Pohar S, Mazeron J J, Ghilezan M, Le Bourgeois J P, Pierquin B
Department of Radiation Oncology, Cleveland Clinic, OH 44195.
Int J Radiat Oncol Biol Phys. 1993 Dec 1;27(5):1073-7. doi: 10.1016/0360-3016(93)90526-2.
This paper reviews the results of intranasal brachytherapy for epistaxis in 43 patients with Rendu-Osler disease treated between 1971-1991 at Henri Mondor Hospital.
2-3 intranasal catheters were afterloaded with 192Ir sources. Computer dosimetry was performed and then the dose was prescribed to an isodose thought to cover the nasal mucosa. The dose rate ranged from 0.16 Gy/h-0.63 Gy/h with a median of 0.34 Gy/h. Dose at one application ranged from 15-35 Gy with a median of 30 Gy. The severity of epistaxis was graded 1 to 5.
The time to recurrence of significant epistaxis ranged from 6-178 months with a median of 24 months. The dose prescribed did not correlate with control rate. The only brachytherapy complication was septal perforation in 4 patients; in one this was a result of repeated nasal coagulation.
We suggest that intranasal brachytherapy is a useful modality in the management of epistaxis in Rendu-Osler disease.
本文回顾了1971年至1991年间在亨利·蒙多医院接受治疗的43例遗传性出血性毛细血管扩张症患者鼻内近距离放射治疗鼻出血的结果。
将2 - 3根鼻内导管用192铱源进行后装。进行计算机剂量测定，然后将剂量规定到一个被认为能覆盖鼻黏膜的等剂量面上。剂量率范围为0.16 Gy/h - 0.63 Gy/h，中位数为0.34 Gy/h。单次照射剂量范围为15 - 35 Gy，中位数为30 Gy。鼻出血的严重程度分为1至5级。
严重鼻出血复发时间为6至178个月，中位数为24个月。规定剂量与控制率无关。唯一的近距离放射治疗并发症是4例患者出现鼻中隔穿孔；其中1例是反复鼻腔凝血的结果。
我们认为鼻内近距离放射治疗是遗传性出血性毛细血管扩张症鼻出血治疗中的一种有用方法。
