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[放射治疗后泌尿系统并发症的发病机制]

[Pathogenesis of urological complications after radiation therapy].

作者信息

Tolkach Y, Kristiansen G

机构信息

Institut für Pathologie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Deutschland.

出版信息

Urologe A. 2017 Mar;56(3):293-300. doi: 10.1007/s00120-016-0292-1.

Abstract

Radiation therapy is a treatment modality that is often used in the uro-oncological setting. The common indication for the radiation therapy in the urological sphere is prostate cancer, whether it is used primarily as a radical approach, or postoperatively as adjuvant or salvage therapy. All urological organs are sensitive to radiation injury with the urinary bladder being the most susceptible with a typical cascade including acute and late changes, arising in the dose-dependent manner. The common indication for radiation therapy in urology is prostate cancer, which collaterally affects the urinary bladder and rarely urethra (especially the bulbo-membranous urethra). Ureteral damage and stricture formation is almost always restricted to the cases of intraoperative therapy and external beam radiation therapy for other urological malignancies (gynecological organs, rectum, retroperitoneal soft tissue tumors) and should not be underestimated. Postradiotherapeutic tissue changes, especially of the prostate, can cause difficulties for pathologists and urologists with regard to diagnosis of prostate cancer recurrence and salvage therapy.

摘要

放射治疗是一种常用于泌尿肿瘤领域的治疗方式。泌尿外科领域放射治疗的常见适应症是前列腺癌,无论是主要作为根治性方法使用,还是术后作为辅助或挽救性治疗。所有泌尿器官对辐射损伤都敏感,其中膀胱最易受影响,典型的变化过程包括急性和晚期改变,且呈剂量依赖性。泌尿外科放射治疗的常见适应症是前列腺癌,这会对膀胱产生附带影响,对尿道(尤其是球膜部尿道)的影响则很少见。输尿管损伤和狭窄形成几乎总是局限于术中治疗以及针对其他泌尿恶性肿瘤(妇科器官、直肠、腹膜后软组织肿瘤)的外照射放疗的情况,不应被低估。放疗后的组织变化,尤其是前列腺的变化,会给病理学家和泌尿外科医生诊断前列腺癌复发及挽救性治疗带来困难。

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