中华脑科疾病与康复杂志（电子版）2015，Vol.5Issue(2)：95-102,8.DOI:10.3877/cma.j.issn.2095-123X.2015.02.006
抗分枝杆菌治疗逆转鼻咽癌放疗后迟发性放射性脑病的初步研究
Anti-mycobacterium treatment reverses radiation-induced delayed brain injuries of nasopharyngeal carcinoma:a pilot study
摘要
Abstract
Objective The mechanism of radiation-induced delayed brain injuries remains poorly understood,and few treatment options are available.The aim of this study was to investigate whether temporal lobe necrosis can be reversed by anti-mycobacterium therapy ( AMT ) .Methods We conducted this prospective,controlled study in southern China.Ten patients with symptomatic delayed radiation injury were monitored during AMT and compared with a control group of 11 patients who received current standard therapies.Activities of daily living were assessed by the Barthel index( BI) at study entry and after 2 years of therapy.Magnetic resonance imaging ( MRI ) was performed before treatment, and changes were monitored during the study.Kaplan-Meier analysis was employed to delineate time-related mortality.Results A significant treatment effect was observed in the AMT group.The patients′headaches,seizures,dizziness,and cognitive deterioration rapidly improved.BI was improved significantly in the AMT treatment group compared with the control group after 2 years(U=13.0,P=0.001).Abnormalities of the temporal lobes,observed by MRI,markedly decreased over time in eight patients,whereas in the control group significant BI deterioration was observed( P=0.003) and the patients did not show favorable MRI changes.By 24 months,there was a significant difference between the AMT and control groups with respect to survival time(χ2 =6.423,P =0.011).Conclusion AMT can effectively treat DRI,and indicates skull-base irradiation may disrupt the local immune function, and predisposes to chronic mycobacterial infection.Trail registration The International Standard Randomised Controlled Trail(ISRCTN04023349)关键词
鼻咽肿瘤/迟发性放射性脑病/抗分枝杆菌治疗Key words
Nasopharyngeal neoplasms/Delayed radiation-induced brain injuries/Anti-mycobacterium treatment引用本文复制引用
丰岩清,张为西,郑民缨,国宁,陈曦,黄帆..抗分枝杆菌治疗逆转鼻咽癌放疗后迟发性放射性脑病的初步研究[J].中华脑科疾病与康复杂志（电子版）,2015,5(2):95-102,8.基金项目
广东省自然科学基金计划项目(2012B03180067) （2012B03180067）
