恶性肿瘤放疗诱发骨肉瘤的研究进展

Research progress on radiation-induced osteosarcoma

随着恶性肿瘤放射治疗的广泛应用、肿瘤综合治疗效果不断提高,肿瘤患者生存期延长,放疗诱发的发生率极低的骨肉瘤发病率逐渐增高。放疗诱发的骨肉瘤(radiation-induced osteosarcoma,RIOS)与原发性骨肉瘤相比恶性程度更高、进展更快、预后更差,严重影响了放疗后患者生存期。目前临床上对放疗诱发的骨肉瘤认识尚不全面,本文结合国内外最新报道,阐述恶性肿瘤放疗诱发的骨肉瘤的发病率、发生分子机制、潜伏期和诊断标准,并与原发性骨肉瘤的临床特点、影像学表现、治疗预后进行比较归纳做一综述。

The extensive application of radiotherapy and the long survival of patients with malignant tumors have led to an in-creased incidence rate of radiation-induced osteosarcoma （RIOS）, one of the most critical radiation-induced complications. Compared with primary osteosarcoma, RIOS has higher grade and poorer prognosis, which reduces the survival of patients with cancers. However, RIOS has not been fully understood in the clinical setting. This paper summarizes the latest progress at home and abroad, focusing on the incidence rate, risk factor, latency, and diagnostic criteria of RIOS. The molecular mechanism of RIOS is associated with the muta-tion of p53, the activation of the Wnt/β-catenin signaling pathway, and the superposition of multiple alleles. Furthermore, we discuss the differences in clinical characteristics, imaging findings, treatment, and prognosis between primary osteosarcoma and RIOS.