Ishizaka A, Kanazawa M, Suzuki Y, Hashimoto T, Kubo A, Kawashiro T, Yokoyama T
School of Medicine, Keio University, Tokyo, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Feb;31(2):199-205.
We prospectively monitored pulmonary 99mTc-DTPA (diethylene triamine penta acetate) clearance in patients who received chest radiation therapy, in order to determine whether this method allows us to predict the development of radiation pneumonitis. The rate constant of pulmonary 99mTc-DTPA clearance (k; %/min) was used to assess pulmonary epithelial damage. Fifteen nonsmoking patients who underwent radiation therapy were studied. The subjects included 4 patients who had already developed radiation pneumonitis at the time of study, and 11 in whom we prospectively observed 99mTc-DTPA clearance serially during the course of chest radiation therapy. In the 4 patients with pre-existing radiation pneumonitis, the mean k value obtained from the area with infiltration on the chest X-ray was significantly greater than that from the opposite lung (p < 0.02). In the prospective study, 3 out of 11 patients developed radiation pneumonitis. The mean k of the irradiated lung field in the 8 patients who did not develop radiation pneumonitis was unchanged. The mean k value obtained in the 3 patients who did develop radiation pneumonitis increased just before the onset, and further increased when the disease manifested clinically. We conclude that pulmonary 99mTc-DTPA clearance may be useful for predicting the development of radiation pneumonitis.
我们前瞻性地监测了接受胸部放射治疗患者的肺 99mTc-DTPA（二乙三胺五乙酸）清除率，以确定该方法是否能让我们预测放射性肺炎的发生。肺 99mTc-DTPA 清除率的速率常数（k；%/分钟）用于评估肺上皮损伤。对 15 名接受放射治疗的非吸烟患者进行了研究。研究对象包括 4 名在研究时已发生放射性肺炎的患者，以及 11 名我们在胸部放射治疗过程中对其 99mTc-DTPA 清除率进行前瞻性连续观察的患者。在 4 名已患放射性肺炎的患者中，从胸部 X 光片上有浸润的区域获得的平均 k 值显著高于对侧肺（p < 0.02）。在前瞻性研究中，11 名患者中有 3 名发生了放射性肺炎。8 名未发生放射性肺炎的患者照射肺野的平均 k 值没有变化。3 名发生放射性肺炎的患者在发病前平均 k 值升高，在疾病临床显现时进一步升高。我们得出结论，肺 99mTc-DTPA 清除率可能有助于预测放射性肺炎的发生。
