Pleuroparenchymal and cardiomediastinal reactions in the radiotherapy of malignant lymphomas. (author's transl)

Abstract

The radiographic documentation for over 300 malignant lymphoma patients who received radiotherapy to the hilo-mediastinal regions at the National Cancer Institute of Milan is examined with a view to ascertaining the pleuroparenchymal and cardiomediastinal sequelae of irradiation in a fairly homogeneous series in respect of treatment techniques. Early and late lesions of varying severity, mild, marked and severe, were found in 60% of the patients. Only in 15% were the lesions severe; in 6% pronounced pleural effusions were found and in 1.2% exudative pericarditis. To identify the etiological factors, the lesions were correlated with several variables: patient age, disease stage, pretreatment condition of the intrathoracic organs, radiotherapeutic techniques and doses, and combined therapy with Bleomycin at the doses usually given in the treatment of lymphomas, where relevant. Of these factors only the radiotherapeutic technique (site and number of fields, division of dose) and especially the dose absorbed seem to be relatively closely related to the frequency and severity of the post-irradiation lesions. There seem to be other factors in the genesis of these lesions, probably related to individual reactivity, but for these we have no evaluation parameters.