Hareyama M, Oouchi A, Nagakura H, Asakura K, Saito A, Satoh M, Tamakawa M, Akiba H, Sakata K, Yoshida S, Koito K, Imai K, Kataura A, Morita K
Department of Radiology, Sapporo Medical University, School of Medicine, Japan.
Int J Radiat Oncol Biol Phys. 1998 Feb 1;40(3):647-51. doi: 10.1016/s0360-3016(97)00813-4.
To evaluate retrospectively the optimum dosage of irradiation for Kimura's disease.
Twenty patients with Kimura's disease were treated with radiotherapy. The sex ratio was 19 males to 1 female. The mean ages at onset, initial treatment, and radiotherapy were 26.2, 29.5, and 32.2 years, respectively. Radiotherapy was mainly applied for residual or recurrent tumors. The eosinophil count increased by more than 10% in 18 of the 20 patients. In most instances, irradiation was given through a single field with dosages ranging from 20 to 44 Gy.
At the completion of radiotherapy, a marked response in tumor size was noted in all cases. The minimum follow-up was 48 months. Local control was obtained in 23 of 31 lesions (74.1%). At dosages of < or =25 Gy, 26-30 Gy, and > 30 Gy, local control was obtained in 2 of 8 (25.0%), 9 of 10 (90.0%), and 12 of 13 sites (92.3%), respectively.
Radiotherapy is an effective treatment for Kimura's disease. This strongly suggests that no surgical procedure other than a biopsy should be carried out. The radiation field should be limited to the lesion and swelling of the adjacent lymph nodes as much as possible, with a optimum dosage of 26-30 Gy regardless of tumor size.
回顾性评估木村病的最佳放疗剂量。
20例木村病患者接受了放射治疗。男女比例为19∶1。发病、初始治疗及放疗时的平均年龄分别为26.2岁、29.5岁和32.2岁。放疗主要用于残留或复发性肿瘤。20例患者中有18例嗜酸性粒细胞计数增加超过10%。多数情况下，通过单野照射，剂量范围为20至44 Gy。
放疗结束时，所有病例肿瘤大小均有明显反应。最短随访时间为48个月。31个病灶中有23个（74.1%）获得局部控制。剂量≤25 Gy、26 - 30 Gy和＞30 Gy时，局部控制率分别为8个病灶中的2个（25.0%）、10个病灶中的9个（90.0%）和13个部位中的12个（92.3%）。
放疗是治疗木村病的有效方法。这强烈提示除活检外不应进行其他手术操作。放射野应尽可能局限于病灶及相邻肿大淋巴结，无论肿瘤大小，最佳剂量为26 - 30 Gy。
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