Malaspina A, Invernizzi A, Maffei S, Pisani P
Minerva Med. 1980 Jan 21;71(2):111-7.
A series of 60 cases in which a departure was made from the usual chronological distribution of preoperative radiation doses for breast cancer is presented. Tardive lesions were noted in the brachial plexus in 33 cases. Their incidence was higher in patients who had received larger dose fractions over a shorter total period. The progress of these lesions was barely influenced by medical and physical management. The underlying pathogenetic problems are examined, with particular reference to the radiotherapeutic technique and dose fractionation. Agreement is expressed with the opinion of other workers that the risk of such lesions can be kept down by employing a scrupulously careful technique, and employing total doses of 4.500-5.500 rads in 5-6 weeks. The conventional pattern of 5 weekly sessions should not be too widely departed from.
本文报告了60例乳腺癌患者，这些患者术前放射剂量的时间分布与常规情况不同。33例患者的臂丛神经出现了迟发性病变。在较短总疗程内接受较大剂量分割的患者中，这些病变的发生率更高。这些病变的进展几乎不受药物和物理治疗的影响。本文探讨了潜在的发病机制问题，特别提及了放射治疗技术和剂量分割。本文赞同其他研究者的观点，即通过采用极为谨慎的技术，并在5至6周内给予4500 - 5500拉德的总剂量，可以降低此类病变的风险。不应过度偏离每周5次治疗的传统模式。
