Turnquist Casmir, Harris Brent T, Harris Curtis C
University of Oxford Medical School, John Radcliffe Hospital, Oxford, UK.
Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA.
Neurooncol Adv. 2020 May 5;2(1):vdaa057. doi: 10.1093/noajnl/vdaa057. eCollection 2020 Jan-Dec.
Continued improvements in cancer therapies have increased the number of long-term cancer survivors. Radiation therapy remains one of the primary treatment modalities with about 60% of newly diagnosed cancer patients receiving radiation during the course of their disease. While radiation therapy has dramatically improved patient survival in a number of cancer types, the late effects remain a significant factor affecting the quality of life particularly in pediatric patients. Radiation-induced brain injury can result in cognitive dysfunction, including hippocampal-related learning and memory dysfunction that can escalate to dementia. In this article, we review the current understanding of the mechanisms behind radiation-induced brain injury focusing on the role of neuroinflammation and reduced hippocampal neurogenesis. Approaches to prevent or ameliorate treatment-induced side effects are also discussed along with remaining challenges in the field.
癌症治疗的持续进步增加了长期癌症幸存者的数量。放射治疗仍然是主要的治疗方式之一，约60%新诊断的癌症患者在病程中接受放射治疗。虽然放射治疗在多种癌症类型中显著提高了患者生存率，但晚期效应仍然是影响生活质量的重要因素，尤其是在儿科患者中。辐射诱发的脑损伤可导致认知功能障碍，包括与海马体相关的学习和记忆功能障碍，进而可能发展为痴呆症。在本文中，我们回顾了目前对辐射诱发脑损伤背后机制的理解，重点关注神经炎症和海马体神经发生减少的作用。还讨论了预防或改善治疗引起的副作用的方法以及该领域仍然存在的挑战。
