Habibollahi F, Mayles H M, Mayles W P, Winter P J, Tong D, Fentiman I S, Chaudary M A, Hayward J L
ICRF, Department of Clinical Oncology, Guy's Hospital, London.
Int J Radiat Oncol Biol Phys. 1988 Feb;14(2):291-6. doi: 10.1016/0360-3016(88)90435-x.
A conservation technique has been developed for the treatment of early breast cancer which involved removal of the tumor, axillary clearance, tumor site implantation with Iridium-192 wires for a boost dose and subsequent treatment of the breast with radical megavoltage external beam therapy. Although the cosmetic results were satisfactory in the majority of the patients, for some it was rated as fair or poor. One variable factor which could have carried some morbidity was the dose of radiation received by the skin. In 51 patients, doses were measured at several points over the treated breast using Thermoluminescent Dosimetry (TLD) at the time of the iridium implant and during the subsequent external beam therapy. Development of skin pigmentation, oedema, and fibrosis were unrelated to the dose received by the skin but the findings suggested that doses greater than 50 Gy to the skin increased the possibility of late (greater than 24 months) telangiectasia over the boosted area. Treatment of tumors in the lower half of the breast, or in large breasts, was associated with a higher incidence of poor cosmesis. This may have been the result of varying posture on the interstitial dose distribution from the Iridium-192 wires and comparison of dose distribution in both supine and erect positions was carried out.
已经开发出一种用于治疗早期乳腺癌的保守技术，该技术包括切除肿瘤、腋窝清扫、在肿瘤部位植入铱 - 192 线以增加剂量，随后用根治性兆伏级外照射治疗乳房。尽管大多数患者的美容效果令人满意，但对一些患者来说，美容效果被评为一般或较差。一个可能带来一些并发症的可变因素是皮肤接受的辐射剂量。在 51 名患者中，在植入铱时以及随后的外照射治疗期间，使用热释光剂量测定法（TLD）在治疗的乳房上的几个点测量剂量。皮肤色素沉着、水肿和纤维化的发展与皮肤接受的剂量无关，但研究结果表明，皮肤接受大于 50 Gy 的剂量会增加增强区域后期（大于 24 个月）出现毛细血管扩张的可能性。乳房下半部分或大乳房中的肿瘤治疗与较差美容效果的发生率较高有关。这可能是由于铱 - 192 线间质剂量分布的姿势变化所致，并对仰卧位和直立位的剂量分布进行了比较。
