Research progress on the prevention and treatment of radiation-induced lung injury
DONG Guangtong1 ZHANG Xieyu2 HOU Wei2
1.Department of Endocrinology Guang′anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China;
2.Department of Oncology, Guang′anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
Abstract:Radiotherapy is one of the main methods for treating malignant tumors of the chest. However, it is unavoidable that normal tissues are involved. The lung is a moderately sensitive organ of ionizing radiation and therefore can easily cause radiation-induced lung injury. It mainly manifests itself as two phases, namely the early stage of radiation pneumonitis periad and the irreversible radiation pulmonary fibrosis period, which seriously reduces the quality of the patient′s life and even causes respiratory failure and endangers the life of the patient. Radiation-induced lung injury greatly limits the radiation dose, affects the therapeutic effect, and even forces it to be interrupted. This article reviews the mechanisms of radiation-induced lung injury, modern research, prediction systems, diagnosis, western medicine prevention and treatment.
[1] 张艺凡,何成诗,郞锦义,等.放射性肺损伤机制及相关因子研究进展[J].云南中医中药杂志,2015,36(5):81-83.
[2] 陈灏珠.实用内科学[M].北京:人民卫生出版社,2009.
[3] 姜炜.血管的辐射损伤[J].国外医学:放射医学核医学分册,2005,29(1):37.
[4] 曾丽绚.淫羊藿苷抑制大鼠慢性阻塞性肺疾病炎症的实验研究[D].上海:复旦大学,2010.
[5] Adamson IYR,Hedgecock C,Bowden DH. Epithelial cell-fibroblast interaction lung injury and repair [J]. Am J Pathol,1990,137(2):385.
[6] Yarnold J,Brotons MC. Pathogenetic mechanisms in radiation fibrosis [J]. Radiother Oncol,2010,97(1):149-161.
[7] Travis EL,Rachakonda G,Zhou X,et al. NRF2 deficiency reduces life span of mice administered thoracic irradiation [J]. Free Radic Biol Med,2011,51(6):1175-1183.
[8] Rube CE,Wilfert F,Palm J. Irradiation induces a biphasic expression of pro-inflammatory cytokines in the lung [J]. Strahlenther Onkol,2004,180(7):442-448.
[9] Rube CE,Rodemann HP,Rube C. The relevance of cytokines in theradiation-induced lung reaction. Experimental basis and clinical significance [J]. Strahlenther Onkol,2004,180(9):541-549.
[10] Bartram U,Speer CP. The role of tansforming growth factor beta in lung development and dissease [J]. Chest,2004, 125(2):754-765.
[11] Lee JE,Cho SM,Park E,et al. Anti-inflammatory effects of rubus coreanus miquel through inhibition of NF-kappa B and MAP kinase [J]. Nutr Res Pract,2014,8(5):501-508.
[12] Kwon DJ,Bae YS,Ju SM,et al. Salicortin suppresses lip-opolysaccharide-stimulated inflammatory responses via blockade of NF-kappa B and JNK activation in RAW 264.7 macrophages [J]. BMB Rep,2014,47(6):318-323.
[13] Hu Z,Xing Y,Qian Y,et al. Anti-radiation damage effect of polyethylenimine as a toll-like receptor 5 targeted agonist [J]. J Radiat Res,2013,54(2):243-250.
[14] Lam RK,Han W,Yu KN. Unirradiated cells rescue cells exposed to ionizing radiation:activation of NF-kappa B pathway in irradiated cells [J]. Mutat Res,2015,782(2015):23-33.
[15] 陈洪菊,李晋辉.mTOR信号通路与调节化[J].医学分子生物学杂志,2009,6(6):542-546.
[16] Tsoutsou PG,Koukourakis MI. Radiation pneumonitis and fibrosis mechanisms underlying its pathogenesis and implications for future research [J]. Int J Radiat Oncol Biol Phys,2006,66(5):1281-1293.
[17] 闵茜,胡伟国,宋启斌.放射性肺损伤发生机制的研究进展[J].肿瘤学杂志,2016,22(2):88-92.
[18] Chen DL,Shuster DP. Positon emission tomograpgy with 18F fluouodeoxyglucose to evaluate neutrophil kinetics during acute lung injury [J]. Am J Physiol Lung Cell Mol Physiol,2004,286(4):L834-L840.
[19] Chen DL,Ferkol TW,Mintum MA,et al. Quantifying pulmonary inflammation in cystic fibrosis with positron emission tomography [J]. Am J Respir Crit Care Med,2006, 173(12):1363-1369.
[20] De Ruysscher D,Houben A,Aerts HJ,et al. Increasede 18F-deoxyglucose uptake in the lung during the first weeks of radiotherapy is correlated with subsequent radiation-induced lung toxicity [J]. Radiother Oncol,2009,91(3),415-420.
[21] Wang D,Sun J,Zhu J,et al. Functional and biologic metrics for predictng radiation pneumonitis in locally advance non-small cell lung cancer patients treated with chemoradiotherapy [J]. Clin Transl Oncol,2012,14(12):943-952.
[22] Antonadou D,Throuvalas N,Petridis A,et al. Effect of amifostine on toxicities associated with radiochemotherapy in patients with locally advanced non- small- cell lung cancer [J]. Int J Radiat Oncol Biol Phys,2003,57(2):402-408.
[23] 冯晓延.骨髓间充质干细胞移植对免放射性肺损伤治疗的研究[D].桂林:桂林医学院,2013.
[24] 乔玉磊,王治东,夏金凤,等.CBLB502对放射性肺炎和肺纤维化的防护作用研究[J].军事医学,2014,38(1):26-30.
[25] 吴荣,孙宇楠,张振勇,等.吡格列酮在大鼠放射性肺纤维化中保护作用的研究[J].实用药物与临床,2015,18(1):13-17.