胸部肿瘤放射治疗中心脏照射剂量体积与损伤效应的关系

Relationship Between Heart Irradiation Dose-volume and Radiation-induced Cardiac Toxicity in Radiotherapy for Thoracic Neoplasms

放射治疗是胸部肿瘤综合治疗的重要组成部分,但其具有明确的致心脏损伤作用。随着放射治疗主流技术的进步,胸部肿瘤放射治疗中心脏照射的剂量体积分布特点发生了转变。放射相关性心脏疾病(radiation-related heart diseases, RRHDs)的发生显著减少,但在以调强放射治疗为主流的精确治疗时代仍不能确保绝对的心脏安全。本文综述了心脏照射剂量体积分布对放射性心脏损伤风险的影响及心脏照射剂量体积评价指标,并对影响心脏照射剂量体积分布的技术因素及放射相关心脏疾病的监测方法进行了探讨。

Radiation therapy is one of the important systematic treatment strategies for thoracic neoplasms,but it also can cause a definite cardiac toxicity.With the evolution of main radiotherapeutic technology,the characteristics of heart irradiation dose-volume distribution in patients with thoracic tumor receiving radiotherapy have been changed.The incidence of radiation-related heart diseases(RRHDs)has been significantly decreased.However,precise radiotherapy based on intensity modulated radiation therapy still can not guarantee the absolute cardiac safety currently.This article reviews the effect of heart irradiation dosevolume distribution on potential risks of RRHDs,and the parameters to evaluate heart doses and volume,as well as other techniques affecting the dose-volume distribution of heart irradiation and the detection of RRHDs.