HEPATIC TOXICITY RESULTING FROM CANCER-TREATMENT
HEPATIC TOXICITY RESULTING FROM CANCER-TREATMENT
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DOI：
10.1016/0360-3016(94)00418-k
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发表时间：
1995-03-30
影响因子：
7
通讯作者：
FAJARDO, LF
中科院分区：
文献类型：
--
作者：
LAWRENCE, TS;ROBERTSON, JM;FAJARDO, LF
放射性肝病 (RILD)，通常称为放射性肝炎，是一种以肝脏照射后约 2 周至 4 个月出现无黄疸腹水为特征的综合征。由于癌症治疗方面的两项重大进展，人们对肝脏照射重新产生了兴趣：三维放射治疗计划和使用全身照射的骨髓移植。肝脏放射引起的 RILD 通常可以在临床上与骨髓移植相关准备方案引起的 RILD 区分开来。然而，这两种综合征都表现出相同的病理病变：静脉闭塞性疾病。最近的证据表明，转化生长因子β水平升高可能在静脉闭塞性疾病的发生中发挥作用。三维治疗计划提供了确定 RILD 的辐射剂量和体积依赖性的潜力，从而允许将高剂量的辐射安全地输送到肝脏部分。 RILD 的主要治疗方法是利尿剂，但有些人主张对严重病例使用类固醇。 RILD 的特点允许开发仿照 NCI 急性常见毒性标准的分级系统，其中纳入了肝功能障碍的标准标准。
Radiation-induced liver disease (RILD), often called radiation hepatitis, is a syndrome characterized by the development of anicteric ascites approximately 2 weeks to 4 months after hepatic irradiation. There has been a renewed interest in hepatic irradiation because of two significant advances in cancer treatment: three dimensional radiation therapy treatment planning and bane marrow transplantation using total body irradiation. RILD resulting from liver radiation can usually be distinguished clinically from that resulting from the preparative regime associated with bone marrow transplantation. However, both syndromes demonstrate the same pathological lesion: veno-occlusive disease. Recent evidence suggests that elevated transforming growth factor beta levels may play a role in the development of veno-occlusive disease. Three dimensional treatment planning offers the potential to determine the radiation dose and volume dependence of RILD, permitting the safe delivery of high doses of radiation to parts of the liver. The chief therapy for RILD is diuretics, although some advocate steroids for severe cases. The characteristics of RILD permit the development of a grading system modeled after the NCI Acute Common Toxicity Criteria, which incorporates standard criteria of hepatic dysfunction.