急性放射病防治研究进展

急性放射病的防治是核事故应急医学处理十分重要的环节，是放射医学与防护研究的重点内容，受到各国学者的高度重视。近些年来，由于生命科学研究的突飞猛进，带动了基础医学、分子生物学和临床诊治技术的不断发展，急性放射病的实验治疗和临床救治研究也取得了明显的进展...     

溴酮醚对急性放射病犬的治疗效果

溴酮醚雌活力较低,副作用小。按1.25～2.5毫克/公斤体重照后6小时一次肌注,对300拉德照射犬有一定疗效。与银耳制剂合用,有明显的相加作用,可提高300和320拉德照射犬活存率72.9%和70%,两者与抗感染药物相伍用,也有明显的叠加作用,初步发现也可提高400拉德照射犬的活存率(5/7)。溴酮醚对照射犬睾丸组织的修复有暂时的抑制作用,后期却有利于其恢复.     

凉血活血颗粒对急性放射病-肺损伤的保护作用

目的 研究凉血活血颗粒对急性放射病-肺损伤小鼠模型的保护作用.方法 采用5.5Gy60Coγ射线一次性全身照射小鼠,制成急性放射病-肺损伤动物模型.小鼠在照前45min至照后30d,给药组以不同剂量的凉血活血颗粒灌胃给药,正常对照组及模型组用等体积蒸馏水灌胃,均为1次/d.观察照后小鼠的一般情况,照后10 d每组抽取6...     

急性放射病防治药物—“500”

“500”是预防和治疗核辐射损伤的药物。经药物合成、剂型、药效、药理毒性、药物代谢及人体试用等研究,证明本药能降低辐射反应的程度,减少染色体的畸变率,对动物与人体辐射损伤具有良好的防治作用,与其他辐射防     

急性放射病的治疗

急性放射病是机体受到100rad以上射线照射所引起的全身性疾病。在核战争时,可发生大量的急性放射病伤员,因此急性放射病的治疗在军事医学中具有重要意义。 急性放射病的治疗原则 总的治疗原则为:根据不同病情的主要发病环节,狠抓早期治疗,以减轻损伤和控制疾病的进展;积极治疗极期并发症,扶持机体渡过极期,促进恢复,不失时机地选用适宜措施,纠正机体营养和代谢     

3例急性放射病患者恢复期骨髓细胞形态学观察

笔者从骨髓细胞形态学角度观察了 3例重、中度骨髓型急性放射病 (ARS)患者进入恢复期后血细胞的变化 ,以期为放射病临床研究积累资料。一、材料和方法1 .对象 :河南“4 2 6”60 Co源辐射事故中 ,3例重、中度骨髓型ARS患者。其中 ,重度病例“例 1” ,女性 ,38岁 ,不均匀照射 ,造血干细胞活存计权等效剂量 5 .0Gy ;中度病例“例2” ,男性 ,8岁 ,不均匀照射 ,造血干细胞活存计权等效剂量2 .6Gy;另一中度病例“例 3” ,男性 ,37岁 ,均匀照射 ,造血干细胞活存计权等效剂量 2 .3Gy。3例患者在第 9天转入我院救治 ,第 33天 ,2例中度骨髓型ARS…     

中度急性放射病的诊断

本文报道了40例中、晚期恶性淋巴瘤病人采用⁶⁰Coγ线一次全淋巴区照射6,8Gy的临床表现。若按病人外周血淋巴细胞染色体畸变估算这一剂量, 则相当于一次全身均匀照射条件下血液平均受照剂量分别为2.73～4.30Gy(平均3.55Gy)和3.48～5.58Gy(平均4.25Gy).按红骨髓千细胞法估算等效剂量为1.85～2.37Gy.可以见到中度急性放射病的临床经过, 表现为消化道反应和造血免疫功能受损, 骨髓受到抑制。白细胞, 血小板迅速减少, 淋巴细胞在早期就有质和量的变化。所有这些均是有意义的诊断指标。此外, 唇肌刺激反应、C反应蛋白、皮质醇, 尿中核苷和碱基, 照射前后皆有显着改变。因此利用肿瘤病人进行6～8Gy全淋巴区照射可以作出中度急性放射病的早期诊断。     

Clinical Implementation of Tangential Field Intensity Modulated Radiation Therapy (IMRT) Using Sliding Window Technique and Dosimetric Comparison with 3D Conformal Therapy (3DCRT) in Breast Cancer

The purpose of this study was to evaluate the clinical implementation of tangential field IMRT using sliding window technique and to compare dosimetric parameters with 3-dimensional conformal radiation therapy (3DCRT). Twenty breast cancer patients were randomly selected for comparison of intensity modulated radiation therapy (IMRT)-based treatment plan with 3DCRT. Inverse treatment was performed using the sliding window technique, employing the Eclipse^® Planning System (version 7.1.59, Varian, Palo Alto, CA). The dosimetric parameters compared were V₉₅ (the percentage of target volume getting ≥95% of prescribed dose), V₁₀₅, V₁₁₀, and dose homogeneity index, DHI (percentage of target volume getting between 95% and 110% of prescribed dose). The mean V₉₅, DHI, V₁₀₅, and V₁₁₀ for target volume for IMRT vs. 3D were 90.6% (standard deviation [SD]: 3.2) vs. 91% (SD: 3.0), 87.7 (SD: 6.0) vs. 82.6 (SD: 7.8), 27.3% (SD: 20.3) vs. 49.4% (SD: 14.3), and 2.8 (SD: 5.6) vs. 8.4% (SD: 7.4), respectively. DHI was increased by 6.3% with IMRT compared to 3DCRT (p < 0.05). The reductions of V₁₀₅ and V₁₁₀ for the IMRT compared to 3DCRT were 44.7% and 66.3%, respectively (p < 0.01). The mean dose and V₃₀ for heart with IMRT were 2.3 (SD: 1.1) and 1.05 (SD: 1.5) respectively, which was a reduction by 6.8% and 7.9%, respectively, in comparison with 3D. Similarly, the mean dose and V₂₀ for the ipsilateral lung and the percentage of volume of contralateral volume lung receiving > 5% of prescribed dose with IMRT were reduced by 9.9%, 2.2%, and 35%, respectively. The mean of total monitor units used for IMRT and 3DCRT was about the same (397 vs. 387). The tangential field IMRT for intact breast using sliding window technique was successfully implemented in the clinic. We have now treated more than 1000 breast cancer patients with this technique. The dosimetric data suggest improved dose homogeneity in the breast and reduction in the dose to lung and heart for IMRT treatments, which may be of clinical value in potentially contributing to improved cosmetic results and reduced late treatment-related toxicity.     

Clinical Implementation of Tangential Field Intensity Modulated Radiation Therapy (IMRT) Using Sliding Window Technique and Dosimetric Comparison with 3D Conformal Therapy (3DCRT) in Breast Cancer

The purpose of this study was to evaluate the clinical implementation of tangential field IMRT using sliding window technique and to compare dosimetric parameters with 3-dimensional conformal radiation therapy (3DCRT). Twenty breast cancer patients were randomly selected for comparison of intensity modulated radiation therapy (IMRT)-based treatment plan with 3DCRT. Inverse treatment was performed using the sliding window technique, employing the Eclipse^® Planning System (version 7.1.59, Varian, Palo Alto, CA). The dosimetric parameters compared were V₉₅ (the percentage of target volume getting ≥95% of prescribed dose), V₁₀₅, V₁₁₀, and dose homogeneity index, DHI (percentage of target volume getting between 95% and 110% of prescribed dose). The mean V₉₅, DHI, V₁₀₅, and V₁₁₀ for target volume for IMRT vs. 3D were 90.6% (standard deviation [SD]: 3.2) vs. 91% (SD: 3.0), 87.7 (SD: 6.0) vs. 82.6 (SD: 7.8), 27.3% (SD: 20.3) vs. 49.4% (SD: 14.3), and 2.8 (SD: 5.6) vs. 8.4% (SD: 7.4), respectively. DHI was increased by 6.3% with IMRT compared to 3DCRT (p < 0.05). The reductions of V₁₀₅ and V₁₁₀ for the IMRT compared to 3DCRT were 44.7% and 66.3%, respectively (p < 0.01). The mean dose and V₃₀ for heart with IMRT were 2.3 (SD: 1.1) and 1.05 (SD: 1.5) respectively, which was a reduction by 6.8% and 7.9%, respectively, in comparison with 3D. Similarly, the mean dose and V₂₀ for the ipsilateral lung and the percentage of volume of contralateral volume lung receiving > 5% of prescribed dose with IMRT were reduced by 9.9%, 2.2%, and 35%, respectively. The mean of total monitor units used for IMRT and 3DCRT was about the same (397 vs. 387). The tangential field IMRT for intact breast using sliding window technique was successfully implemented in the clinic. We have now treated more than 1000 breast cancer patients with this technique. The dosimetric data suggest improved dose homogeneity in the breast and reduction in the dose to lung and heart for IMRT treatments, which may be of clinical value in potentially contributing to improved cosmetic results and reduced late treatment-related toxicity.     

Intensity-Modulated Radiation Therapy (IMRT) with Different Combinations of Treatment-Planning Systems and Linacs

PURPOSE: To compare different combinations of intensity-modulated radiation therapy (IMRT) system components with regard to quality assurance (QA), especially robustness against malfunctions and dosimetry. MATERIAL AND METHODS: Three different treatment-planning systems (TPS), two types of linacs and three multileaf collimator (MLC) types were compared: commissioning procedures were performed for the combination of the TPS Corvus 5.0 (Nomos) and KonRad v2.1.3 (Siemens OCS) with the linacs KD2 (Siemens) and Synergy (Elekta). For PrecisePLAN 2.03 (Elekta) measurements were performed for Elekta Synergy only. As record and verify (R&V) system Multi-Access v7 (IMPAC) was used. The use of the serial tomotherapy system Peacock (Nomos) was investigated in combination with the Siemens KD2 linac. RESULTS: In the comparison of calculated to measured dose, problems were encountered for the combination of KonRad and Elekta MLC as well as for the Peacock system. Multi-Access failed to assign the collimator angle correctly for plans with multiple collimator angles per beam. Communication problems of Multi-Access with both linacs were observed, resulting in incorrect recording of the treatment. All reported issues were addressed by the manufacturers. CONCLUSION: For the commissioning of IMRT systems, the whole chain from the TPS to the linac has to be investigated. Components that passed the commissioning in another clinical environment can have severe malfunctions when used in a new environment. Therefore, not only single components but the whole chain from planning to delivery has to be evaluated in commissioning and checked regularly for QA.     

Experimental Analysis of Radiation Protection Offered by a Novel Exoskeleton-Based Radiation Protection System versus Conventional Lead Aprons

PurposeTo evaluate the radiation protection offered by an exoskeleton-based radiation protection system (Stemrad MD) and to compare it with that offered by conventional lead aprons.MethodsThe experimental setup involved 2 anthropomorphic phantoms, an operator, a patient, and a C-arm as the x-ray radiation source. Thermoluminescent detectors were used to measure radiation doses to different radiosensitive body parts on the operator phantom both with the exoskeleton and a conventional lead apron at the left radial and right femoral positions. Detected radiation doses for the exoskeleton and lead apron for different body parts and positions were compared.ResultsAt the left radial position, the mean radiation dose (mGy) reduction by the exoskeleton compared with that by the lead apron was >90% for the left eye lens (0.22 ± 0.13 vs 5.18 ± 0.08; P < .0001), right eye lens (0.23 ± 0.13 vs 4.98 ± 0.10; P < .0001), left head (0.11 ± 0.16 vs 3.53 ± 0.07; P < .0001), right head (0.27 ± 0.09 vs 3.12 ± 0.10; P < .0001), and left brain (0.04 ± 0.08 vs 0.46 ± 0.07; P < .0001). At the right femoral position, radiation reduction was >90% for the left eye lens (0.14 ± 0.10 vs 4.16 ± 0.09; P < .0001), right eye lens (0.06 ± 0.08 vs 1.90 ± 0.11; P < .0001), left head (0.10 ± 0.08 vs 4.39 ± 0.08; P < .0001), left brain (0.03 ± 0.07 vs 1.44 ± 0.08; P < .0001), right brain (0.00 ± 0.14 vs 0.11 ± 0.13; P = .06), and thyroid (0.04 ± 0.07 vs 0.27 ± 0.09; P < .0001). Protection of the torso was equivalent to that offered by conventional lead aprons.ConclusionsThe exoskeleton-based system provided superior radiation protection to the physician compared with that provided by conventional lead aprons. The effects are particularly impactful for the brain, eye lens, and head areas.