摘要
目的总结国内外对颅脑放射治疗引起认知功能障碍的研究现状。方法应用检索PubMed及CNKI期刊全文数据库检索系统,以"颅脑放疗、放射性脑损伤、认知功能障碍"等为关键词,检索2000-01-2013-12的相关文献,共检索到英文文献2 099条,中文文献557条。纳入标准:1)先初步阅读,文章内容提示有放射性脑损伤的研究报道。2)研究中有一定数量的样本。3)文章内容主要是以放射性脑损伤(包括认知功能障碍)的临床表现、检测或诊断方法以及治疗方式为主的。剔除标准:1)重复报告。2)会议摘要。3)经验总结文献。符合纳入标准的中文文献33条,英文文献195条,根据剔除标准剔除中文文献30条,英文文献170条,最后纳入分析28篇文献。结果随着放射治疗技术方法的不断更新,颅脑肿瘤放疗患者的疗效得到一定提高,但相应潜在的放射治疗晚期并发症日渐突出。患者在接受颅脑放疗的后期会出现认知功能障碍,这可以发生在相对低剂量的照射和没有放射影像或临床证据显示脱髓鞘或脑白质坏死的情况下,而目前还缺乏有效的检测方法。因此,对于放射性脑损伤研究的重点是在减少发生及尽早发现。非侵入性的技术,如MRI、PET、pMRI等的应用为及早发现和预测放射引起的认知功能障碍奠定了基础.在治疗上,虽然颅脑放疗引起的脑损伤,包括认知功能障碍的确切机制不明,但仍有潜在的治疗策略用以防止放射性脑损伤,如消炎药、皮质醇激素、神经干细胞移植和高压氧治疗等.结论虽然颅脑放疗引起认知功能障碍已在颅脑肿瘤治疗过程中得到重视,但还需要进一步的研究及早且安全检测和评估颅脑放疗引起认知功能障碍的方法。
OBJECTIVE Summarizes research status of post-cranial irradiation cognitive impairment in the clinic in China and abroad. METHODS Using the ＂Cranial irradiation, Post-radiation brain injury, Cognitive impairment in the clinic＂ as the keys words, to search the literatures from Jan. 2000 to Dec. 2013 in the Pubmed and CNKI Database Retrieval System, then got 2099 English literatures and 557 Chinese literatures. The inclusion criteria： the content of the article is about the study of post-radiation brain injury; there are a number of study samples in the research; the main content of the artichle is about the clinical manifestations, detection, therapy methods of post-radiation brain injury（including the cognitive impairment）. The exclusion criteria： repeated reports; meeting summary; experience summary. According to the inclusion and exclusion criterias,there are finally 25 literatures included in the analysis. RESULTS As the development of radiation therapy methods,improved survival following radiation therapy may come with a cost, including the potential complication of post-radiation cognitive impairment in the clinic. Importantly, all of these late sequelae can be seen in the absence of radiographic or clinical evidence of demyelination or white matter necrosis. However we don＇t have the effective detection methods. Therefore, the focus in the study of radiation brain injury would happened in reducing and early detection. Non-invasive techniques such as magnetic resonance imaging （MRI）, PET, pMRI to early detection and prediction of the application of cognitive dysfunction caused by radiation laid a foundation. In treatment, although cerebral radiation caused by brain damage, including cognitive dysfunction in the exact mechanism is unclear, but there are still a potential treatment strategy in order to prevent radioactive brain damage, such as anti-inflammatory drugs, the hormone cortisol, neural stem cell transplantation, hyperbaric oxygen therapy, etc. CONCLUSION Although post-cranial irradi
出处
《中华肿瘤防治杂志》
CAS
北大核心
2014年第23期1925-1928,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
颅脑肿瘤
放射性脑损伤
认知功能障碍
评估
检测
治疗
综述文献
intracranial tumor
post-radiation brain injury
cognitive impairment in the clinic
evaluation
detection
therapy
review literature
