Sindelar W F, Tepper J, Travis E L, Terrill R
Ann Surg. 1982 Nov;196(5):601-8. doi: 10.1097/00000658-198211000-00017.
In conjunction with the clinical development of intraoperative radiotherapy, a study was undertaken in dogs to define the tolerance of normal anatomic structures in the retroperitoneum to radiation delivered during operation. Twenty adult dogs were subjected to laparotomy and intraoperative 11 MeV electron irradiation in single doses ranging from 0.to 5000 rad. Animals were followed regularly with clinical observation, blood count, serum chemistries, pyelography, and angiography. Animals were sacrificed and autopsied at regular intervals up to 12 months following treatment to assess radiation-induced complications or tissue damage. Irradiation field in all dogs consisted of a 4 X 15 cm rectangle extending inthe retroperitoneum from the level of the renal vessels to the bifurcation of aorta and vena cava. The field included aorta, vena cava, inferior portion of left kidney, and distal portion of left ureter. No complications or histologic changes occurred in any animal given doses of 2000 rad, with a follow-up in excess of 18 months. A dose of 3000 rad was well tolerated, except for left ureteral occlusion in one animal. Mild vascular fibrosis was present inthe aorta and vena cava, and significant ureteral fibrosis developed by six months after doses of 4000 or 5000 rad. All animals that received 5000 rad died of radiation-related complications, including ureteral obstruction and rectal perforation. It was concluded that major vessels tolerate intraoperative irradiation well up to and including 3000 rad and that no clinically significant vascular problems develop after 4000 and 5000 rad, although some fibrosis does occur. The ureter and kidney appear to be the most radiosensitive structures inthe retroperitoneum, showing progressive changes at 300 rad or greater and showing the potential for serious complications after doses of 4000 rad or more.
结合术中放疗的临床开发，在犬类动物中开展了一项研究，以确定腹膜后正常解剖结构对手术期间所给予辐射的耐受性。20只成年犬接受了剖腹术，并在术中接受了单次剂量范围为0至5000拉德的11兆电子伏电子照射。定期对动物进行临床观察、血细胞计数、血清化学分析、肾盂造影和血管造影。在治疗后的12个月内定期处死动物并进行尸检，以评估辐射引起的并发症或组织损伤。所有犬的照射野均为一个4×15厘米的矩形，从肾血管水平延伸至腹膜后主动脉和腔静脉的分叉处。该照射野包括主动脉、腔静脉、左肾下部和左输尿管远端。给予2000拉德剂量且随访超过18个月的任何动物均未出现并发症或组织学变化。3000拉德的剂量耐受性良好，只有一只动物出现左输尿管闭塞。主动脉和腔静脉出现轻度血管纤维化，在给予4000或5000拉德剂量后6个月出现明显的输尿管纤维化。所有接受5000拉德剂量的动物均死于与辐射相关的并发症，包括输尿管梗阻和直肠穿孔。得出的结论是，主要血管对术中照射的耐受性良好，最高可达并包括3000拉德，并且在4000和5000拉德之后不会出现临床上显著的血管问题，尽管确实会发生一些纤维化。输尿管和肾脏似乎是腹膜后最具放射敏感性的结构，在300拉德或更高剂量时显示出渐进性变化，在4000拉德或更高剂量后显示出出现严重并发症的可能性。
