Sindelar W F, Hoekstra H J, Kinsella T J, Barnes M, DeLuca A M, Tochner Z, Pass H I, Kranda K C, Terrill R E
Surgery Branch, National Cancer Institute, Bethesda, MD 20892.
Int J Radiat Oncol Biol Phys. 1988 Sep;15(3):663-9. doi: 10.1016/0360-3016(88)90309-4.
Tolerance of esophagus to intraoperative radiotherapy (IORT) was investigated in dogs. Thirteen adult foxhounds were subjected to right thoractomy, mobilization of the intrathoracic esophagus, and IORT to a 6 cm full-thickness esophageal segment using 9 MeV electrons at doses of 0, 2,000, or 3,000 cGy. Dogs were followed clinically and were evaluated at regular intervals after treatment with fiberoptic esophagoscopy, barium swallows, and postmortem histologic evaluations. One sham-irradiated control dog showed no abnormalities during follow-up of 24 months. Seven dogs receiving 2,000 cGy IORT showed transient mild dysphagia and mild esophagitis, but no clinically or pathologically significant complications. Five dogs receiving 3,000 cGy demonstrated severe ulcerative esophagitis within 6 weeks of treatment which progressed to chronic ulcerative esophagitis with stricture formation by 9 months following IORT. One 3,000 cGy dog died at 13 months from an esophageal perforation. On the basis of a pilot experience using 13 experimental animals, it was concluded that intact canine esophagus tolerates IORT well to doses of 2,000 cGy, but doses of 3,000 cGy pose serious and potentially lethal risks. The clinical application of IORT to the treatment of human intrathoracic neoplasms requiring esophageal irradiation should be approached with caution, particularly at doses exceeding 2,000 cGy.
对犬类食管术中放疗（IORT）的耐受性进行了研究。13只成年猎狐犬接受了右胸切开术、胸段食管游离，并使用9兆电子伏特电子对6厘米全层食管段进行IORT，剂量分别为0、2000或3000厘戈瑞。对犬类进行临床随访，并在治疗后定期通过纤维食管镜检查、吞钡检查和死后组织学评估进行评估。1只假照射对照犬在24个月的随访期间未出现异常。7只接受2000厘戈瑞IORT的犬出现短暂轻度吞咽困难和轻度食管炎，但无临床或病理上显著的并发症。5只接受3000厘戈瑞照射的犬在治疗后6周内出现严重溃疡性食管炎，在IORT后9个月进展为伴有狭窄形成的慢性溃疡性食管炎。1只接受3000厘戈瑞照射的犬在13个月时死于食管穿孔。基于使用13只实验动物的初步经验，得出结论：完整的犬食管对2000厘戈瑞的IORT耐受性良好，但3000厘戈瑞的剂量会带来严重且潜在致命的风险。IORT在治疗需要食管照射的人类胸内肿瘤中的临床应用应谨慎对待，尤其是在剂量超过2000厘戈瑞时。
