放射性胃、十二指肠损伤的研究进展

Research status of radiation induced gastroduodenal injury

随着三维适形、伽马刀、螺旋断层放疗等现代放疗技术的发展,肝癌、胰腺癌、肠癌等腹部肿瘤患者显示出更多的生存时间.腹部肿瘤放疗的广泛应用使胃、十二指肠放射性损伤越来越引起临床医生的重视,现有关放射性胃、十二指肠损伤发生机制的研究较少.本文对放射性胃、十二指肠损伤的发生机制及病理特点、影响因素、诊疗进展等进行总结,指出放疗后行内镜检查的最佳时间仍无定论,胃V25、十二指肠V35、十二指肠a V55 Gy等物理因素与大于2级(CTCAE3.0)胃、十二指肠损伤相关,放射性胃、十二指肠炎现在无确定的诊断、治疗标准,而祖国医学在防治放射性胃、十二指肠损伤中具有独特的地位.

With the development of modern radiotherapy techniques,such as three dimensional conformal radiotherapy,Gamma-knife treatment,and tomotherapy,patients who have abdominal tumors like liver cancer,pancreatic cancer,and colon cancer can live longer.The wide use of radiation therapy increases the incidence of gastroduodenal radioactive injury.This article reviews the pathogenesis and pathological characteristic of radiation induced gastroduodenal injury,factors influencing the injury,and the diagnosis and treatment of radiation induced gastroduodenal injury.Currently,there have been few studies on the mechanism of radiation induced gastroduodenal injury.The optimal timing of endoscopic examination after radiotherapy is still inconclusive.V25 for the stomach,V35 for the duodenum and aV55 Gy for the duodenum are predictive factors for gastroduodenal toxicity（grade2,CTCAE3.0）.There has been no treatment standard for curing radiation induced gastroduodenitis.Traditional Chinese medicine has unique advantages in the prevention and control of radiation induced gastroduodenal injury.