Mikuriya S, Kamimura S, Kato T, Ooami H, Oda T
Gan No Rinsho. 1983 Oct;29(13):1521-36.
There are several opinions which denied therapeutic effects of preoperative irradiation, however, we have obtained favorable results by preoperative irradiation for the advanced breast and stomach cancers. Because we treated them by less-fractionated irradiation method with a large dose instead of conventional fractionated one. We adopted this kind of radiation method for the purpose of enhancing the antigenicity of the cancer cells (that means to inhibit the suppression of immune reaction in hosts). Cases of advanced breast cancer were irradiated with 30 Gy at once or 10 Gy at three times a week (total 30 Gy) by betatron electron and we treated advanced stomach cancer with twice a week method (5 Gy or 3 Gy each time, total 40 Gy) by 6 MV X-ray. Cellular infiltration into the stroma of malignant tumor is able to be considered as cellular immunity of the tumor. The same reaction could be observed in radiotherapy for cancer by using above method. After preoperative irradiation, we examined the resected specimen histopathologically. Remarkable cellular infiltrations into the tumor nests, such as neutrophils, lymphocytes, macrophages and plasma cells were observed and these cellular infiltrations after the preoperative irradiation were more remarkable than the cases without radiotherapy or with conventional fractionated radiotherapy. The abscopal effects could be seen in several cases. Peripheral lymphocytes, T cells, B cells and blastoid formation rate induced by PHA in vitro were all increased after less-fractionated irradiation. The reaction to 4 kinds of immunological skin tests was also enhanced.
有几种观点否认术前放疗的治疗效果,然而,我们通过对晚期乳腺癌和胃癌进行术前放疗取得了良好的效果。因为我们采用大剂量少分割照射方法治疗,而不是传统的分割照射方法。我们采用这种放疗方法的目的是增强癌细胞的抗原性(即抑制宿主免疫反应的抑制)。晚期乳腺癌病例用电子感应加速器一次照射30 Gy或每周三次,每次10 Gy(共30 Gy),我们用6 MV X射线每周两次(每次5 Gy或3 Gy,共40 Gy)的方法治疗晚期胃癌。恶性肿瘤间质中的细胞浸润可被视为肿瘤的细胞免疫。用上述方法进行癌症放疗时也能观察到同样的反应。术前放疗后,我们对切除的标本进行了组织病理学检查。观察到肿瘤巢中有显著的细胞浸润,如中性粒细胞、淋巴细胞、巨噬细胞和浆细胞,术前放疗后的这些细胞浸润比未放疗或采用传统分割放疗的病例更显著。在一些病例中可以看到远隔效应。少分割照射后,外周血淋巴细胞、T细胞、B细胞以及体外PHA诱导的母细胞形成率均增加。对4种免疫皮肤试验的反应也增强了。