Henderson R H, Parsons J T, Morgan L, Million R R
Int J Radiat Oncol Biol Phys. 1984 Jun;10(6):811-9. doi: 10.1016/0360-3016(84)90381-x.
Most radiologists accept that modest doses of irradiation (4500-5000 rad/4 1/2-5 weeks) can control subclinical regional lymph node metastases from squamous cell carcinomas of the head and neck and adenocarcinomas of the breast. There have been few reports concerning elective irradiation of the ilioinguinal region. Between October 1964 and March 1980, 91 patients whose primary cancers placed the ilioinguinal lymph nodes at risk received elective irradiation at the University of Florida. Included are patients with cancers of the vulva, penis, urethra, anus and lower anal canal, and cervix or vaginal cancers that involved the distal one-third of the vagina. In 81 patients, both inguinal areas were clinically negative; in 10 patients, one inguinal area was positive and the other negative by clinical examination. Tumor doses most commonly used were 4500-5000 rad/5 weeks (180 rad to 200 rad per fraction). With a minimum two-year follow-up, there were only two regional failures in patients whose primaries were controlled; both failures occurred outside of the radiation fields. The single significant complication was a bilateral femoral neck fracture. The inguinal areas of four patients developed mild to moderate fibrosis. One patient with moderate fibrosis had bilateral mild leg edema that was questionably related to irradiation. No other instances of leg or genital edema were noted. Complications were dose-related. The advantages and disadvantages of elective ilioinguinal node irradiation versus elective inguinal lymph node dissection or no elective treatment are discussed.
大多数放射科医生都认为，适度剂量的辐射（4500 - 5000拉德/4.5 - 5周）能够控制头颈部鳞状细胞癌和乳腺癌亚临床区域淋巴结转移。关于髂腹股沟区选择性放疗的报道较少。1964年10月至1980年3月期间，91例原发性癌症使髂腹股沟淋巴结有转移风险的患者在佛罗里达大学接受了选择性放疗。这些患者包括患有外阴癌、阴茎癌、尿道癌、肛门癌和低位肛管癌的患者，以及累及阴道远端三分之一的宫颈癌或阴道癌患者。81例患者双侧腹股沟区临床检查均为阴性；10例患者临床检查发现一侧腹股沟区阳性，另一侧阴性。最常用的肿瘤剂量为4500 - 5000拉德/5周（每次分割剂量为180拉德至200拉德）。经过至少两年的随访，在原发肿瘤得到控制的患者中，仅出现两例区域复发；两例复发均发生在放疗野之外。唯一显著的并发症是双侧股骨颈骨折。4例患者的腹股沟区出现轻度至中度纤维化。1例有中度纤维化的患者双侧下肢轻度水肿，这与放疗的关系存疑。未发现其他下肢或生殖器水肿的情况。并发症与剂量相关。文中讨论了髂腹股沟淋巴结选择性放疗与腹股沟淋巴结选择性清扫或不进行选择性治疗相比的优缺点。
