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头颈部癌患者放疗后颈段脊髓的放射性脱髓鞘

Radiation Induced Demyelination in Cervical Spinal Cord of the Head and Neck Cancer Patients after Receiving Radiotherapy.

作者信息

H Goyal, N Singh, O P Gurjar, R K Tanwar

机构信息

MD, Department of Radiotherapy, Government Medical College & Hospital, Kota, India.

PhD, Department of Radiotherapy, King George Medical University, Lucknow, India.

出版信息

J Biomed Phys Eng. 2020 Feb 1;10(1):1-6. doi: 10.31661/jbpe.v0i0.1055. eCollection 2020 Feb.

Abstract

BACKGROUND

Cervical spinal cord is important and radiosensitive. It is the most critical organ for the head and neck (H&N) cancer patients during radiotherapy. If the delivered dose to the cord is more than tolerance dose, demyelination may occur.

OBJECTIVE

Current study aims to analyze the post radiotherapy status of cord in the H&N cancer patients.

MATERIAL AND METHODS

In this analytical study, sixty patients who received more than 50 Gray (Gy) dose for more than 10 cm length of spinal cord participated in the study. All the patients were clinically examined and magnetic resonance imaging (MRI) was performed for patients who had demyelination symptoms. Adequate medical management was provided for all the patients having demyelination.

RESULTS

Out of sixty patients, ten cases were reported with demyelination symptoms, and only six cases gave consent for this study. One patient was found to have irreversible demyelination while five patients had reversible demyelination.

CONCLUSION

Demyelination may occur if long segment spinal cord receives dose more than tolerance limit. However target dose should not be compromised up to 54 Gy to spinal cord.

摘要

背景

颈段脊髓至关重要且对放疗敏感。它是头颈部(H&N)癌症患者放疗期间最关键的器官。如果脊髓所接受的剂量超过耐受剂量,可能会发生脱髓鞘。

目的

本研究旨在分析头颈部癌症患者放疗后脊髓的状况。

材料与方法

在这项分析性研究中,60例脊髓长度超过10厘米且接受超过50格雷(Gy)剂量放疗的患者参与了研究。对所有患者进行了临床检查,对有脱髓鞘症状的患者进行了磁共振成像(MRI)检查。为所有有脱髓鞘的患者提供了适当的医疗处理。

结果

60例患者中,有10例报告有脱髓鞘症状,只有6例同意参与本研究。发现1例患者有不可逆脱髓鞘,5例患者有可逆性脱髓鞘。

结论

如果长节段脊髓接受的剂量超过耐受极限,可能会发生脱髓鞘。然而,脊髓的靶剂量在54 Gy以内不应受到影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/faee/7036413/38e38eda1fd8/JBPE-10-1-g001.jpg

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