大脑放射治疗和背部阴道复合照射:一个新的器官有减少辐射引起的恶心和吐的风险?
Valentine Caspar1, Nicolas Giraud1, Thomas Charleux2
1Department of Radiation Oncology, Bordeaux University Hospital, F33000 Bordeaux, France.
Clinical and translational radiation oncology
|January 15, 2025
概括
对背部阴道综合体 (DVC) 的辐射剂量与脑瘤患者的恶心有关. 限制DVC平均剂量低于8.82 Gy可能会减少恶心的发生率,需要前性验证.
科学领域:
- 辐射瘤学 辐射瘤学
- 神经科学是一个神经科学.
- 医学物理 医学物理
背景情况:
- 恶心是放射治疗良性脑瘤的常见副作用.
- 大脑干中的背部阴道综合体 (DVC) 被认为是恶心和吐的关键中心.
- 了解剂量反应关系对于优化放射治疗计划至关重要.
研究的目的:
- 调查DVC输送的平均辐射剂量与为良性脑瘤治疗的患者中恶心发生的相关性.
- 为了确定与辐射诱导的恶心相关的DVC的潜在剂量值.
主要方法:
- 对102名患有良性脑瘤的患者进行了回顾性分析,这些患者接受了强度调节放射治疗.
- 使用MRI T1序列与加多对比的DVC和脑干 (BS) 划分.
- 统计分析以将平均DVC和BS剂量与恶心发生率相关联.
主要成果:
- 恶心发生在39.2%的患者中,年轻患者的发病率更高.
- 在平均DVC剂量和恶心 (p < 10^-4) 之间发现了显著的关联.
- 最佳的DVC剂量值为8.82 Gy,恶心风险在这个值以上增加了16%至62%.
结论:
- 平均DVC辐射剂量是辐射诱导的恶心的重要预测指标.
- 建议DVC剂量限制在8.82 Gy以下,以减轻恶心.
- 需要前性研究来验证这种剂量限制在临床实践中.
相关概念视频
Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
147
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
147
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
174
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
174
Pathophysiology of Vomiting
289
Vomiting is a complex physiological response to expel harmful or irritating substances from the body. It's a defensive mechanism triggered by stimuli like poisons, microbial toxins, cytotoxic drugs, and mechanical abdominal distension. The process is centrally coordinated by the vomiting (or emetic) center located in the medulla of the brainstem. This area, rich in muscarinic M1, histamine H1, neurokinin 1 (NK1), and serotonin 5-HT3 receptors, coordinates the act of vomiting through...
289
Chemotherapy-Induced Nausea and Vomiting: Cannabinoids
201
Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
Two synthetic agonists of THC,...
Two synthetic agonists of THC,...
201
Radiological Investigation III: Pulmonary Angiogram and PET Scan
82
Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
82


