Pieroni P L, Rudick J, Adler M, Nacchiero M, Rybak B J
Ann Surg. 1976 Nov;184(5):610-4. doi: 10.1097/00000658-197611000-00013.
Effects of irradiation on the pancreas was studied in 6 dogs receiving a dose equivalent to the biologic effect of 4000 R/6 weeks (with a nominal stnadard dose of 1175 rets) given to patients with Hodgkins disease. After control secretory, histologic and pancreatographic studies, 6 Thomas fistula dogs were subjected to 2400 R tumor dose over two weeks. There was a biphasic response to secretin alone or secretin with cholecystokininpancreozymin. An initial hypersecretion occurred at 2 weeks --volume was increased, but bicarbonate and enzyme output remained unchanged. Thereafter there was a progressive reduction in volume, bicarbonate and enzyme outputs ( greater than 90% after 3 months). Histology showed early ductal reduplication but with progressive fibrosis, features compatible with chronic pancreatitis. Pancreatic insufficiency may contribute to post-irradiation gastrointestinal symptomatology. Close field irradiation of the pancreas results in actual destruction of the parenchyma.
在6只犬身上研究了照射对胰腺的影响,这些犬接受的剂量相当于给予霍奇金病患者的4000伦琴/6周(标称标准剂量为1175拉德)的生物效应剂量。在进行对照分泌、组织学和胰造影研究后,6只带有托马斯瘘管的犬在两周内接受2400伦琴的肿瘤剂量照射。单独使用促胰液素或促胰液素与胆囊收缩素-胰酶泌素联合使用时出现双相反应。最初在2周时出现分泌亢进——分泌量增加,但碳酸氢盐和酶的分泌量保持不变。此后,分泌量、碳酸氢盐和酶的分泌量逐渐减少(3个月后减少超过90%)。组织学显示早期导管增生,但伴有进行性纤维化,这些特征与慢性胰腺炎相符。胰腺功能不全可能导致照射后胃肠道症状。胰腺近距离照射会导致实质的实际破坏。