Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.
Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S108-15. doi: 10.1016/j.ijrobp.2009.02.089.
The kidneys are the dose-limiting organs for radiotherapy to upper abdominal cancers and during total body irradiation. The incidence of radiotherapy-associated kidney injury is likely underreported owing to its long latency and because the toxicity is often attributed to more common causes of kidney injury. The pathophysiology of radiation injury is poorly understood. Its presentation can be acute and irreversible or subtle, with a gradual progressive dysfunction over years. A variety of dose and volume parameters have been associated with renal toxicity and are reviewed to provide treatment guidelines. The available predictive models are suboptimal and require validation. Mitigation of radiation nephropathy with angiotensin-converting enzyme inhibitors and other compounds has been shown in animal models and, more recently, in patients.
肾脏是上腹部癌症放射治疗和全身照射的剂量限制器官。由于其潜伏期长，且毒性通常归因于更常见的肾损伤原因，因此放射治疗相关肾损伤的发生率可能被低估。放射损伤的病理生理学机制尚不清楚。其表现可以是急性和不可逆的，也可以是隐匿的，随着时间的推移逐渐进行性功能障碍。已经研究了多种剂量和体积参数与肾毒性的关系，并对其进行了综述，以提供治疗指南。现有的预测模型并不理想，需要验证。在动物模型中已经证明了血管紧张素转换酶抑制剂和其他化合物可以减轻放射性肾病，最近在患者中也证明了这一点。
