Thoracic reirradiation for symptomatic relief after prior radiotherapeutic management for lung cancer
Thoracic reirradiation for symptomatic relief after prior radiotherapeutic management for lung cancer
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DOI：
10.1097/00000421-200004000-00011
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发表时间：
2000-04-01
影响因子：
2.6
通讯作者：
Curran, WJ
中科院分区：
文献类型：
--
作者：
Gressen, EL;Werner-Wasik, M;Curran, WJ
关于复发性/持续性肺癌或新发原发性肺肿瘤患者胸部再照射的医学文献信息有限。由于担心辐射毒性风险，关于再治疗存在争议。检索了1982年至1997年在托马斯杰斐逊大学医院放射肿瘤科就诊的1,500多名肺癌患者的医疗和放射记录。23例既往有胸部放疗史的患者因活检证实和/或影像学明显的肿瘤复发、转移或第二肺原发性肿瘤而接受胸部再放疗。大多数患者由于进行性呼吸困难、咳嗽、胸痛或咯血而再次接受放射治疗。这些症状中的每一个都分别评价了对再照射的主观反应。从完成再照射到与患者和/或家属最后一次通信的中位随访时间为3.2个月，范围为0至17.5个月。在6例咯血患者中，注意到该症状减轻或消退。在5例因癌症引起胸痛的患者中，4例在再次照射后疼痛有所改善。15例咳嗽患者中，9例咳嗽改善，15例呼吸困难患者中，11例改善。胸部再照射是治疗由于放射学定义的肺癌复发和/或进展而导致的咳血、胸痛、咳嗽和呼吸困难患者的有效方法。
Limited information is available in the medical literature on thoracic reirradiation for patients with recurrent/persistent lung carcinoma or new primary lung tumors. Controversy exists regarding the retreatment because of concerns regarding the risk of radiation toxicity. The medical and radiotherapeutic records of more than 1,500 patients a with lung cancer seen in the Department of Radiation Oncology at Thomas Jefferson University Hospital from 1982 through 1997 were searched. Twenty-three patients with history Of previous thoracic radiation therapy underwent thoracic reirradiation for either biopsy-proven and/or radiographically evident tumor recurrence, metastasis, or second lung primary. Most patients were reirradiated because of progressive dyspnea, cough, thoracic pain, or hemoptysis. Each of these symptoms was evaluated separately with regard to the subjective response to reirradiation. The median follow-up time from completion of reirradiation to last correspondence with the patient and/or family was 3.2 months, with a range of 0 to 17.5 months. In six patients with hemoptysis a decrease or resolution of this symptom was noted. Of five patients with thoracic pain attributed to carcinoma, four noted an improvement in pain after reirradiation. Of 15 patients with cough, 9 had an improvement in cough, and of 15 patients with dyspnea, 11 had an improvement. Thoracic reirradiation is an effective modality in patients with hemoptysis, thoracic pain, cough, and dyspnea attributed to a radiographically defined recurrence and/or progression of lung cancer.