during a 13-year period from 1923 to 1936 in North America and Europe. Twenty studies from clinicians in the United States reported that approximately 1500 cases of pertussis were treated by X-ray therapy usually with less than 0.5 erythema dose. Young children (<3 years) comprised about 70% to 80% of the cases, with the age of cases ranging from as young as 1 month to 50 years. In general, symptoms of severe coughing, vomiting episodes, and spasms were significantly relieved in about 85% of cases following up to 3 treatments, while about 15% of the cases showed nearly full relief after only 1 treatment. The X-ray therapy was also associated with a marked reduction in mortality of young (<3 years) children by over 90%. Despite such reported clinical success from a wide range of experienced researchers, the use of X-rays for the treatment of pertussis in young children was controversial, principally due to concerns of exposure to the thymus and thyroid even with the availability of lead shielding. By the mid-1930s, the treatment of pertussis cases via vaccine therapy came to dominate the therapeutic arena, and the brief era of a radiotherapy option for the treatment of pertussis ended.

摘要

1923年至1936年的13年间,北美和欧洲使用X射线疗法治疗百日咳。美国临床医生的20项研究报告称,约1500例百日咳患者接受了X射线疗法治疗,通常使用的红斑剂量小于0.5。幼儿(<3岁)约占病例的70%至80%,病例年龄范围从1个月至50岁。一般来说,在接受多达3次治疗后,约85%的病例中严重咳嗽、呕吐发作和痉挛症状得到显著缓解,而约15%的病例仅接受1次治疗后症状几乎完全缓解。X射线疗法还使幼儿(<3岁)的死亡率显著降低了90%以上。尽管众多经验丰富的研究人员报告了这样的临床成功,但使用X射线治疗幼儿百日咳仍存在争议,主要是因为即使有铅屏蔽,人们仍担心会暴露于胸腺和甲状腺。到20世纪30年代中期,通过疫苗疗法治疗百日咳病例开始主导治疗领域,百日咳放射治疗选择的短暂时代结束了。

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