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Delayed Radiation Injury to the Brain : In Relation to Therapeutic View Point

脑迟发性放射损伤：与治疗观点的关系

基本信息

批准号：
63570671
负责人：
YOSHII Yoshihiko
金额：
$ 1.34万
依托单位：
University of Tsukuba
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1988
资助国家：
日本
起止时间：
1988 至 1990
项目状态：
已结题

项目摘要

This report discusses the effects on normal brain tissue of radiotherapy in relation to age and irradiation dose as determined from whole-brain sections of the autopsied brains with tumors. Twenty eight patients were treated by cobaltor linear accelerator radiotherapy. Nine patients without brain disease (4 aged and 5 non-aged) were used as a control group. Hyalinization of the small vessels was observed within postradiation 12 months in fields exposed to total doses of less than 800 neuret. Hyalinization of the capillary vessels was greater in the irradiated group than in the control group. Demyelination was observed within the postradiation 12 months in fields irradiated by more than 800 neuret in aged patients and in fields irradiated by less than 800 neuret in non-aged patients. Fibrinoid nicrosis was observed after the post-radiation 12 months in fields irradiated by less than 800 neuret in aged patients and in fields irradiated by more than 800 neuret in non-aged patients. It is … More worth nothing that in non-aged patients with brain tumors, adverse effects of radiotherapy on vessels and parenchyma were very high even in low-dose radiation areas ; and in aged patients fibrinoid necrosis, which indicates irreversible damage of vessels, was observed in low-dose radiation areas.In CT scans, the enhanced area and the low density area were always observed within a zone of more than 80% of the total doses. A low density area was observed 4-15 months after radiotherapy, then the contrast-enhanced area appeared within the low-density area about 4 months later. In the histologically verified case, the fibrinoid necrosis of the blood vessel and demyelination appeared significantly higher in the enhanced area than in the low-density area.In conclusion, when a low-density area was observed by CT scan within the field of radiotherapy, we also suspected radiation injury and considered steroid or anticoagulant therapy in order to reverse it. However, if an enhanced area appeared within the injured lesion, the area seemed to have become irreversible and surgical therapy might also be needed. Less

本报告讨论了放射治疗对正常脑组织的影响与年龄和辐射剂量的关系，这些影响是根据尸检肿瘤大脑的全脑切片确定的。 28 名患者接受了钴直线加速器放射治疗。将 9 名无脑部疾病的患者（4 名老年患者和 5 名非老年患者）作为对照组。在辐射后 12 个月内，在暴露于总剂量低于 800 个神经突的视野中观察到小血管透明化。照射组的毛细血管透明化程度高于对照组。照射后12个月内，老年患者接受超过800个神经细胞照射的视野和非老年患者接受少于800个神经细胞照射的视野中观察到脱髓鞘。照射后12个月后，老年患者照射轴数小于800的视野和非老年患者照射轴数超过800的视野观察到纤维蛋白样坏死。毫无意义的是，在非老年脑肿瘤患者中，即使在低剂量辐射区域，放疗对血管和实质的不良影响也非常高； CT扫描中，增强区和低密度区总是出现在总剂量80%以上的区域内。放疗后4-15个月观察到低密度区，约4个月后低密度区内出现造影增强区。在经组织学证实的病例中，增强区的血管纤维蛋白样坏死和脱髓鞘现象明显高于低密度区。综上所述，当CT扫描在放疗野范围内观察到低密度区时，我们也怀疑放射损伤，并考虑使用类固醇或抗凝治疗来逆转它。然而，如果受伤病灶内出现增强区域，则该区域似乎已变得不可逆转，也可能需要手术治疗。较少的