CAJ | 학술논문

目的报道皮肤蕈样霉菌病的全身电子线照射技术、治疗并发症及近远期疗效.方法回顾性分析5例皮肤蕈样霉菌病患者的临床资料,并作长期随访.男4例,女1例,中位年龄51岁(14 ～56岁).4例患者8周接受30 ～31.25 Gy/30次的全身电子线照射,另1例患者之前接受了6个周期化疗,后接受8周全身电子线照射31Gy/31次,残留病灶局部补充电子线剂量至36 Gy.皮肤剂量约为处方剂量的90％,照射野内剂量均匀性控制在处方剂量的±10％以内.结果放疗后6个月,4例患者疗效评价均为完全缓解,1例为近期治疗,放疗结束时评价为接近完全缓解.急性不良反应可以耐受.2例患者分别于全身电子线治疗后3年和1年死于内脏受累,死亡前皮肤无复发表现,2例患者至随访17年及15年时仍健康存活,1例近期治疗患者放疗结束后2个月仍健康存活.结论全身电子线照射皮肤蕈样霉菌病局部疗效确切,不良反应可以耐受,脏器侵犯是主要的失败原因.
목적 보도피부심양매균병적전신전자선조사기술、치료병발증급근원기료효.방법 회고성분석5례피부심양매균병환자적림상자료,병작장기수방.남4례,녀1례,중위년령51세(14 ～56세).4례환자8주접수30 ～31.25 Gy/30차적전신전자선조사,령1례환자지전접수료6개주기화료,후접수8주전신전자선조사31Gy/31차,잔류병조국부보충전자선제량지36 Gy.피부제량약위처방제량적90％,조사야내제량균균성공제재처방제량적±10％이내.결과 방료후6개월,4례환자료효평개균위완전완해,1례위근기치료,방료결속시평개위접근완전완해.급성불량반응가이내수.2례환자분별우전신전자선치료후3년화1년사우내장수루,사망전피부무복발표현,2례환자지수방17년급15년시잉건강존활,1례근기치료환자방료결속후2개월잉건강존활.결론 전신전자선조사피부심양매균병국부료효학절,불량반응가이내수,장기침범시주요적실패원인.
Objective To report the total skin electron irradiation(TSEI) to treat the mycosis fungoides and the related acute toxicity,short-term efficacy and long-term results.Methods Five patients with pathologically confirmed mycosis fungoides were enrolled from 1990 to 2011,including 4 males and 1 female.Median age was 51 years old(range 14-56 years old).Dose homegeneity within the field were ± 10％ of the prescribed dose with a skin surface dose of about 90％ of the prescribed dose.Four cases received a total dose of about 30 Gy in 30-32 fractions in 8 weeks,and the other case received an electron boost of 5 Gy to the residual tumor after irradiation with 31 Gy within 31 fractions in 8 weeks,who had received 6 cycles chemotherapy before TSEI.Results 4 cases with a follow-up time of more than 15 years achieved complete response 6 months after radiotherapy.For the recently treated case,a great partial response was achieved after radiotherapy.Acute toxicities for all patients were acceptable.Two patients survived after a follow-up of more than 15 years while the other two cases died of visceral involvement at 1 and 3 years later,respectively.The case treated recently survived 2 months later.Conclusions A total TSEI dose of about 30 Gy within 30-32 fractions during 8 weeks could be proved to be very effective and safe in skin lesion control.Visceral involvement is the main failure type.