Lee M S, Kim J C, Saxena V S, Kartha P, Zusag T, Hendrickson F R
Radiology. 1980 Jun;135(3):771-3. doi: 10.1148/radiology.135.3.7384472.
Twenty-one patients with cervical or endometrial carcinoma and metastases to the para-aortic lymph nodes were treated with extended-field para-aortic irradiation. The late effects of this treatment were evaluated in 16 patients who had a minimum follow-up of six months. All of the patients with massive pelvic tumours died of active disease in the pelvis with or without metastases. Three patients had small-bowel complications; none of the patients who underwent exploratory laparotomy for lymph node biospy had bowel complications. The results indicate that patients with central lesions and minimal para-aortic disease benefit most from para-aortic irradiation. It is concluded that metastases to the para-aortic lymoh nodes do not necessarily indicate more distant spread, and can be cured with irradiation. The late complication rate can be minimized by reducing the dosage to the small bowel with a combination of anterior-posterior fields and 360 degree rotation or opposing lateral 120 degree arc fields, and by using the extraperitoneal approach for lymph node biopsy.
21例患有宫颈癌或子宫内膜癌且发生腹主动脉旁淋巴结转移的患者接受了扩大野腹主动脉旁照射治疗。对其中16例至少随访6个月的患者评估了该治疗的晚期效应。所有患有巨大盆腔肿瘤的患者均死于盆腔活动性疾病，无论有无转移。3例患者出现小肠并发症；接受淋巴结活检而进行剖腹探查的患者均未出现肠道并发症。结果表明，中央病灶且腹主动脉旁疾病轻微的患者从腹主动脉旁照射中获益最大。得出的结论是，腹主动脉旁淋巴结转移不一定意味着有更远的扩散，且可通过照射治愈。通过前后野与360度旋转野或对侧120度弧形野相结合减少小肠剂量，并采用腹膜外途径进行淋巴结活检，可将晚期并发症发生率降至最低。
