Liang D C, Lin J C, Shih S L, Huang J K, Wong L Y, Shu S G, Hsieh Y L, Yang C P, Tsai Y M, Lin S T
Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China.
Cancer. 1993 Mar 15;71(6):2105-8. doi: 10.1002/1097-0142(19930315)71:6<2105::aid-cncr2820710627>3.0.co;2-g.
Thirty-one children with acute lymphoblastic leukemia (ALL) who had received cranial radiation therapy (CrRT) and five concomitant doses of intrathecal methotrexate (IT MTX) for central nervous system prophylaxis (CNSP) and who had an event-free survival exceeding 5 years had cranial computed tomography (Cr CT) examination. The fractional dose for 21 of them was 1.5 Gy. The interval between the completion of CNSP and the time of Cr CT ranged from 5 to 8.5 years, with a median of 5 years 2 months.
Unlike the previous reports in the literature that 9-77% of children with ALL who had received Cr RT 18 Gy and IT MTX as CNSP had CT scan abnormalities, in this study no patient had CT scan abnormalities.
Our results might be attributable to the fractional dose of Cr RT being adequate, the IT chemotherapy being suitable, and the systemic chemotherapy not being intensive.
31例接受过颅脑放射治疗（CrRT）及5次鞘内注射甲氨蝶呤（IT MTX）以预防中枢神经系统（CNS）受累的急性淋巴细胞白血病（ALL）患儿，无事件生存超过5年，均接受了头颅计算机断层扫描（Cr CT）检查。其中21例的分次剂量为1.5 Gy。CNSP完成至Cr CT检查的时间间隔为5至8.5年，中位数为5年2个月。
既往文献报道，接受18 Gy Cr RT及IT MTX作为CNS预防措施的ALL患儿中，9% - 77%存在CT扫描异常，而本研究中无患儿出现CT扫描异常。
我们的结果可能归因于Cr RT的分次剂量充足、IT化疗适宜且全身化疗强度不大。
