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放射治疗的神经系统并发症。

Neurologic Complications of Radiation Therapy.

机构信息

Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, 75 Francis Street, L2, Boston, MA 02115, USA.

Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, 420 Brookline Avenue, Boston, MA 02215, USA.

出版信息

Neurol Clin. 2018 Aug;36(3):599-625. doi: 10.1016/j.ncl.2018.04.012. Epub 2018 Jun 15.

Abstract

Cranial radiation therapy (CRT) is used to treat a wide range of malignant and benign conditions and is associated with a unique set of risks and complications. Early complications from CRT include fatigue, skin reaction, alopecia, headaches, anorexia, nausea/vomiting, exacerbation of neurologic symptoms, serous otitis media, parotitis, and encephalopathy. Delayed complications include pseudoprogression, radiation necrosis, neurocognitive changes, cerebrovascular effects, migrainelike disorders, cataracts, xerophthalmia, optic neuropathy, hearing loss, tinnitus, chronic otitis, endocrinopathy, and secondary malignancy. This article presents an overview of clinically relevant neurologic complications for CRT, basic pathophysiology of radiation injury, and risk factors for neurologic complications.

摘要

颅放射治疗(Cranial Radiation Therapy,CRT)被广泛用于治疗多种恶性和良性疾病,并伴随着一系列独特的风险和并发症。CRT 的早期并发症包括疲劳、皮肤反应、脱发、头痛、厌食、恶心/呕吐、神经症状恶化、浆液性中耳炎、腮腺炎和脑病。迟发性并发症包括假性进展、放射性坏死、认知功能改变、脑血管效应、偏头痛样疾病、白内障、干眼症、视神经病变、听力损失、耳鸣、慢性中耳炎、内分泌疾病和继发恶性肿瘤。本文介绍了 CRT 相关的、有临床意义的神经并发症,辐射损伤的基本病理生理学,以及神经并发症的风险因素。

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