乳癌病人单次卡铂和阿霉素化疗诱发的染色体损伤和细胞生物…

应用常规染色体畸变分析和胞浆分裂阻滞微核（ｃｙｔｏｋｉｎｅｓｉｓ－ｂｌｏｃｋｍｉｃｒｏｎｕｃｌｅｉ，ＣＢＭＮ）法对１０例接受单次卡铂（平均剂量为４６２．９ｍｇ／ｍ＾２）和单次阿霉素（平均剂量为４８．１ｍｇ／ｍ＾２）化疗的乳癌病人血样进行了淋巴细胞色体畸变（ｃｈｒｏｍｏｓｏｍｅａｂｅｒｒａｔｉｏｎ，ＣＡ）和微核（ｍｉｃｒｏｎｕｃｌｅｉ，ＭＮ）的观察分析，并通过有丝分裂指数（ｍｉｔｏｔｉｃ，ｉｎｄｅｘ     

ANTI-INFLAMMATORY DRUGS,KIDNEY FUNCTION,AND EXERCISE

ＡＮＴＩ－ＩＮＦＬＡＭＭＡＴＯＲＹＤＲＵＧＳ，ＫＩＤＮＥＹＦＵＮＣＴＩＯＮ，ＡＮＤＥＸＥＲＣＩＳＥＢｉｌｌＦａｒｑｕｈａｒ，Ｍ．Ｓ．ＮｏｌｌＰｈｙｓｉｏｌｏｇｉｃａｌＲｅｓｅａｒｃｈＣｅｎｔｅｒ，ＴｈｅＰｅｎｎｓｙｌｖａｎｉａＳｔａｔｅＵｎｉｖｅｒｓ...     

吸烟及某些化疗药物对微核估算辐射剂量的影响

研究证实,微核（ＭＮ）法是继经典染色体畸变（ＣＡ）分析之后估算辐射剂量又一可靠的生物剂量计［１３］。但有研究表明,ＭＮ率受性别、年龄、吸烟、饮酒等因素和某些化学诱变剂的影响［４］,致使ＭＮ法用于低剂量估算不够敏感。为阐明吸烟及某些化疗药物对ＭＮ剂量估算的干扰,作者对９例吸烟者及１０例接受化疗（卡铂及阿霉素）的乳癌病人进行了ＭＮ及ＣＡ分析。一、材料和方法１－观察对象（１）男性吸烟者９例,年龄３０～５６岁,烟龄５～２７年,吸烟量１０～３０支／日。对照组为７例不吸烟健康男性,年龄２５～６０岁。上述受…     

~(99m) Tc- HM PAO 和~(99m) Tc- ECD 脑血流灌注显像的比较

方法：对 １７ 例（女 ４ 例、男 １３ 例，平均 ７１ 岁）患有不同神经疾患（急性与亚急性中风除外）的病人分别进行９９ｍ　 Ｔｃ Ｅ Ｃ Ｄ 和９９ｍ　 Ｔｃ Ｈ Ｍ Ｐ Ａ Ｏ 脑血流灌注显像。在两种脑血流显像图上分别对称性地画取７０ 个感兴趣区（ Ｒ Ｏ Ｉ），以每个 Ｒ Ｏ Ｉ的平均计数／全脑 Ｒ Ｏ Ｉ的总计数计算局部指数（ Ｒ Ｉ）。分三步进行分析：①比较随机选取的 ９ 例病人两次影像上相应部位 Ｒ Ｉ的差异；②比较两组显像剂在所有 １７ 例病人影像上分布的差异；③将各相邻层面上的相应 Ｒ Ｏ Ｉ合并至２７个，再进行比较分析。计算７ 例诊断为中风病人的两次影像上病灶侧与健侧相应部位计数之比，得出不对称指数（ Ａ Ｉ）。结果：在脑血管病人中，９９ｍ　 Ｔｃ Ｈ Ｍ Ｐ Ａ Ｏ 和９９ｍ　 Ｔｃ Ｅ Ｃ Ｄ 显像结果与临床症状相一致。９９ｍ　 Ｔｃ Ｅ Ｃ Ｄ 的影像质量优于９９ｍ　 Ｔｃ Ｈ Ｍ Ｐ Ａ Ｏ。９９ｍ　 Ｔｃ Ｅ Ｃ Ｄ 在枕叶的滞留相对较高，而在颞中叶的分布较低。９９ｍ　 Ｔｃ Ｈ Ｍ Ｐ Ａ Ｏ 无局部高灌注现象。 Ｒ Ｉ计算结果显示：９９ｍ　 Ｔｃ Ｈ Ｍ Ｐ Ａ Ｏ 在右小脑、脑干、颞中皮质、右基底节和丘脑的摄取明显增高，而９９ｍ　 Ｔｃ     

METHODS AND STRATEGIES FOR WEIGHT LOSS IN ATHLETES

ＭＥＴＨＯＤＳＡＮＤＳＴＲＡＴＥＧＩＥＳＦＯＲＷＥＩＧＨＴＬＯＳＳＩＮＡＴＨＬＥＴＥＳＰａｒｔｉｃｉｐａｎｔｓ：ＰｒｉｓｃｉｌｌａＣｌａｒｋｓｏｎ，Ｐｈ．ＤＤｅｐｔ．ｏｆＥｘｅｒｃｉｓｅＳｃｉｅｎｃｅＵｎｉｖｅｒｓｉｔｙｏｆＭａｓｓａｃｈｕｓｅｔｔｓ...     

离子型和非离子型造影剂在头颈部血管DSA中的应用研究

目的：探讨各种脑血管造影方法中离子型和非离子型造影剂（ＩＣＭ和ＮＩＣＭ）的合理应用及临床、技术等因素与造影剂不良反应（ＡＤＲｓ）发生率的关系。材料与方法：２６１例分别行ＩＶＤＳＡ（外围法，中心法和选择法）和ＩＡＤＳＡ（非选择法和选择法）共４５９例次造影，注射造影剂９７６次，１２例分别同时行ＩＶＤＳＡ外围法和中心法或ＩＡＤＳＡ非选择法和选择法，应用ＩＣＭ１６５例（６３．２１％），ＮＩＣＭ９６例（３６．７９％）。ＩＶＤＳＡ３７例次全部用ＩＣＭ，ＩＡＤＳＡ４２２例次用ＩＣＭ１９９例次，ＮＩＣＭ２２３例次。结果：本组ＡＤＲｓ发生率１１．１１％（２９／２６１），ＩＣＭ为１５．１５％（２５／１６５），ＮＩＣＭ为４．１６％（４／９６），两者差别有显著性（Ｐ＜０．０１），中重度反应１２例均见于经动脉注射（７例为选择性动脉注射）且经造影证实有脑内病变。结论：ＩＡＤＳＡ选择法，尤其椎动脉造影且术前已明确某些脑内病变，选用ＮＩＣＭ可明显降低ＡＤＲｓ发生率，合理选用ＩＣＭ可降低医疗费用。     

L─ARGININE IMPROVES THE SPLANCHNIC VASODILATATION AND INTESTINAL BLOOD FLOW IN ENDOTOXEMIA

Ｌ┐ＡＲＧＩＮＩＮＥＩＭＰＲＯＶＥＳＴＨＥＳＰＬＡＮＣＨＮＩＣＶＡＳＯＤＩＬＡＴＡＴＩＯＮＡＮＤＩＮＴＥＳＴＩＮＡＬＢＬＯＯＤＦＬＯＷＩＮＥＮＤＯＴＯＸＥＭＩＡＸＩＡＯＮａｎ（肖南），ＣＨＥＮＨｕｉ－ｓｕｎ（陈惠孙），ＨＵＤｅ－ｙａｏ（胡德耀）ＬＵＳ...     

L-NAME对小肠上皮细胞辐射防护作用机理的探讨

目的探讨硝基左旋精氨酸甲基酯（Ｌ－ＮＡＭＥ）对小肠上皮细胞辐射防护的机理。方法实验用大鼠ＩＥＣ－６细胞，６０Ｃｏγ射线照射；荧光分光光度法测定培养液上清中一氧化氮（ＮＯ）含量；ＮＡＤＰＨ黄递酶组化法（ＮＤ组化法）和免疫细胞化学法观察一氧化氮合酶（ＮＯＳ）活性变化；ＭＴＴ法检测细胞的生存力。结果ＩＥＣ－６细胞经射线照射后，其培养液上清中ＮＯ含量明显增加，细胞内结构型一氧化氮合酶（ｃＮＯＳ）活性升高，诱导型一氧化氮合酶（ｉＮＯＳ）活性降低，Ｌ－ＮＡＭＥ能明显提高细胞的生存力，ＮＯ底物－左旋精氨酸（Ｌ－Ａｒｇ）部分逆转其作用。结论ＮＯ参与了ＩＥＣ－６细胞的辐射损伤，Ｌ－ＮＡＭＥ对ＩＥＣ－６细胞具有辐射防护作用。     

MENISCAL INJURY IN CHILDREN

ＭＥＮＩＳＣＡＬＩＮＪＵＲＹＩＮＣＨＩＬＤＲＥＮＤＡＩＬｉ－ｙａｎｇ（戴力扬），ＺＨＡＮＧＷｅｎ－ｌｉｎ（张文林），ＸＵＹｉｎ－ｋａｎ（徐印坎）ＤｅｐａｒｔｍｅｎｔｏｆＯｒｔｈｏｐａｅｄｉｃｓ，ＣｈａｎｇｚｈｅｎｇＨｏｓｐｉｔａｌ，Ｓｈａｎｇｈａｉ２...     

南昌飞机制造公司学龄前儿童乙型肝炎表面抗原携带情况调查

本文采用反向血凝试验对本公司２１７４例学龄前儿童进行了乙型肝炎表面抗原携带情况调查，阳性人数２４９例，阳性率为１１．４５％，结果显示携带率高于全国人群平均携带率，（８．３％，属高度感染区。经过对已接对乙肝疫苗与未接种乙肝疫苗儿童间表面抗原携带率的对比性分析，提示需加强幼托机构的卫生管理，对婴幼儿进行乙肝疫苗的免疫接种，以做到有效地避免和控制乙肝病毒的传播。ＴＨＥＩＮＶＥＳＴＩＧＡＴＩＯＮＯＦＨＥＰＡＴＩＴＩＳＢＶＩＲＵＳＡＮＴＩＧＥＮＣＡＲＲＩＥＤＢＹＰＲＥＳＣＨＯＯＬＥＲＳＩＮＮＡＮＣＨＡＮＧＡＩＲＣＲＡＦＴＭＡＮＵＦＡＣＴＵＲＩＮＧＣＯＭＰＡＮＹＣｈｅｎＷｅｉｑｉ１９９４．５（２）：１１９（Ｎａｎｃｈａｂｇ３３４Ｈｏｓｐｉｔａｌ）ＡｂｓｔｒａｔＨｅｐａｔｉｔｉｓＢｖｉｒｕｓａｎｔｉｇｅｎｗａｓｉｎｖｅｓｔｉｇａｔｅｄｂｙｒｅｖｅｒｓｅｈｅｍａｇｇｌｕｔｉｎａｔｉｏｎｔｅｓｔｉｎ２１７４ｃａｓｅｓｏｆｐｒｅｓｃｈｏｏｌｅｒｔｏｏｕｒｃｏｍｐａｎｙ．Ａｍｏｎｇｔｈｅｍ２４９（１１．４５％）ｗｅｒｅｐｏｓｉｔｉｖｅ．ＴｈｅｐｏｓｉｔｉｖｅｒａｔｅｓｉｎｐｒｅｓｃｈｏｏｌｅｒｓｗｉｔｈｈｅｐａｔｉｔｉｓＢｖｉｒ     

胞质分裂阻滞微核法对辐射事故受照射人员的生物剂量估算

目的 探讨胞质分裂阻滞微核(CBMN)分析在估算辐射事故受照射者的生物剂量中的应用价值.方法 2008年山西太原辐射事故发生后16 h收集5名受照射者(1、2、3、4和5号)的外周血及I号的骨髓,进行CBMN分析,以微核(MN)频率估算生物剂量.对较严重的受照射者(1号)结合体外"co 1射线大剂量照射实验获得的核分裂...     

Biological dose estimation for two severely exposed patients in a radiation accident in Shandong Jining,China, in 2004

Purpose:?To estimate the biological doses for two severely exposed subjects (A and B) in a radiation accident in Shandong Jining, China in 2004.

Materials and methods:?Conventional chromosome aberration analysis and cytokinesis-block micronuclei (CBMN) assay were performed in peripheral blood and bone marrow samples on two subjects after the accident. A new dose-effect curve and the nuclear division index (NDI) obtained from in vitro irradiation experiments using high dose of ⁶⁰Co γ-rays were used to estimate the exposed doses.

Results:?No metaphases or binucleated cells were observed in the peripheral blood cultures from either of the subjects. However, metaphases and binucleated cells were obtained from both subjects after bone marrow cultures. Both dicentric/ring and micronuclei yields were very high. The dose estimated for A and B were 20.0 Gy and 8.8 Gy, respectively, by dicentric/ring scoring, similar to the data by combination of the CBMN and NDI (CBMN?+?NDI) assay. The estimated doses by the two methods were in accordance with the clinical symptoms.

Conclusion:?The new curve, together with the CBMN?+?NDI assay, are reliable for estimating higher doses of irradiation. In future radiation accidents, the accuracy and significance of these methods can be further tested.     

香兰素衍生物VND3207对小鼠骨髓细胞遗传损伤的防护效应研究

目的 研究香兰素衍生物4-羟基-3,5-二甲氧基苯甲醛(VND3207)对γ射线整体照射小鼠骨髓细胞遗传损伤的防护作用。方法 BALB/c小鼠按10、50和100 mg/kg不同剂量灌胃给药,1次/d,连续5 d,最后一次给药后2 h, 2 Gy ⁶⁰Co γ射线照射,照射后48 h观察小鼠骨髓嗜多染红细胞微核、染色体畸变和骨髓有丝分裂指数的改变。结果 不同剂量(10、50和100mg/kg)的VND3207均能有效地降低小鼠骨髓嗜多染红细胞微核率(t=2.40～4.26,P<0.05)和染色体畸变率(t=2.36～3.52,P<0.05),同时提高骨髓有丝分裂指数。药物保护效果与给药剂量呈依赖关系,其中100 mg/kg剂量组的微核率和染色体畸变率与单纯照射组相比,分别降低了65%和50%。结论 VND3207对⁶⁰Co γ射线诱发的小鼠骨髓辐射损伤有良好的保护作用。     

Cytogenetic damage of radiotherapy in long-term head and neck cancer survivors

Purpose: To evaluate cytogenetic damage of radiotherapy (RT) and chemoradiotherapy (CRT) in long-term head and neck cancer survivors.

Materials and methods: This study included 20 patients treated with RT (10 patients) or CRT (10 patients) for head and neck cancer. Nine healthy volunteers were included as control subjects. Cytochalasin B-blocked micronucleus (CBMN) assay was used to evaluate cytogenetic damage. To evaluate micronucleus (MN) by CBMN, the venous blood samples were drawn median 68 months (range 60–239 months) after the completion of treatment (RT or CRT) for head and neck cancer.

Results: Nuclear division index (NDI) and number of MN in mononuclear and binuclear lymphocytes were significantly higher in patients with head and neck cancer than in control subjects [1.19 (1.08–1.47) vs. 1.07 (1.04–1.14), p?p?p?=?0.020, respectively]. NDI and number of MN in mononuclear lymphocytes were significantly lower in control subjects compared patients received CRT and those received only RT, but there was no significant difference between patients received CRT and those received only RT. Number of MN in binuclear lymphocytes was significantly lower in control subjects compared to patients received CRT, but there was no significant difference between control subjects and those received only RT. Also there was no significant difference between patients received CRT and those received only RT in terms of number of MN in binuclear lymphocytes.

Conclusions: MN frequency of mononuclear and binuclear lymphocytes in medical follow-up of patients with head and neck cancer after RT could be important in evaluating cytogenetic damage of RT. However, further investigations are needed to provide quantitative correlations between MN yields and the clinical features in post-radiotherapy period.     

Dose estimation by chromosome aberration analysis and micronucleus assays in victims accidentally exposed to 60Co radiation

The objective of this study was to assess the radiation exposure levels in victims of a ⁶⁰Co radiation accident using chromosome aberration analysis and the micronucleus assay. Peripheral blood samples were collected from three victims exposed to ⁶⁰Co 10 days after the accident and were used for the chromosome aberration and micronucleus assays. After in vitro culture of the lymphocytes, the frequencies of dicentric chromosomes and rings (dic+r) and the numbers of cytokinesis blocking micronuclei (CBMN) in the first mitotic division were determined and used to estimate radiation dosimetry. The Poisson distribution of the frequency of dic+r in lymphocytes was used to assess the uniformity of the exposure to ⁶⁰Co radiation. Based on the frequency of dic+r in lymphocytes, estimates of radiation exposure of the three victims were 5.61 Gy (A), 2.48 Gy (B) and 2.68 Gy (C). The values were estimated based on the frequencies of CBMN, which were 5.45 Gy (A), 2.78 Gy (B) and 2.84 Gy (C). The estimated radiation dosimetry demonstrated a critical role in estimating the radiation dose and facilitating an accurate clinical diagnosis. Furthermore, the frequencies of dir+r in victims A and B deviated significantly from a normal Poisson distribution. Chromosome aberration analysis offers a reliable means for estimating biological exposure to radiation. In the present study, the micronucleus assay demonstrated a high correlation with the chromosome aberration analysis in determining the radiation dosimetry 10 days after radiation exposure.As early as the mid-1960s, ionising radiation was known to be capable of inducing chromosome aberrations in the metaphase of human peripheral lymphocytes [1, 2]. Since then, the chromosome aberration assay has been widely used as a sensitive biomarker for dose reconstruction following radiation exposure [3–6]. In particular, the analysis of dicentric chromosomes and rings (dic+r), two aberrations exemplifying inter- and intrachromosomal exchanges, respectively, has been generally considered to be the standard means for estimating biodosimetry based on its well-established dose–response relationship with radiation exposure and its low baseline levels in the general population [7, 8]. However, the utility of the chromosome aberration assay relies heavily on the expertise and experience of individual investigators. As an alternative method for determining radiation biodosimetry, the cytokinesis blocking micronucleus (CBMN) assay is easy to perform and less time-consuming, but its drawbacks include large individual variations in baseline values in the general population [7] and a markedly lower sensitivity when used for estimating low dose exposure compared with the chromosome aberration assay. Therefore, the micronucleus assay is widely used as a supplement to the chromosome aberration analysis [9]. In the present study, we made a comparative estimate of the radiation exposure in three victims of a ⁶⁰Co radiation accident that occurred in 1999 using dose–response curves of γ-ray-induced chromosome aberration and micronuclei, which were previously established in our laboratory. The results provide evidence of the utility of both methods in estimating biological doses of radiation exposure in humans.     

胞浆分裂阻滞微核法对山东"10·21"辐射事故病人受照射剂量的估算

目的 对山东"10·21"辐射事故中2例严重受照射者进行淋巴细胞微核(MN)检测,并估算受照射剂量.方法 用胞浆分裂阻滞微核(CBMN)法对2例患者(A和B)的外周血和骨髓样本分别进行MN检测.结果 2例患者的外周血培养均未见双核淋巴细胞.患者A的骨髓培养所获双核细胞极少,依据双核淋巴细胞多少粗估剂量＞20Gy.患者B的骨髓MN率为2.42个/细胞,剂量估计为8.7(8.0～9.4)Gy,与用染色体畸变分析、物理方法及ESR法所估算剂量接近,与临床表现基本一致.结论 MN法简便快速,结果准确,是除染色体畸变分析之外又一种可靠的生物剂量计.     

深圳市2015—2020年放射工作人员上岗前职业健康检查染色体畸变率与微核率分析

目的 分析深圳市2015—2020年放射工作人员上岗前职业健康检查染色体畸变率与微核率的水平及其分布特征,为加强放射工作人员辐射防护和职业健康管理提供科学依据。 方法 选取2015—2020年在深圳市职业病防治院接受上岗前职业健康检查的2 777名放射工作人员开展横断面研究,其中男性2 210名、女性567名,年龄17~69（27.6±6.8）岁,将受检者按年龄分为5组:17~20岁、21~30岁、31~40岁、41~50岁、51~69岁。采用全血微量培养法制备受检者的淋巴细胞微核和染色体,应用全自动染色体扫描分析系统对每名受检者的100个淋巴细胞染色体中期分裂相进行分析,统计双着丝粒体、着丝粒环和无着丝粒体等染色体畸变类型,比较不同年龄组以及同年龄组不同性别受检者染色体畸变情况和微核情况的差异。计量资料的组间比较采用方差分析;染色体畸变和微核的分布服从泊松分布,采用非参数检验,2组间比较采用Mann-Whitney U检验,多组间比较采用Kruskal-Wallis秩和检验。受检者年龄与染色体畸变率、微核率的相关性分析采用Spearman秩相关分析。 结果 2 777名受检者的染色体畸变（双着丝粒体+着丝粒环+无着丝粒体）率为（0.072±0.005）%、双着丝粒体+着丝粒环畸变率为（0.016±0.002）%、染色体畸变细胞率为（0.068±0.005）%、微核率为（0.43±0.01）‰、微核细胞率为（0.40±0.01）‰、淋巴细胞转化率为（85.07±3.16）%。各年龄组间染色体畸变率、双着丝粒体+着丝粒环畸变率、染色体畸变细胞率以及各年龄组不同性别受检者的染色体畸变率、染色体畸变细胞率间的差异均无统计学意义（χ2=1.193、0.931、0.691,Z=?0.929~?0.059,均P>0.05）。与17~20岁年龄组相比,其余各年龄组受检者的微核率、微核细胞率均较高,淋巴细胞转化率均较低,且差异均有统计学意义（Z=?6.981~?2.510,F=4.922~52.860,均P<0.05）;受检者的微核率和微核细胞率均与年龄呈正相关（r=0.166、0.168,均P<0.001）,而淋巴细胞转化率与年龄呈负相关（r=?0.197,P<0.001）;21~30岁年龄组、31~40岁年龄组女性受检者的微核率、微核细胞率以及17~20岁年龄组、21~30岁年龄组女性受检者的淋巴细胞转化率均显著高于同年龄组的男性受检者,且差异均有统计学意义（Z=?4.826~?3.516,F=6.947、14.563,均P<0.01）。 结论 深圳市2015—2020年放射工作人员上岗前职业健康检查染色体畸变率与微核率均未超过国内文献报道的健康人群的本底水平范围,但有随年龄增大而升高的趋势,需加强放射工作人员的辐射防护与职业健康管理。     

鼻咽癌放射治疗后染色体畸变率预测放射性脑病的相关研究

目的对染色体畸变率与鼻咽癌放疗后放射性脑病的相关性进行分析，以探讨该指标预测放射性脑病发生及病情严重程度的可行性和可靠性。方法运用分裂中期染色体方法检测17例鼻咽癌放疗后放射性脑病患者和17例鼻咽癌放疗后未发生放射性脑病患者的染色体畸变率，并以多种统计方法分析染色体畸变率与鼻咽癌放疗后放射性脑病发生和病情的相关性。结果染色体畸变以及与自发畸变的累积效应均与放射性脑病的发生和病情严重程度存在相关性，而且累积效应与放射性脑病发生和病情严重程度的相关性更密切。结论染色体畸变具有应用于临床预测放射性脑病发生和病情的价值。     

60Coγ射线超大剂量照射离体人外周血染色体畸变的剂量-效应研究

目的 探讨超大剂量γ射线离体照射后人外周血淋巴细胞染色体畸变的量效关系,建立双+环(dic+r)大剂量-效应曲线。方法 外周静脉血样采自3名健康男性,经 ⁶⁰Co γ线(0~50 Gy,剂量率2.35Gy/min)照射。采用即刻加秋水仙素的微量全血法,分别培养52、72及96h。计数有丝分裂指数(MI)、双着丝粒体(dic)和环(r)畸变数,拟合dic+r剂量-效应曲线,对2例受大剂量照射的事故患者进行剂量估算。结果 MI随照射剂量的增加而逐渐减少。每细胞dic+r频率随照射剂量增加而增加直到23Gy(5Gy之后增加幅度较前变小),＞23Gy后趋于饱和。对所获数据进行回归分析,拟合dic+r大剂量-效应曲线(5~23Gy):每细胞dic+r频率y=-1.608(±0.300)+0.830 (±0.051)D-0.013(±0.002) D² (R²=0.998)。用拟合曲线对2例受照患者剂量的估算结果与用物理方法和电子自旋共振(ESR)法估算的剂量及临床表现基本一致。结论 本研究建立的dic+r大剂量-效应曲线, 可估计的上限剂量达23Gy,有可能提高常规染色体畸变分析用作生物剂量计的实用价值。     

Analysis of Local Control in Patients with Non-Hodgkin’s Lymphoma According to the WHO Classification

PURPOSE: To analyze the influence of radiotherapy doses, chemotherapy doses, and clinical parameters on in-field disease control to assess the optimal radiation doses for treatment of non-Hodgkin's lymphoma according to the newly proposed WHO classification. PATIENTS AND METHODS: Subjects consisted of 35 extranodal marginal-zone B-cell lymphomas of mucosa-associated lymphoid tissue (MALT) type, 75 diffuse large B-cell lymphomas (DLBCL), 14 follicular lymphomas, 17 extranodal natural killer (NK)/T-cell lymphomas, nasal type, eight unclassified peripheral T-cell lymphomas, four anaplastic large-cell lymphomas, T/null cell type, and five others. 59 patients received radiotherapy alone. 98 patients received CHOP, modified CHOP, or more intensive chemotherapy, and six patients were treated with other combination. RESULTS: No patients with MALT lymphoma had in-field local recurrence. There were no recurrences in DLBCL patients who received chemotherapy in which the doses of adriamycin were > 200 mg/m(2), nor in DLBCL patients who were treated with > 45 Gy. Only nine of 15 patients with T-cell lymphoma treated with < or = 50 Gy and three of five patients treated with > 50 Gy had local control. The dose of adriamycin had no influence on local control of T-cell lymphoma. CONCLUSION: T/NK-cell lymphomas were more radioresistant than B-cell lymphomas. The prognosis for peripheral T/NK-cell lymphomas is poor even when treated by irradiation combined with chemotherapy.