Schewe K L, Reavis J, Kun L E, Cox J D
Medical College of Wisconsin, Milwaukee.
Int J Radiat Oncol Biol Phys. 1988 Jul;15(1):25-8. doi: 10.1016/0360-3016(88)90342-2.
There are important uncertainties in the radiation therapy of Hodgkin's disease. These uncertainties are related to dose-fractionation and total dose necessary to control subclinical disease (prophylactic irradiation), small-size tumors, and especially bulky tumors such as those frequently encountered in the mediastinum. Data are lacking on total dose and tumor control as a function of tumor volume. A retrospective study was undertaken of patients with Hodgkin's disease Stages I-III treated with radiation therapy alone at the Medical College of Wisconsin Affiliated Hospitals between 1970 and 1982. Detailed dose calculations of off-axis points were made to assign precise minimum doses to 1,304 separate lymph node regions. Treatment volumes received individual fractions of 150 cGy to 300 cGy and total doses of 30 Gy to 42 Gy. Tumor control was correlated with tumor size at presentation, fractionation schedule, and total dose. The results confirm the absence of a dose-response relationship for tumor control, between 30 Gy and 42 Gy total dose. In addition, there is no apparent difference in total dose required for larger tumors relative to that required for small tumors.
霍奇金病的放射治疗存在重要的不确定性。这些不确定性与剂量分割以及控制亚临床疾病（预防性照射）、小尺寸肿瘤，尤其是纵隔常见的大体积肿瘤所需的总剂量有关。目前缺乏关于总剂量和肿瘤控制与肿瘤体积关系的数据。对1970年至1982年期间在威斯康星医学院附属医院仅接受放射治疗的I - III期霍奇金病患者进行了一项回顾性研究。对离轴点进行了详细的剂量计算，以便为1304个单独的淋巴结区域精确分配最小剂量。治疗体积接受的单次剂量为150 cGy至300 cGy，总剂量为30 Gy至42 Gy。肿瘤控制与就诊时的肿瘤大小、分割方案和总剂量相关。结果证实，在总剂量30 Gy至42 Gy之间，肿瘤控制不存在剂量反应关系。此外，相对于小肿瘤，大肿瘤所需的总剂量没有明显差异。
