Burger P C, Mahley M S, Dudka L, Vogel F S
Cancer. 1979 Oct;44(4):1256-72. doi: 10.1002/1097-0142(197910)44:4<1256::aid-cncr2820440415>3.0.co;2-t.
To investigate the pathologic consequences of therapeutic radiation, this morphologic study evaluated the brains of 25 patients with intracranial gliomas treated both with and without this form of therapy. Although beneficial effects such as the retardation of tumor growth were evident in these studies, among the seventeen patients who received from 5000--6000 rads for malignant gliomas, four developed "late delayed" radiation necrosis. The strong predilection of this tissue response for the white matter adjacent to the neoplasm suggests a local sensitivity which may have been engendered or enhanced by cerebral edema. A fifth case disclosed focal demyelination in the mid-brain suggesting "early delayed" radiation necrosis, and an additional case had distinctive foci of necrosis within the brain stem. Changes of diffuse cerebral edema were noted in many of the radiated brains. It is concluded that radiation therapy in commonly employed dosages for malignant gliomas carries a risk of injury to surrounding cerebral tissues.
为了研究放射治疗的病理后果，这项形态学研究评估了25例接受或未接受这种治疗方式的颅内胶质瘤患者的大脑。尽管在这些研究中肿瘤生长延缓等有益效果明显，但在17例接受5000 - 6000拉德治疗恶性胶质瘤的患者中，有4例出现了“晚期延迟”放射性坏死。这种组织反应对肿瘤邻近白质的强烈偏好表明存在局部敏感性，这可能是由脑水肿引起或增强的。第五例显示中脑局灶性脱髓鞘，提示“早期延迟”放射性坏死，另外一例在脑干内有独特的坏死灶。在许多接受放疗的大脑中都观察到弥漫性脑水肿的变化。得出的结论是，用于恶性胶质瘤的常用剂量放射治疗存在损伤周围脑组织的风险。
