Peacock L M, Leavitt D D, Gibbs F A, Stewart J R
Int J Radiat Oncol Biol Phys. 1984 Nov;10(11):2149-53. doi: 10.1016/0360-3016(84)90216-5.
In order to overcome the technical problems commonly encountered in fixed field photon and electron beam chest wall irradiation, we have treated the chest wall in 22 breast cancer patients with a moving electron beam that rotates about the patient's thorax. This paper discusses the clinical results of chest wall treatment by electron arc therapy. Twenty-one patients were treated following mastectomy, 16 electively because of high risk for local failure, and 5 because of local recurrence. One patient with advanced local-regional disease was treated primarily. During a median follow-up period of 24 months there has been one chest failure in one of the patients treated for local recurrence. No major complications were observed in skin, lung, soft tissue or esophagus, even in the 7 patients recently or concomitantly treated with multiagent cytotoxic chemotherapy. In 3 patients, small areas of telangiectasia developed in the region of abutment of the electron arc field to a photon field used to irradiate the supraclavicular nodal area. We conclude that the technique as applied to these patients is safe and efficacious. In certain clinical settings it has advantage over standard, fixed field approaches to treat the chest wall.
为了克服在固定野光子和电子束胸壁照射中常见的技术问题，我们采用围绕患者胸部旋转的移动电子束对22例乳腺癌患者的胸壁进行了治疗。本文讨论了电子弧形治疗胸壁的临床结果。21例患者在乳房切除术后接受治疗，其中16例因局部复发风险高而进行选择性治疗，5例因局部复发而接受治疗。1例局部区域病变晚期的患者主要接受了治疗。在中位随访期24个月期间，1例接受局部复发治疗的患者出现了1次胸壁复发。即使在7例近期或同时接受多药细胞毒性化疗的患者中，皮肤、肺、软组织或食管均未观察到重大并发症。3例患者在电子弧形野与用于照射锁骨上淋巴结区域的光子野相邻的区域出现了小面积的毛细血管扩张。我们得出结论，应用于这些患者的技术是安全有效的。在某些临床情况下，它比标准的固定野方法治疗胸壁具有优势。
