放射性肺炎分析解析.pptVIP

Radiation Pneumonitis 放射性肺炎 Kenneth B. Roberts Sara Rockwell 放射性肺炎 I. BRIEF OVERVIEWOF RADIOLOGIC PHYSICS II. RADIOBIOLOGY OF RADIOTHERAPY III. PATHOPHYSIOLOGY OF RADIATION PNEUMONITIS IV. CONFOUNDING EFFECTS OF CHEMOTHERAPY V. CLINICAL SYNDROMES Acute Manifestations Late Manifestations VI. DEFINING THE RADIATION TOLERANCE OF THE LUNGS VII. WHOLE-LUNG IRRADIATION VIII. PARTIAL-LUNG IRRADIATION Assessment of Risk Lung Cancer: Local Tumor Boosting Breast Cancer Early-Stage Hodgkin’s Disease IX. PROGNOSTIC ASSAYS AND FUTURE TRENDS 放射性肺炎--定义 系由于肺部、纵隔、肿瘤、食管癌、乳腺癌、恶性淋巴瘤或胸部其他部位肿瘤经放射治疗后，在放射野内正常肺组织受到损伤引起的炎症反应。 放射性肺炎—流行病学 Approximately one in three people in the United States will be diagnosed with cancerat some point in their lifetimes. Over half of these patients willbe permanently cured of their malignancies. Approximately65 percent of all cancer patients now receive radiotherapy at 在美国近1/3的人会得肿瘤，而超过一半的病人将要治疗他们的恶性肿瘤。大约65%的肿瘤病人将要接受 放射治疗。 放射性肺炎—流行病学 number of studies in experimental animals, show that lung，injury can be produced by inhalation of insoluble particulateradionuclides that are deposited in lung tissue and producelong-term irradiation of the tissue. Therefore, radiation in-jury to lung is possible in cases in which people are exposedto high levels of inhaled radionuclides through theiroccupations, accidents, or acts of war or terrorism.A working 研究表明，不能溶解的放射性核素颗粒被肺组织吸入并滞留在肺组织并对肺组织造成长期的辐射，导致放射性肺炎。因此放射性损伤可发生在因为居住环境、意外事故、战争、恐怖行动而暴露在高水平吸入性放射性核素环境的人群中。 放射性肺炎-概述 放射性肺炎—概述 。 RADIOBIOLOGY OF RADIOTHERAPY 放射疗法的生物学 RADIOBIOLOGY OF RADIOTHERAPY 放射疗法的生物学 。 RADIOBIOLOGY OF RADIOTHERAPY 放射疗法的生物学 化疗的关键在于最大限度的提高疗效毒性比 PATHOPHYSIOLOGY OF RADIATION PNEUMONITIS放射性肺炎的病理生理学 肺脏的细胞构成 I型肺泡细胞 -83%肺泡表面 非增殖细胞 受损伤时不增值 II型肺泡细胞-16%肺泡表面 分泌表面活性物质 1月 损伤进入快速的有丝分裂 分化为I型肺泡细胞 上皮细胞 –肺脏细胞的30%、位于血液和肺组织之间 、构成肺实质，其中毛细血管内皮细胞 更新时间为2个月 损害时可被诱导进入代偿性的快速增殖 PATHOPHYSIOLOGY OF RADIATION P