放射性脑坏死的新认识与防治

Research advances in prevention and treatment of cerebral radiation necrosis

放射性脑坏死是颅内肿瘤和颅底部位肿瘤放疗后的严重并发症，由于既往缺少有效的治疗手段．放射性脑坏死曾经被认为是进展性的、不可逆转的。随着组织病理学和神经影像学的发展．放射性脑坏死的发生、发展逐渐明确，新的治疗手段也不断出现。最近几年，国内外的学者尝试用贝伐单抗．针对血管内皮生长因子的人源化单克隆抗体、神经生长因子、神经节苷脂等治疗放射性脑坏死，取得了确切的疗效，部分脑坏死病例甚至能够修复逆转。本文针对放射性脑坏死的发病率、病理生理、治疗和预后进行综述。

Cerebral radiation necrosis （CRN） is a serious complication of radiotherapy for intraeranial tumors and skull base tumors. Since there lacked effective therapeutic methods in the past, CRN was once considered to be progressive and irreversible. With the development of histopathology and neuroimaging, the development and progression of CRN is gradually clarified, and new therapeutic methods have been developed. In recent years, the scholars at home and abroad have tried to use bevaeizumab （a humanized monoclonal antibody targeting vascular endothelial growth factor）, nerve growth factor, and ganglioside in the treatment of CRN and have achieved definite therapeutic effects. In some patients, cerebral necrosis was even repaired and reversed. This article reviews the incidence, pathophysiology, treatment, and prognosis of CRN.