Slanina J, Wannenmacher M, Bruggmoser G, Krüger H U
Radiologe. 1982 Feb;22(2):74-82.
X-ray radiographs of the thorax of 119 patients suffering from Morbus Hodgkin (period of therapy VI/1974-III/1979) which have been taken during radiotherapy and at routine follow up examinations have been analysed with regard to temporal progress and extent of the pulmonary radioreaction after standardised mantle-field irradiation with a 4-MeV linear accelerator, extended-field satellite technique and tumor doses of 40-46 Gy. After a characteristic latency period without radio-morphological reaction the patients on average showed 12 weeks after beginning of irradiation signs of a beginning pneumonitis (phase I), after 15 weeks a florid pneumonitis (phase IIa), and after 20 weeks a florid pneumonitis with beginning shrinkage (phase IIb). After 5-9 months (average level 34 weeks) the pulmonary radioreaction was complete after having reached a steady paramediastinal lung fibrosis (phase IV). Classifying the radioreaction into 3 degrees of gravity a light pneumonitis was found in 44%, a medium one in 29%, and a severe pneumonitis in 16% of the cases. For clinical use it is important to know that after beginning shrinkage new expansion of mediastinum and/or of peripheral parenchymal shadows cannot be radioreactions. Primarily these new changes have to be interpreted as recurrence.
对119例霍奇金病患者（治疗期为1974年6月至1979年3月）在放疗期间及常规随访检查时拍摄的胸部X光片进行了分析，这些患者采用4兆伏直线加速器进行标准化斗篷野照射、扩大野卫星技术，肿瘤剂量为40 - 46戈瑞，分析内容包括肺部放射反应的时间进展和程度。在一段无放射形态学反应的特征性潜伏期后，患者平均在照射开始后12周出现初期肺炎迹象（I期），15周出现明显肺炎（IIa期），20周出现伴有开始收缩的明显肺炎（IIb期）。5 - 9个月（平均34周）后，肺部放射反应在达到稳定的纵隔旁肺纤维化（IV期）后完成。将放射反应分为3度，轻度肺炎占44%，中度肺炎占29%，重度肺炎占16%。对于临床应用而言，重要的是要知道在开始收缩后，纵隔和/或外周实质阴影的新扩张不可能是放射反应。这些新变化首先应被解释为复发。
