Langlois D, Le Bourgeois J P, Leung S, Kuentz M
Radiother Oncol. 1985 Jun;3(4):293-8. doi: 10.1016/s0167-8140(85)80041-4.
We report bowel complications on a series of 32 patients treated with wide field abdominal irradiation for lymphoma between 1979 and 1983. Irradiation was preceded by chemotherapy in 30/32 patients. Fifteen of the 32 patients received total abdominal irradiation and 17/32 received upper hemi-abdominal irradiation to a dose of 20-25 Gy. A boost of 5-20 Gy to a reduced volume was added in 14/32. A special diet was prescribed from the start of irradiation. Immediate tolerance to irradiation was good in 94% of patients. Only five patients developed delayed bowel complications. Definite radiation-induced bowel changes were demonstrated in only two of these cases and other pathology was found to explain the symptomatology in the remaining three. Comparison with a previous series of 50 lymphoma patients treated with total abdominal irradiation to 30 Gy plus inverted Y boost to 10 Gy demonstrated a net improvement in the immediate tolerance and reduction in the incidence and gravity of delayed radiation-related bowel complications in the current series. The reasons for the improved early and late bowel tolerance (radiation dose and volume, etc.) as well as conditions which can mimic late radiation enteritis, will be discussed.
我们报告了1979年至1983年间接受全腹大面积照射治疗淋巴瘤的32例患者出现的肠道并发症。32例患者中有30例在照射前接受了化疗。32例患者中15例接受了全腹照射，17例接受了上腹半腹照射，剂量为20 - 25 Gy。32例中有14例对缩小体积部位追加了5 - 20 Gy的增强照射。从照射开始就规定了特殊饮食。94%的患者对照射的即时耐受性良好。只有5例患者出现了迟发性肠道并发症。其中仅2例证实有明确的放射性肠道改变，其余3例发现有其他病理情况可解释其症状。与先前一组50例接受30 Gy全腹照射加10 Gy倒Y形增强照射的淋巴瘤患者相比，本系列患者的即时耐受性有明显改善，迟发性放射性相关肠道并发症的发生率和严重程度有所降低。将讨论肠道早期和晚期耐受性改善的原因（辐射剂量和体积等）以及可能模拟晚期放射性肠炎的情况。
