脑部放疗引起认知功能障碍的预防和治疗

Prevention and treatment of cognitive dysfunction caused by radiotherapy to the brain

放射性脑损伤是恶性肿瘤放疗后的严重不良反应,在放疗后期常出现认知功能障碍,严重影响患者的生命质量。尽管放疗引起的认知功能障碍的机制尚不完全明确,但随着人们对认知功能障碍的关注,越来越多的预防策略应用于临床,包括海马回避的全脑放疗、立体定向放射外科在多发性脑转移患者中的应用以及使用神经保护药物美金刚、多奈哌齐等。为脑瘤患者选择合适的放疗管理模式,规律进行认知测试,并在适当的时机提供治疗措施对改善患者的生命质量至关重要。

Radiation-induced brain injury is a serious untoward effect of radiotherapy for malignant tumors.Patients received radiotherapy frequently occur cognitive dysfunction which seriously affects the quality of life.Although the exact mechanisms regarding radiation-induced cognitive dysfunction remain unclear,prevention strategies targeting cognitive dysfunction are increasingly applied to clinical intervention,including whole brain radiotherapy with hippocampus avoidance,stereotactic radiosurgery in patients with multiple brain metastases,and pretreatment with neuroprotective drugs such as memantine and donepezil.In addition,measures including appropriate radiotherapy management models,regular cognitive tests,and therapeutic measures at the appropriate time are critical to improve the quality of life for brain tumor patients.