胸部肿瘤放射治疗对心脏损伤的研究进展  

Advances in research on chest tumor radiotherapy for cardiac injury

作　　者：林展[1] 梁雷锋[1] 甘媚[1] 李国余 严浩林[1] Lin Zhan;Liang Leifeng;Gan Mei;Li Guoyu;Yan Haolin

机构地区：[1]广西玉林市第一人民医院

出　　处：《中医临床研究》2019年第18期94-96,共3页Clinical Journal Of Chinese Medicine

摘　　要：放射治疗是肿瘤的重要治疗方法,也是乳腺癌、食管癌、肺癌和纵隔淋巴瘤等恶性肿瘤的主要治疗方法之一。早期的研究表明,心脏具有高度耐受性和抗辐射性。心脏是一种抗放射治疗的器官。它被认为比这种剂量更安全,但随着研究的继续,直到20世纪60年代,人们逐渐认识到胸部放疗与各种形式的心脏病有关。已经证实,胸部肿瘤的放射治疗可以引起不同程度的心脏损伤,尤其是心脏病延迟。特别是在乳腺癌放疗的研究中,心脏放射损伤已成为乳腺癌病死率上升的主要原因。如今,关于放射治疗安全性的研究表明,即使相对低剂量的放射也会导致心脏损伤以及一系列并发症,包括急性和慢性心包疾病、心肌病、瓣膜功能不全、传导异常和冠状动脉疾病,统称为放射性。心脏受损。随着放射治疗技术的进步,更多的癌症患者具有长期生存能力,并且心脏的放射损伤受到越来越多的关注心脏的机制是心脏对辐射的耐受性非常不同,心肌细胞最强。微循环系统相对较弱,因此辐射对心肌的损伤主要是继发于小血管和结缔组织的损伤。减少胸部肿瘤放射对心脏造成的伤害,可有效降低放疗后并发症的发生率,成为放疗界亟待解决的问题,本研究从引起胸部肿瘤放射性心脏损伤的发病机制、发生条件、放疗性心脏病的分类、预防与治疗等方面进行综述。Radiation therapy is an important treatment for tumors and one of the main treatments for malignant tumors such as breast cancer,esophageal cancer,lung cancer and mediastinal lymphoma.Earlier studies suggest that the heart is highly tolerant and resistant to radiation.The heart is an organ that is resistant to radiation therapy.It is considered safer than this dose,but as the research continues,until the 1960s,it is only gradually recognized that chest radiotherapy is associated with various forms of heart disease.It has been confirmed that radiotherapy of chest tumors can cause different degrees of heart damage,especially delayed heart disease.Especially in the study of breast cancer radiotherapy,cardiac radiation damage has become the main cause of increased breast cancer mortality.Nowadays,studies on radiotherapy safety suggest that even relatively low doses of radiation can cause heart damage,leading to a range of complications,including acute and chronic pericardial disease,cardiomyopathy,valvular insufficiency,conduction abnormalities,and coronary artery disease,collectively known as radioactive heart damage.With the advancement of radiotherapy technology,more cancer patients have longterm survival,and the radiation damage of the heart has received more and more attention.The mechanism of the heart is that the tolerance of the heart to radiation is very different,and the cardiomyocytes are the strongest.The microcirculatory system is relatively weak,so the damage of the radiation to the myocardium is mainly secondary to the damage of small blood vessels and connective tissue.Reducing the damage of chest tumor radiation to the heart can effectively reduce the incidence of complications after radiotherapy,and it has become an urgent problem to be solved in the radiotherapy field.This study classifies the pathogenesis,occurrence conditions,and radiotherapy heart disease caused by radiation-induced cardiac damage in thoracic tumors.Prevention and treatment are reviewed.

关 键 词：胸部肿瘤 放射治疗 心脏损伤 研究进展 综述 

分 类 号：R73-361[医药卫生—肿瘤]