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辐射诱发的胶质瘤

Radiation-Induced Gliomas.

作者信息

Aherne Noel J, Murphy Brona M

机构信息

Department of Radiation Oncology, Mid North Coast Cancer Institute, Coffs Harbour, New South Wales, Australia; RCS Faculty of Medicine, University of New South Wales, New South Wales, Australia.

Department of Physiology and Medical Physics; Centre for Systems Medicine, Royal College of Surgeons in Ireland, Dublin 2, Ireland.

出版信息

Crit Rev Oncog. 2018;23(1-2):113-118. doi: 10.1615/CritRevOncog.2018025740.

Abstract

Radiation therapy has been a cornerstone of cancer management for many decades and is an integral part of the multi-modality care of patients with brain tumors. The known serious side effects of radiation therapy on the head or central nervous system are uncommon and include radiation necrosis, microangiopathy, and progressive leukencephalopathy. In addition, there have been descriptions of radiation-induced tumors including sarcomas, gliomas, lymphomas, and carcinomas of the thyroid. Patients who have received radiation therapy of the head or face may rarely develop radiation-induced tumors, a majority of which are meningiomas, followed by radiation-induced gliomas (RIGs) and sarcomas. The increased risk of RIGs is well described in both the pediatric and adult populations and after the use of both therapeutic and diagnostic radiations. The incidence of RIGs is estimated at approximately 0.5-2.7% at a latent period of approximately 15 years. The risk appears to be dependent on patient age at treatment, as well as radiation dose and treatment volume considerations. The scope of this review focuses on the etiology, clinical features, and management of RIGs as they relate to previous radiation therapy.

摘要

几十年来,放射治疗一直是癌症治疗的基石,也是脑肿瘤患者多模式治疗不可或缺的一部分。放射治疗对头或中枢神经系统已知的严重副作用并不常见,包括放射性坏死、微血管病和进行性白质脑病。此外,还有关于辐射诱发肿瘤的描述,包括肉瘤、胶质瘤、淋巴瘤和甲状腺癌。接受过头或面部放射治疗的患者很少会发生辐射诱发肿瘤,其中大多数是脑膜瘤,其次是辐射诱发胶质瘤(RIG)和肉瘤。在儿童和成人人群中,以及在使用治疗性和诊断性辐射后,RIG的风险增加都有详细描述。在大约15年的潜伏期,RIG的发病率估计约为0.5-2.7%。风险似乎取决于治疗时的患者年龄,以及辐射剂量和治疗体积等因素。本综述的范围聚焦于与既往放射治疗相关的RIG的病因、临床特征和治疗。

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