Loeffler R K
Am J Clin Oncol. 1983 Dec;6(6):619-27.
When major volumes of the abdomen are the tolerable dose is frequently limited by the tolerance of the small intestine and other gastrointestinal tissues. In an attempt to increase the tolerable dose, a twice-daily, 5 day/week fractionation scheme was used. One hundred and thirty-nine patients were started on treatment for abdominal and pelvic malignancies, of whom 124 received the planned dose, usually in the prescribed time. Fifty-five hundred to 6000 rad in about 8 weeks was administered to large volumes of the pelvis and abdomen, frequently with "boost" radiation to 7500 rad to limited volumes. Ninety percent of the patients were able to complete treatment without interruption. In 90% of all cases there were no late radiation-related complications. The acute reactions and late complications have been comparable to those incurred when total doses 20-30% less are administered with one fraction per day. The survival rates of these patients indicates a probable improvement in therapeutic ratio. The physical techniques, areas treated, and time-dose sequence are described. A detailed analysis by primary organ, patient characteristics, performance status, types of complications, cause of death, and survival characteristics is presented.
当腹部大体积组织接受照射时，可耐受剂量常常受小肠和其他胃肠道组织耐受性的限制。为了提高可耐受剂量，采用了每周5天、每天2次的分割方案。139例患者开始接受腹部和盆腔恶性肿瘤的治疗，其中124例按计划剂量接受治疗，通常在规定时间内完成。在约8周内，对盆腔和腹部的大体积组织给予5500至6000拉德的照射，对局部体积常常追加照射至7500拉德。90%的患者能够不间断地完成治疗。在所有病例中，90%没有出现晚期放射性相关并发症。急性反应和晚期并发症与每天照射1次、总剂量减少20% - 30%时所发生的情况相当。这些患者的生存率表明治疗比可能有所提高。文中描述了物理技术、治疗区域以及时间 - 剂量顺序。还给出了按主要器官、患者特征、身体状况、并发症类型、死亡原因和生存特征进行的详细分析。
