鼻咽癌放疗后放射性脑病诊断技术与治疗研究进展
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摘要
鼻咽癌放疗后的严重并发症之一是放射性脑病,随着放疗技术的提升,鼻咽癌的生存期也不断延长,鼻咽癌放疗后的并发症越来越受到关注,尤其是放射性脑病。放射性脑病是患者放疗一段时间后,出现与照射相关的神经系统损害性疾病,往往是不可逆性的,预后较差。放射性脑病病程为进展性,严重影响患者的生存质量。加强对鼻咽癌放疗后放射性脑病的诊断技术研究,及早诊断,及时采取相应的方法进行治疗对患者的预后有重要的意义。本文对鼻咽癌放疗后放射性脑病的诊断技术和治疗进行如下综述。
One of the serious complications of radiotherapy for nasopharyngeal carcinoma is radiation encephalopathy.With the improvement of radiotherapy technology,the survival of nasopharyngeal carcinoma is also prolonged.The complications after radiotherapy for nasopharyngeal carcinoma are getting more and more attention,especially the radiation encephalopathy.Radiation encephalopathy is a neurological damaging disease associated with radiation after a period of radiotherapy in patients.It is often irreversible and has a poor prognosis.The course of radiation encephalopathy is progressive,which seriously affects the quality of life of patients.Strengthening the diagnostic techniques for radiation encephalopathy after radiotherapy for nasopharyngeal carcinoma,early diagnosis,and timely adoption of corresponding methods for treatment have important implications for the prognosis of patients.This article reviews the diagnostic techniques and treatment of radiation encephalopathy after radiotherapy for nasopharyngeal carcinoma.
One of the serious complications of radiotherapy for nasopharyngeal carcinoma is radiation encephalopathy.With the improvement of radiotherapy technology,the survival of nasopharyngeal carcinoma is also prolonged.The complications after radiotherapy for nasopharyngeal carcinoma are getting more and more attention,especially the radiation encephalopathy.Radiation encephalopathy is a neurological damaging disease associated with radiation after a period of radiotherapy in patients.It is often irreversible and has a poor prognosis.The course of radiation encephalopathy is progressive,which seriously affects the quality of life of patients.Strengthening the diagnostic techniques for radiation encephalopathy after radiotherapy for nasopharyngeal carcinoma,early diagnosis,and timely adoption of corresponding methods for treatment have important implications for the prognosis of patients.This article reviews the diagnostic techniques and treatment of radiation encephalopathy after radiotherapy for nasopharyngeal carcinoma.
引文
[1]罗琼.鼻咽癌放疗后致放射性脑病的影响因素分析[J].实用癌症杂志,2017,32(5):859-861.
[2]李坊铭,陈国健,林剑毅,等.鼻咽癌放疗后放射性脑病影响因素分析[J].中国肿瘤外科杂志,2016,8(6):402-404.
[3]潘素明,陈志仁,张素敏,等.鼻咽癌调强放疗后放射性脑病23例临床分析[J].解放军预防医学杂志,2016,34(s2):116-117.
[4]楼建军,崔珍,何斌,等.鼻咽癌放射治疗后放射性脑病120例临床分析[J].齐齐哈尔医学院学报,2015,36(17):2523-2524.
[5]赵昆玉,黄小龙,胡震,等.多奈哌齐治疗放射性脑病认知功能障碍的疗效研究[J].中华放射医学与防护杂志,2017,37(6):426.
[6]李光芒,印群.放射性脑病CT影像诊断及鉴别诊断[J/OL].临床医药文献电子杂志,2016,3(27):5432-5433.
[7]尹本德.鼻咽癌放射治疗后放射性脑病的影像学的临床诊断[J].世界最新医学信息文摘,2017,17(29):131.
[8]肖来华,刘建国.鼻咽癌放疗后放射性脑病29例的MRI观察及治疗分析[J].中国社区医师,2014,30(15):89-90.
[9]李梅芳,黄远桃,颜福斌,等.鼻咽癌放疗后放射性脑病40例的诊治分析[J].中国中西医结合耳鼻咽喉科杂志,2018,26(2):74-76.
[10]闰蕊,宋建波,武志芳,等.18F-FDG PET/CT显像在早期诊断放射性心脏损伤中的应用[J].中华核医学与分子影像杂志,2017,37(11):710-713.
[11]梁平,蒙富斌,王洪乾.鼻咽癌放疗后放射性脑病36例临床分析[J].肿瘤基础与临床,2010,23(1):40-42.
[12]杨灵,宋伟平,袁传平,等.高压氧联合同步放化疗对局部晚期鼻咽癌的近期疗效及放射性脑病的临床观察[J].实用癌症杂志,2016,31(12):2093-2095.
[13]豆道勤.高压氧治疗鼻咽癌放射性脑病患者疗效分析[J].黑龙江医药,2017,30(4):867-868.
[14]刘涛,叶金辉,陈冬梅,等.高压氧联合药物治疗放射性脑病的临床观察[J].深圳中西医结合杂志,2016,26(11):128-130.
[15]黄慧,许阳子.鼻咽癌放疗后重症放射性脑病行手术治疗的围术期护理[J].微创医学,2016,11(3):474-475.
[16]Huang X M,Zheng Y Q,Mai H Q,et al.Diagnosis and Management of Skull Base Osteoradionecrosis After Radiotherapy for Nasopharyngeal Carcinoma[J].Laryngoscope,2010,116(9):1626-1631.
[17]Desalvo M N.Radiation necrosis of the pons after radiotherapy for nasopharyngeal carcinoma:Diagnosis and treatment[J].J Radiol Case Rep,2012,6(7):9-16.
[18]Wang F Z,Yong F P,Wang L.Clinical features of 307 patients with radiation encephalopathy after radiotherapy in nasopharyngeal carcinoma[J].Chinese Journal of Cancer Prevention&Treatment,2011,3(10):56-57.
[19]Zeng L,Tian Y M,Sun X M,et al.Late toxicities after intensitymodulated radiotherapy for nasopharyngeal carcinoma:patient and treatment-related risk factors[J].Br J Cancer,2014,110(1):49-54.
[20]Liao L Q,Yan H H,Mai J H,et al.Radiation-induced osteosarcoma of the maxilla and mandible after radiotherapy for nasopharyngeal carcinoma[J].Chinese Journal of Cancer,2016,35(1):89.
[21]梁锦辉,钟伟铭,高健全,等.鼻咽癌放疗后放射性脑病65例临床分析[J].现代肿瘤医学,2013,21(11):2432-2434.
[22]龙亚兰,成浩,周琳翔,等.56例鼻咽癌放疗后放射性脑病的临床分析[J].现代肿瘤医学,2018,26(16):39-41.
[23]周爱民,邓歆波,易静.鼻咽癌放疗后放射性脑病的临床疗效观察[J].宜春学院学报,2015,37(12):74-75.
[24]陈简兴.高压氧联合药物治疗鼻咽癌放疗后放射性脑病的护理体会[J].医疗装备,2015(13):165-166.
[25]周和超,陈兴贵,王镇南,等.依达拉奉联合丹参粉针治疗鼻咽癌放疗后脑损伤的近期疗效观察[J].中国现代医生,2014,52(22):42-44.
[2]李坊铭,陈国健,林剑毅,等.鼻咽癌放疗后放射性脑病影响因素分析[J].中国肿瘤外科杂志,2016,8(6):402-404.
[3]潘素明,陈志仁,张素敏,等.鼻咽癌调强放疗后放射性脑病23例临床分析[J].解放军预防医学杂志,2016,34(s2):116-117.
[4]楼建军,崔珍,何斌,等.鼻咽癌放射治疗后放射性脑病120例临床分析[J].齐齐哈尔医学院学报,2015,36(17):2523-2524.
[5]赵昆玉,黄小龙,胡震,等.多奈哌齐治疗放射性脑病认知功能障碍的疗效研究[J].中华放射医学与防护杂志,2017,37(6):426.
[6]李光芒,印群.放射性脑病CT影像诊断及鉴别诊断[J/OL].临床医药文献电子杂志,2016,3(27):5432-5433.
[7]尹本德.鼻咽癌放射治疗后放射性脑病的影像学的临床诊断[J].世界最新医学信息文摘,2017,17(29):131.
[8]肖来华,刘建国.鼻咽癌放疗后放射性脑病29例的MRI观察及治疗分析[J].中国社区医师,2014,30(15):89-90.
[9]李梅芳,黄远桃,颜福斌,等.鼻咽癌放疗后放射性脑病40例的诊治分析[J].中国中西医结合耳鼻咽喉科杂志,2018,26(2):74-76.
[10]闰蕊,宋建波,武志芳,等.18F-FDG PET/CT显像在早期诊断放射性心脏损伤中的应用[J].中华核医学与分子影像杂志,2017,37(11):710-713.
[11]梁平,蒙富斌,王洪乾.鼻咽癌放疗后放射性脑病36例临床分析[J].肿瘤基础与临床,2010,23(1):40-42.
[12]杨灵,宋伟平,袁传平,等.高压氧联合同步放化疗对局部晚期鼻咽癌的近期疗效及放射性脑病的临床观察[J].实用癌症杂志,2016,31(12):2093-2095.
[13]豆道勤.高压氧治疗鼻咽癌放射性脑病患者疗效分析[J].黑龙江医药,2017,30(4):867-868.
[14]刘涛,叶金辉,陈冬梅,等.高压氧联合药物治疗放射性脑病的临床观察[J].深圳中西医结合杂志,2016,26(11):128-130.
[15]黄慧,许阳子.鼻咽癌放疗后重症放射性脑病行手术治疗的围术期护理[J].微创医学,2016,11(3):474-475.
[16]Huang X M,Zheng Y Q,Mai H Q,et al.Diagnosis and Management of Skull Base Osteoradionecrosis After Radiotherapy for Nasopharyngeal Carcinoma[J].Laryngoscope,2010,116(9):1626-1631.
[17]Desalvo M N.Radiation necrosis of the pons after radiotherapy for nasopharyngeal carcinoma:Diagnosis and treatment[J].J Radiol Case Rep,2012,6(7):9-16.
[18]Wang F Z,Yong F P,Wang L.Clinical features of 307 patients with radiation encephalopathy after radiotherapy in nasopharyngeal carcinoma[J].Chinese Journal of Cancer Prevention&Treatment,2011,3(10):56-57.
[19]Zeng L,Tian Y M,Sun X M,et al.Late toxicities after intensitymodulated radiotherapy for nasopharyngeal carcinoma:patient and treatment-related risk factors[J].Br J Cancer,2014,110(1):49-54.
[20]Liao L Q,Yan H H,Mai J H,et al.Radiation-induced osteosarcoma of the maxilla and mandible after radiotherapy for nasopharyngeal carcinoma[J].Chinese Journal of Cancer,2016,35(1):89.
[21]梁锦辉,钟伟铭,高健全,等.鼻咽癌放疗后放射性脑病65例临床分析[J].现代肿瘤医学,2013,21(11):2432-2434.
[22]龙亚兰,成浩,周琳翔,等.56例鼻咽癌放疗后放射性脑病的临床分析[J].现代肿瘤医学,2018,26(16):39-41.
[23]周爱民,邓歆波,易静.鼻咽癌放疗后放射性脑病的临床疗效观察[J].宜春学院学报,2015,37(12):74-75.
[24]陈简兴.高压氧联合药物治疗鼻咽癌放疗后放射性脑病的护理体会[J].医疗装备,2015(13):165-166.
[25]周和超,陈兴贵,王镇南,等.依达拉奉联合丹参粉针治疗鼻咽癌放疗后脑损伤的近期疗效观察[J].中国现代医生,2014,52(22):42-44.