脳原発悪性リンパ腫の放射線治療　照射効果と放射線脳障害の解析

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タイトル別名
  • Radiation therapy of primary malignant lymphoma of the brain. Analysis of radiation response and brain damage.
  • ANALYSIS OF RADIATION RESPONSE-AND BRAIN DAMAGE
  • 照射効果と放射線脳障害の解析

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This report analyzes 18 cases of primary malignant lymphoma of the brain treated by whole cranial and local boost irradiation (total dose, mean 54Gy) in Niigata University Hospital between January 1980 and December 1987. The cumulative 5-year survival rate was 12%. During the treatment, tumors responded well and disappeared in all cases. However, relapse in 7 patients was detected by follow-up CT study or autopsy. The site of relapse was the CNS in 5 cases (one at the original site and 4 at other sites), anth e extra-CNS in two cases. Multiplicity of lesion was considered to be at high risk for relapse. In cases without relapse, deterioration of mental and physical activity was observed frequently. The CT study revealed brain damage such as diffuse brain atrophy and low density of white matter in these patients. Our results indicated that reduction of brain damage was necessary, and considering the mode and risk of relapse, radiotherapy might be optimized. The possibility of reduction of cranial radiation dose and significance of prophylactic spinal irradiation are discussed.

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