辐射诱导的脊椎骨干细胞病变:一个全面的临床和剂量测量研究
Zineb Dahbi1,2, Reyzane El Mjabber1,2, Amal Bouziyane3,4
1Radiation Oncology, Mohammed VI University of Sciences and Health, Casablanca, MAR.
Cureus
|January 30, 2026
概括
脊椎神经 (LSP) 的较高辐射剂量与盆腔放射治疗后的辐射诱导的脊椎神经病 (RILP) 有关. 性别和糖尿病也预测了RILP,强调需要个性化剂量限制.
科学领域:
- 辐射瘤学 辐射瘤学
- 神经学 神经学
- 医学物理 医学物理
背景情况:
- 辐射诱导的腰部神经根系病变 (RILP) 是盆腔放射治疗的一个未被认可的并发症.
- 它可以导致长期的神经缺陷,并影响生活质量.
研究的目的:
- 为了研究辐射剂量分布到腰部神经 (LSP) 和RILP的发生之间的关联.
- 为了确定RILP的预测因素.
主要方法:
- 在骨盆放射治疗后,对175名无癌症患者进行了回顾性分析.
- 在CT/MRI扫描上下腰部神经 (LSP) 的划线.
- 对治疗计划的剂量分析和与奥斯威斯特残疾指数 (ODI) 成绩的相关性.
主要成果:
- 在13%的患者中观察到RILP (3级).
- 较高的LSP中位数最大剂量 (72.1 Gy vs 60.2 Gy) 和较大的LSP体积与计划目标体积重叠 (54.5% vs 18.4%) 与RILP相关.
- 男性性别和先前存在的糖尿病也是预测因素.
结论:
- 对LSP的辐射剂量增加,特别是Dmax和高剂量体积,与RILP有显著的相关性.
- 在盆腔放射治疗规划中,LSP应被视为一个有风险的器官.
- 个性化剂量限制对于最小化神经毒性至关重要.
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