Guiney M J, Liew K H, Quong G G, Cooper I A
Department of Haematology and Oncology, Peter MacCallum Cancer Institute, Melbourne, Australia.
Int J Radiat Oncol Biol Phys. 1989 Jan;16(1):225-9. doi: 10.1016/0360-3016(89)90035-7.
A retrospective study was performed to assess the effect of splenic irradiation (SI) on splenomegaly, splenic pain, anemia, and thrombocytopenia in patients with chronic lymphocytic leukemia. Twenty-two patients received 32 courses of SI. Of 31 courses of SI given for splenomegaly there were 19 responders (61%). Ten courses of SI were given for splenic pain resulting in partial relief of pain in 4 courses and complete relief in 4 courses. Only 4 of 16 courses given for anemia resulted in elevations of hemaglobin of 2 g/dL or more. Of the 14 courses of SI given for thrombocytopenia there were only 2 responses with platelet counts decreasing further in another 9 courses. The median duration of response was 14 months (range: 3-116 months). There was no dose-response relationship detected for SI in CLL. Treatment related toxicity was hematologic and secondary to leucopenia and thrombocytopenia. We recommend the use of small fraction sizes of 25 cGy to 50 cGy and close monitoring of hematological parameters. Splenic irradiation effectively palliates splenomegaly and reduces spleen size in CLL. It was of limited value in correcting anemia and thrombocytopenia in this patient population.
开展了一项回顾性研究，以评估脾照射（SI）对慢性淋巴细胞白血病患者脾肿大、脾区疼痛、贫血和血小板减少的影响。22例患者接受了32疗程的脾照射。在针对脾肿大进行的31疗程脾照射中，有19例有反应（61%）。针对脾区疼痛进行了10疗程脾照射，4疗程疼痛部分缓解，4疗程疼痛完全缓解。针对贫血进行的16疗程脾照射中，只有4疗程血红蛋白升高2 g/dL或更多。针对血小板减少进行的14疗程脾照射中，只有2例有反应，另有9疗程血小板计数进一步下降。反应的中位持续时间为14个月（范围：3 - 116个月）。在慢性淋巴细胞白血病中未检测到脾照射的剂量反应关系。治疗相关毒性为血液学毒性，继发于白细胞减少和血小板减少。我们建议采用25 cGy至50 cGy的小分割剂量，并密切监测血液学参数。脾照射可有效缓解慢性淋巴细胞白血病患者的脾肿大并减小脾脏大小。在纠正该患者群体的贫血和血小板减少方面价值有限。
