Dunst J, Dunst U, Wittmoser W
Strahlentherapeutische Klinik, Universität Erlangen-Nürnberg.
Strahlenther Onkol. 1993 Sep;169(9):543-4.
We report a case of suspected radiation-induced myelitis after twice-daily irradiation with a cord dose of 45.8 Gy. The 48-year old patient had been irradiated with two daily fractions of 1.8 Gy up to 70.2 Gy for oropharyngeal cancer T4 N2 G3 M0 and achieved a complete remission. The spinal cord received 42 Gy by open fields plus 3.8 Gy scatter irradiation after field reduction. Six months after radiotherapy clinical signs of tetraparesis occurred with two lesions in the cervical cord on MR-images. A complete neurological diagnostic procedure revealed no other causes than suspected radiation damage. This is the only case of radiation myelitis among 90 patients treated twice daily and over 2000 patients irradiated with conventional fractionation in the same technique and doses.
我们报告一例在每日两次照射且脊髓剂量达45.8 Gy后疑似放射性脊髓炎的病例。该48岁患者因口咽癌T4 N2 G3 M0接受每日两次、每次1.8 Gy、总量达70.2 Gy的照射，并实现完全缓解。脊髓在野缩野后通过开放野接受了42 Gy照射以及3.8 Gy散射照射。放疗后6个月，患者出现四肢轻瘫的临床症状，磁共振成像显示颈髓有两处病灶。完整的神经学诊断程序显示除了疑似放射性损伤外没有其他病因。这是90例每日接受两次照射以及2000多例采用相同技术和剂量进行常规分割照射的患者中唯一一例放射性脊髓炎病例。
