Saad Shumaila, Wang Tony J C
Department of Radiation Oncology, College of Physicians and Surgeons, Columbia University, New York, NY.
Am J Clin Oncol. 2015 Dec;38(6):634-40. doi: 10.1097/COC.0000000000000158.
Radiotherapy (RT) has proven to be an effective therapeutic tool in treatment of a wide variety of brain tumors; however, it has a negative impact on quality of life and neurocognitive function. Cognitive dysfunction associated with both the disease and adverse effects of RT is one of the most concerning complication among long-term survivors. The effects of RT to brain can be divided into acute, early delayed, and late delayed. It is, however, the late delayed effects of RT that lead to severe neurological consequences such as minor-to-severe cognitive deficits due to irreversible focal or diffuse necrosis of brain parenchyma. In this review, we discuss current and emerging data regarding the relationship between RT and neurocognitive outcomes, and therapeutic strategies to prevent/treat postradiation neurocognitive deficits.
放射治疗(RT)已被证明是治疗多种脑肿瘤的有效治疗手段;然而,它会对生活质量和神经认知功能产生负面影响。与疾病及放疗不良反应相关的认知功能障碍是长期幸存者中最令人担忧的并发症之一。放疗对大脑的影响可分为急性、早期延迟和晚期延迟效应。然而,正是放疗的晚期延迟效应会导致严重的神经后果,如由于脑实质不可逆的局灶性或弥漫性坏死而导致的轻度至重度认知缺陷。在本综述中,我们讨论了关于放疗与神经认知结果之间关系的当前及新出现的数据,以及预防/治疗放疗后神经认知缺陷的治疗策略。