海马回避-预防性颅脑照射对小细胞肺癌患者的影响
Impact of Hippocampal Avoidance - Prophylactic Cranial Irradiation in Small Cell Lung Cancer Patients.
作者信息
Maragkoudakis Emmanouil, Kouloulias Vasileios, Grenzelia Maria, Kougioumtzopoulou Andromachi, Zygogianni Anna, Ramfidis Vasileios, Charpidou Andrianni
机构信息
National and Kapodistrian University of Athens, 2nd Radiology Department, Radiotherapy Unit, Attikon University Hospital, Athens, Greece.
National and Kapodistrian University of Athens, 1st Radiology Department, Radiotherapy Unit, Aretaieion University Hospital, Athens, Greece.
出版信息
Cancer Diagn Progn. 2022 May 3;2(3):279-284. doi: 10.21873/cdp.10105. eCollection 2022 May-Jun.
BACKGROUND/AIM: Prophylactic cranial irradiation (PCI) is a well-established treatment of small cell lung cancer (SCLC) patients following response to initial chemoradiotherapy. The benefit of PCI does, however, come at the cost of cognitive decline. This has been attributed to radiation-induced toxicity at the hippocampus, a crucial anatomic area for cognition. Modern radiotherapy techniques allow dose reduction at the hippocampal region. In this review, the safety profile, effect on cognition, and changes on brain imaging modalities of hippocampal avoidance-PCI (HA-PCI) will be presented, aiming to identify a potential clinical rationale for SCLC patients.
MATERIALS AND METHODS
A systematic review of the literature was performed in Pubmed, Cochrane library databases and ClinicalTrials.gov with no past date limitations until 07/01/2022. Principles as outlined in the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement were followed.
RESULTS
Eight studies published from 2015 to 2021 were included.
CONCLUSION
HA-PCI is safe, yet its effect on neurocognition and imaging remains unclear, as studies have shown contradictory results.
背景/目的：预防性颅脑照射（PCI）是小细胞肺癌（SCLC）患者在对初始放化疗产生反应后的一种成熟治疗方法。然而，PCI的益处是以认知功能下降为代价的。这被归因于海马体（认知的关键解剖区域）的辐射诱导毒性。现代放疗技术可减少海马体区域的剂量。在本综述中，将介绍海马体避让PCI（HA-PCI）的安全性、对认知的影响以及脑成像方式的变化，旨在为SCLC患者确定潜在的临床依据。
材料与方法
在PubMed、Cochrane图书馆数据库和ClinicalTrials.gov中对文献进行系统综述，截至2022年1月7日无既往日期限制。遵循系统综述和Meta分析的首选报告项目（PRISMA）声明中概述的原则。
结果
纳入了2015年至2021年发表的8项研究。
结论
HA-PCI是安全的，但其对神经认知和成像的影响仍不明确，因为研究显示结果相互矛盾。
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