Zimmermann J S, Kumpf L, Kimmig B
Klinik für Strahlentherapie (Radioonkologie), Christian-Albrechts-Universität Kiel.
Strahlenther Onkol. 1998 Nov;174 Suppl 3:16-9.
The variability of normal-tissue response is of major concern for radiation therapy. Multiple endogenous and exogenous factors are qualitatively known to alter the acute and late tissue response. Which of them are regarded most important by the European radiation oncologists and what is, empirically, their quantitative influence on the acute or late tissue tolerance?
In August 1997, we sent a questionnaire to 255 European radiation oncology departments. Among others, the questionnaire asked for endogenous and exogenous factors modifying the tissue response to radiation therapy and their quantitative influence on the acute and late radiation morbidity (TD 5/5). Fifty-five questionnaires (21.5%) were answered.
Empirically, the most important endogenous factors to modify the acute tissue tolerance are a) metabolic/other diseases with macro- or microangiopathia (17 answers [a]/32% mean decrease of tissue tolerance), b) collagen diseases (9 a/37%) and c) immune diseases (5 a/53%). As endogenous response modifiers for the TD 5/5 are recognized a) metabolic or other diseases leading to macro- or microangiopathia (15 a/31%), b) collagen diseases (11 a/38%) and c) immune diseases (2 a/50%). Inflammations from any reason are assumed to alter the acute tissue tolerance by (6 a/26%) and the TD 5/5 by (10 a/24%). Exogenous modifiers of the acute tissue response mentioned are a) smoking (34 a/44%), b) alcohol (23 a/45%), c) nutrition/diets (16 a/45%), d) hygiene (9 a/26%) and e) medical therapies (10 a/37%). Exogenous factors assumed to influence the TD 5/5 are a) smoking (22 a/40%), b) alcohol (15 a/38%), c) nutrition/diets (9 a/48%), d) hygiene (5 a/34%) and e) medical therapies (10 a/30%).
Exogenous factors are regarded more important by number and extent on the acute and late tissue response than endogenous modifiers. Both may have an important influence on the individual expression of normal tissue response.
正常组织反应的变异性是放射治疗中主要关注的问题。定性地了解到多种内源性和外源性因素会改变急性和晚期组织反应。欧洲放射肿瘤学家认为其中哪些因素最为重要，从经验上来说，它们对急性或晚期组织耐受性的定量影响是什么？
1997年8月，我们向255个欧洲放射肿瘤学部门发送了一份调查问卷。问卷除其他内容外，询问了改变组织对放射治疗反应的内源性和外源性因素，以及它们对急性和晚期放射发病率（TD 5/5）的定量影响。共收到55份问卷回复（21.5%）。
从经验来看，改变急性组织耐受性的最重要内源性因素为：a）伴有大血管或微血管病变的代谢性/其他疾病（17份回复[a]/组织耐受性平均降低32%），b）胶原病（9份回复[a]/37%），以及c）免疫疾病（5份回复[a]/53%）。被认为是TD 5/5内源性反应调节因素的有：a）导致大血管或微血管病变的代谢性或其他疾病（15份回复[a]/31%），b）胶原病（11份回复[a]/38%），以及c）免疫疾病（2份回复[a]/50%）。任何原因引起的炎症被认为会使急性组织耐受性改变（6份回复[a]/26%），使TD 5/5改变（10份回复[a]/24%）。提及的急性组织反应外源性调节因素有：a）吸烟（34份回复[a]/44%），b）饮酒（23份回复[a]/45%），c）营养/饮食（16份回复[a]/45%），d）卫生状况（9份回复[a]/26%），以及e）药物治疗（10份回复[a]/37%）。被认为会影响TD 5/5的外源性因素有：a）吸烟（22份回复[a]/40%），b）饮酒（15份回复[a]/38%），c）营养/饮食（9份回复[a]/48%），d）卫生状况（5份回复[a]/34%），以及e）药物治疗（10份回复[a]/30%）。
在数量和影响程度上，外源性因素被认为比内源性调节因素对急性和晚期组织反应更为重要。两者都可能对正常组织反应的个体表现产生重要影响。
