Imperato J P, Folkman J, Sagerman R H, Cassady J R
Cancer. 1986 Jun 1;57(11):2127-9. doi: 10.1002/1097-0142(19860601)57:11<2127::aid-cncr2820571107>3.0.co;2-o.
Plasma cell granuloma is a rare, benign tumor that affects people at all ages and most frequently involves the lung, gastrointestinal tract, and salivary gland. They are the most common, isolated, primary lesion of the lung in children less than 16 years of age, and usually present as circumscribed, peripheral, parenchymal tumors, which may be static or increase slowly in size without causing symptoms. Whereas surgical excision is the treatment of choice, there are situations in which the lesion cannot be resected without significant morbidity because of direct extension into the mediastinum or lymph nodes. In these circumstances, radiation therapy may be a better therapeutic option. Two cases of plasma cell granuloma that could not be completely resected are described. The patients were treated with radiation therapy consisting of 4320 rad in 4.5 weeks and 4500 rads in 4.5 weeks, respectively, and both have been cured. Although surgery as the primary treatment for most patients is still recommended, especially in the young so the potential side effects of radiation therapy can be avoided, the authors believe that in rare cases where the lesion is locally aggressive and surgically unresectable or resectable only with major morbidity, radiation therapy can be an effective alternative. Currently, the recommended treatment is 4000 to 4500 rad given in 180 to 200 rad fractions, with the fields being carefully tailored to tumor volume in order to minimize the dose to the surrounding normal tissue.
浆细胞肉芽肿是一种罕见的良性肿瘤，可发生于各年龄段人群，最常累及肺部、胃肠道和唾液腺。在16岁以下儿童中，它们是肺部最常见的孤立性原发性病变，通常表现为边界清晰的外周实质性肿瘤，可能静止不变或缓慢增大而不引起症状。虽然手术切除是首选治疗方法，但在某些情况下，由于病变直接侵犯纵隔或淋巴结，若不造成严重并发症则无法切除。在这些情况下，放射治疗可能是更好的治疗选择。本文描述了两例无法完全切除的浆细胞肉芽肿病例。患者分别接受了4.5周内4320拉德和4.5周内4500拉德的放射治疗，均已治愈。尽管对于大多数患者，尤其是年轻人，仍建议首选手术治疗以避免放射治疗的潜在副作用，但作者认为，在罕见情况下，若病变具有局部侵袭性且无法手术切除或仅能在造成严重并发症的情况下切除，放射治疗可作为一种有效的替代方法。目前，推荐的治疗方案是给予4000至4500拉德，分180至200拉德分次照射，照射野要根据肿瘤体积精心调整，以尽量减少对周围正常组织的剂量。
