| 李京,薛竹宏,周光明.放射治疗致神经系统损伤的研究进展[J].中华放射医学与防护杂志,2026,46(8):804-810.Li Jing,Xue Zhuhong,Zhou Guangming.Advances in research on radiotherapy-induced nervous system injury[J].Chin J Radiol Med Prot,2026,46(8):804-810 |
| 放射治疗致神经系统损伤的研究进展 |
| Advances in research on radiotherapy-induced nervous system injury |
| 投稿时间：2025-10-17 |
| DOI：10.3760/cma.j.cn112271-20251017-00362 |
| 中文关键词: 放射治疗|中枢神经系统|肿瘤|放射性损伤 |
| 英文关键词:Radiotherapy|Central nervous system|Tumor|Radiation-induced damage |
| 基金项目:黑龙江省卫生健康委科研课题(2020-441);齐齐哈尔市科技计划创新激励项目(CSFGG-2020001) |
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| 中文摘要: |
| 放射治疗具有显著的疗效和较好的耐受性,是中枢神经系统(CNS)各类肿瘤及血管畸形的重要治疗手段,临床应用日益广泛。然而,放疗不可避免会照射到周围正常神经组织,常引发短期至远期的多种并发症,症状轻重不一,既包括轻度自限性反应,也涵盖不可逆甚至致死性的神经组织损伤。近年来,放疗靶区勾画、剂量递送等技术与精准放疗方案持续优化,有效降低了靶区周围正常组织的辐射受量,但患者仍出现各类放疗相关不良反应,其中头颈部神经组织的放射性损伤尤为突出。机制层面,放疗所致神经系统损伤主要通过氧化应激介导,具体表现为神经元凋亡增加、神经炎症激活、细胞功能失调及血管内皮功能障碍,进而诱发组织纤维化,导致神经亚结构功能紊乱,最终引发脑组织坏死、白质损伤及血管病变等不良结局。本文对放疗方案及治疗策略进行概述,系统阐明了放疗所致神经系统损伤的核心机制,并重点分析和解读放疗相关神经系统并发症的临床特征,旨在为该类损伤的防治研究提供理论基础。 |
| 英文摘要: |
| Owing to its high efficacy and tolerability, radiotherapy represents an important treatment method for various tumors and vascular malformations of the central nervous system (CNS), having found increasingly wide clinical applications. However, radiotherapy inevitably causes surrounding normal nerve tissues of the CNS to be irradiated, thereby tending to induce multiple short- to long-term complications, including both mild self-limiting reactions and irreversible or even fatal damage to nervous tissues. In recent years, the constant optimization of radiotherapy techniques (e.g., target delineation and dose delivery) and precise radiotherapy solutions have effectively lowered the radiation doses to normal tissues surrounding target volumes. However, patients still suffer from various radiotherapy-related adverse reactions, especially radiation-induced damage to nervous tissues in the head and neck. Regarding underlying mechanisms, radiation-induced nervous system injury is primarily mediated by oxidative stress, being manifested as increased neuronal apoptosis, neuroinflammation activation, cell dysfunction, and vascular endothelial dysfunction. These reactions then trigger tissue fibrosis, leading to the dysfunction of neural substructures and eventually inducing adverse outcomes including brain tissue necrosis, white matter injury, and vascular lesions. This review summarizes radiotherapy solutions and relevant treatment strategies and systematically elucidates the core mechanisms underlying radiotherapy-induced nervous system injury, focusing on the analysis and interpretation of the clinical characteristics of radiotherapy-related neurologic complications, in order to provide a theoretical basis for the prevention and treatment of such injury. |
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