Bonadonna G, Chiappa S, Musumeci R, Uslenghi C
Cancer. 1968 Oct;22(4):885-98. doi: 10.1002/1097-0142(196810)22:4<885::aid-cncr2820220427>3.0.co;2-t.
The authors report treatment of inguinal and retroperitoneal lymph nodes of 285 malignant lymphomas (143 Hodgkin's disease and 142 lymphoreticular sarcomas) with Lipiodol Fluide 131I (endolymphatic radiotherapy). From 1961 to 1966 the radioactive contrast material was injected in doses ranging from 0.2 to 2.5 mc/cc (10 cc each foot). Adequately opacified nodes responded promptly with marked and progressive reduction in size. When indicated, a second administration of Lipiodol 131I in a dose of 2.5 mc/cc was always feasible. Several factors prevented a homogeneous and satisfactory distribution of radioactive contrast material throughout the iliac and the para-aortic nodes in one third of the cases. Therefore, in many instances patients had to be treated with external radiation therapy. Histopathologic examination of lymph nodes removed at exploratory laparotomy (four cases) or at autopsy (ten cases) confirmed that Lipiodol 131I did not fill all the iliac and para-aortic nodes and that destruction of lymphomatous tissue was often incomplete. Recurrences were seen mostly in abnormal adequately filled nodes opacified with high doses of Lipiodol 131I. In Hodgkin's disease they occurred particularly in the para-aortic area and in lymphoreticular sarcomas in the inguinal and iliac chains. Side effects were minimal. They included amenorrhea, pulmonary insufficiency, hepatic failure and hemolytic anemia. Clinical and histologic signs of pulmonary and hepatic fibrosis were not seen. The authors conclude that endolymphatic radiotherapy should not be considered as a radical treatment for retroperitoneal adenopathies in malignant lymphomas and that its role as a prophylactic therapeutic tool deserves more extensive long-term studies.
作者报告了用碘油131I（淋巴内放射疗法）治疗285例恶性淋巴瘤（143例霍奇金病和142例淋巴网状肉瘤）的腹股沟和腹膜后淋巴结。1961年至1966年期间，放射性造影剂的注射剂量为0.2至2.5毫居里/立方厘米（每侧足部10立方厘米）。显影充分的淋巴结迅速出现反应，大小明显且逐渐缩小。如有必要，以2.5毫居里/立方厘米的剂量再次注射碘油131I总是可行的。在三分之一的病例中，有几个因素妨碍了放射性造影剂在整个髂淋巴结和腹主动脉旁淋巴结中均匀且令人满意地分布。因此，在许多情况下，患者不得不接受外照射治疗。对在剖腹探查术时切除的淋巴结（4例）或尸检时切除的淋巴结（10例）进行组织病理学检查证实，碘油131I并未充盈所有的髂淋巴结和腹主动脉旁淋巴结，并且淋巴瘤组织的破坏往往不完全。复发大多见于用高剂量碘油131I显影充分的异常淋巴结。在霍奇金病中，复发尤其发生在腹主动脉旁区域，而在淋巴网状肉瘤中，复发则发生在腹股沟和髂淋巴结链。副作用极小。包括闭经、肺功能不全、肝功能衰竭和溶血性贫血。未见到肺和肝纤维化的临床和组织学征象。作者得出结论，淋巴内放射疗法不应被视为恶性淋巴瘤腹膜后腺病的根治性治疗方法，其作为预防性治疗工具的作用值得进行更广泛的长期研究。
