专家共识
ENGLISH ABSTRACT
放射性脑损伤诊治中国专家共识
中国放射性脑损伤多学科协作组
中国医师协会神经内科分会脑与脊髓损害专业委员会
作者及单位信息
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DOI: 10.3760/cma.j.issn.1671-8925.2019.06.001
Diagnoses and treatments of radiation-induced brain injury: an expert consensus
Chinese Multidisciplinary Collaboration Group of Radiation-induced Brain Injury
Specialized Committee Professional Board of Brain and Spinal Cord Injury, Neurology Branch of Chinese Medical Doctor Association
Authors Info & Affiliations
Chinese Multidisciplinary Collaboration Group of Radiation-induced Brain Injury
Specialized Committee Professional Board of Brain and Spinal Cord Injury, Neurology Branch of Chinese Medical Doctor Association
·
DOI: 10.3760/cma.j.issn.1671-8925.2019.06.001
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摘要

放射治疗是头颈部原发及转移肿瘤的重要治疗方法。放射性脑损伤是头颈部肿瘤患者在放射治疗后产生中枢神经系统损害症状的疾病,是肿瘤患者放疗后的严重并发症,偶发于电离辐射事故中。近年来,放射性脑损伤的确诊率总体呈上升趋势,原因可能包括以下方面:(1)随着社会经济和医学的发展,肿瘤发病率、确诊率增加,综合治疗率也较前提高;(2)肿瘤综合治疗方案的推广、各种放射治疗新技术的应用,使肿瘤患者在生存率得到提高、生存期延长的同时,其生活质量也受到重视;(3)先进的影像诊断、检查手段的使用,使得脑部病灶的发现率升高、发现时间提早。据相关报道总结,立体定向放射治疗脑膜瘤后放射性脑损伤的发生率为28%~50% [ 1 ] ;鼻咽癌放疗后放射性脑损伤的4年累计发生率为1.9%~5% [ 2 , 3 ] ;低分化胶质瘤放疗后放射性脑损伤的4年累计发生率为1%~24% [ 4 , 5 ] ;脑转移瘤放疗后放射性脑损伤的1年累计发生率为8%~20% [ 6 , 7 ] 。在患者生活质量已成为仅次于生存率评价放射治疗疗效的今天,该类放射性损伤愈来愈受到关注 [ 8 ]

放射性脑损伤;诊断;治疗;专家共识
引用本文

中国放射性脑损伤多学科协作组,中国医师协会神经内科分会脑与脊髓损害专业委员会. 放射性脑损伤诊治中国专家共识[J]. 中华神经医学杂志,2019,18(6):541-549.

DOI:10.3760/cma.j.issn.1671-8925.2019.06.001

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放射治疗是头颈部原发及转移肿瘤的重要治疗方法。放射性脑损伤是头颈部肿瘤患者在放射治疗后产生中枢神经系统损害症状的疾病,是肿瘤患者放疗后的严重并发症,偶发于电离辐射事故中。近年来,放射性脑损伤的确诊率总体呈上升趋势,原因可能包括以下方面:(1)随着社会经济和医学的发展,肿瘤发病率、确诊率增加,综合治疗率也较前提高;(2)肿瘤综合治疗方案的推广、各种放射治疗新技术的应用,使肿瘤患者在生存率得到提高、生存期延长的同时,其生活质量也受到重视;(3)先进的影像诊断、检查手段的使用,使得脑部病灶的发现率升高、发现时间提早。据相关报道总结,立体定向放射治疗脑膜瘤后放射性脑损伤的发生率为28%~50% [ 1 ];鼻咽癌放疗后放射性脑损伤的4年累计发生率为1.9%~5% [ 2 , 3 ];低分化胶质瘤放疗后放射性脑损伤的4年累计发生率为1%~24% [ 4 , 5 ];脑转移瘤放疗后放射性脑损伤的1年累计发生率为8%~20% [ 6 , 7 ]。在患者生活质量已成为仅次于生存率评价放射治疗疗效的今天,该类放射性损伤愈来愈受到关注 [ 8 ]
为促进放射性脑损伤相关的放射治疗学、神经病学等相关专业临床医师对放射性脑损伤的关注和认识,针对诊断与治疗做出正确决策,中国放射性脑损伤多学科协作组、中国医师协会神经内科医师分会脑与脊髓损害专委会联合相关的肿瘤放疗科、神经外科、神经影像专家就上述问题展开讨论,并结合目前国内外现有研究和临床证据,就放射性脑损伤的临床诊疗相关原则达成共识。
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备注信息
A
唐亚梅,Email: nc.defudabe.usys.liammygnat
B

本共识由中国放射性脑损伤多学科协作组、中国医师协会神经内科分会脑与脊髓损害专业委员会专家共同讨论,由唐亚梅教授和李艺副教授起草完成

C
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