颅脑放疗中保护下丘脑-垂体轴功能的意义及研究现状

Significance and research status of protecting hypothalamic-pituitary axis function in craniocerebral radiotherapy

放射治疗是绝大多数颅脑及头颈部肿瘤治疗的重要手段之一,对提高患者的生存率、减少局部复发及改善疾病症状有不可替代的作用。然而,颅脑放疗后可能会出现不同程度的不良反应,其中以下丘脑-垂体(the hypothalamo-pituitary,HT-P)轴相关内分泌功能障碍较为常见。本文通过文献复习阐明放疗引起HT-P相关神经内分泌功能障碍的影响因素、病理机制及筛查手段,从而强调在颅脑放疗中下丘脑-垂体功能保护的重要性。同时,对比不同放疗技术在颅脑放疗中实现保护下丘脑-垂体功能的应用现状,由此展望未来该领域研究方向。

Radiotherapy is one of the most important treatment technique of craniocerebral tumors as well as head and neck carcinoma,which had an irreplaceable effect in improving the survival rate,reducing local recurrence and ameliorating clinical symptom.However,different degrees of adverse effects often occurs after craniocerebral radiotherapy.Radiation-induced hypothalamic-pituitary(HT-P)axis endocrine dysfunction is particularly common.This paper mainly review the relevant influencing factors,pathophysiological mechanism and its screening in HT-P-induced endocrine dysfunction,thereby emphasizing the importance of the protection of HT-P function in cranial radiotherapy.Meanwhile,it contrasts the application of different radiotherapy techniques on the protection of HT-P function in craniocerebral radiotherapy,and prospects the furture research direction.