用于肿瘤治疗的放射性药物

由于恶性肿瘤靠单一治疗手段往往难以达到根治效果，目前，常采用多学科的综合治疗方法，其中，放射性核素内照射治疗的手段正逐渐受到重视。本阐述了对放射性治疗药物的要求，对常用的肿瘤治疗放射性药物，包括一般化合物药物、放射性标记的胶体和颗粒，以及放射性导向治疗药物的种类和应用作了简要介绍。     

星形胶质细胞在放射性脑损伤中的研究进展

放射性脑损伤是正常脑组织接受电离辐射后出现的严重颅脑损伤,表现为认知功能障碍、学习和记忆能力下降,严重者可导致痴呆。目前,现有药物对于放射性脑损伤的治疗效果有限,且预后较差。电离辐射诱导星形胶质细胞发生病理性激活,进而通过诱导神经炎症和破坏血脑屏障促进了放射性脑损伤的进程。该文主要综述了星形胶质细胞的生理病理功能及其在放射性脑损伤中的病理变化和细胞机制。同时,对靶向星形胶质细胞的治疗潜力进行展望,为扩展放射性脑损伤的治疗手段,探索新的治疗靶点和方法提供参考。     

放射性核素治疗的进展

内服放射性药物(非封闭的放射源)有取代现在放射治疗和化疗的可能性,其理由如下: 1.给予大剂量的放射性药物,靶组织选择性吸收得到的拉德剂量比常规放射治疗要多。2.经40余年的随访,用放射性药物治疗后,白血病和癌的发生率十分低。3.放射性药物治疗属相对的无创伤性。以发病率和死亡率对~(131)Ⅰ、~(83)P治疗与放疗、化疗进行了比较,得到了新的评价。这些比较使我们有兴趣重新使用放射性药物治疗。Saeger等最近评论了各种放射治疗方法,结论是放射性药物比常规体外放射治疗能给予靶组织以更特异和更大的拉德剂量。     

外照射放射性皮肤损伤救治进展

皮肤在放射生物学中有着特殊的地位,它是接受外照射的必经途径.放射性皮肤损伤具有长期性、持久性、潜在性和进行性作用特征.放射性皮炎治疗手段主要有药物、物理和手术治疗等.该文介绍外照射放射性皮肤损伤救治进展.     

外照射放射性皮肤损伤救治进展

皮肤在放射生物学中有着特殊的地位,它是接受外照射的必经途径.放射性皮肤损伤具有长期性、持久性、潜在性和进行性作用特征.放射性皮炎治疗手段主要有药物、物理和手术治疗等.该文介绍外照射放射性皮肤损伤救治进展.     

放射性皮肤纤维化的研究进展

放射性皮肤纤维化是电离辐射作用于皮肤组织后的晚期效应,是放射性核事故和肿瘤放疗等之后常见的晚期并发症,严重影响患者的生活质量。放射性皮肤纤维化表现为皮肤外观的改变、皮肤弹性消失与挛缩、皮肤坚硬难以捏起折痕,可伴发毛细血管扩张、疼痛与瘙痒,部分患者甚至会发生进展性的纤维化,反复出现皮肤感染。目前关于放射性皮肤纤维化的发生机制尚不完全清楚,也缺乏针对性的救治手段及有效治疗药物。因此,深入探索电离辐射所致放射性皮肤纤维化的机制,寻找更有效的防治手段显得尤为重要。笔者就放射性皮肤纤维化的影响因素、临床表现、发生机制及其治疗方法等进行综述,并对其发展进行展望,旨在为放射性皮肤纤维化的研究提供参考。     

实尔新软膏对放射治疗所致皮肤损伤的预防作用

放射治疗是肿瘤治疗的主要手段之一.在放射治疗过程中,放射线除对肿瘤细胞有杀伤作用外,同时对正常组织也有损伤.放射性皮肤损伤尤为多见,是放射治疗中最为常见的并发症之一.因此,许多学者都在努力寻找防治放射性皮肤损伤的有效药物.本研究采用实尔新制剂,观察其对放疗病人放射性皮肤损伤的预防作用.     

放射性皮炎的发生机制与相关防治药物

放射性皮炎是一种在肿瘤放疗和核事故中经常发生的伴有红斑、脱皮、水肿、溃疡等不同程度皮肤损伤的皮肤炎症。本文介绍了放射性皮炎的病因、影响因素、诊断和疗效标准,本文对防治放射性皮炎的常见药物进行了综述,并提出了现阶段药物防治放射性皮炎所存在的问题及其展望,以期为今后的临床治疗和科研提供参考。     

第11届全国放射性药物与标记化合物学术会议征文通知

第11届全国放射性药物与标记化合物学术会议将于2011年11月在广州召开。本次会议将进行大会论文交流,评选优秀论文,并特邀国内外著名专家、学者做报告。会议征文范围：单光子放射性药物制备,放射性治疗药物制备,正电子放射性药物合成,放射性药物的质量控制,放射性药物的生物学评价及应用,标记化合物研究、制备及应用,放射性药物与标记化合物相关的其他研究。     

高压氧联合药物治疗放射性脑病的Meta分析

目的 通过Meta分析,探讨高压氧(HBO)联合药物治疗放射性脑病的地位与价值.方法 通过Pubmed等数据库及论文集检索国内外已发表的与放射性脑病治疗相关的文献.选择治疗组为HBO联合药物治疗方案、对照组为单纯药物治疗的随机对照实验(randomized controlled trial,RCT).采用Review Manager 4.2软件对HBO联合药物治疗方案治疗放射性脑病的疗效进行Meta分析.结果 从262篇文献中筛选出符合纳入标准的4个RCT,涉及275例患者.结果显示,HBO联合药物治疗比单纯药物治疗有效率提高5倍(OR =5.35,95％ CI =2.87 ～ 10.01,P＜0.01).结论 文献收集结果显示,HBO联合药物治疗放射性脑病,可以显著提高疗效,改善生活质量.该治疗方案可用于放射性脑病的一线治疗,值得进一步临床试验验证.     

Cystic Echinococcal Liver Disease: New Insights into an Old Disease and an Algorithm for Therapy Planning

Human cystic echinococcosis (CE) continues to be a major health problem in developing countries. A review of current literature discloses four alternatives for the management of active CE, consisting of surgery, percutaneous treatment (PT), chemotherapy, and follow-up without intervention, but no clear guidelines for directing patients to the different management options. Palliation of symptoms or prevention of complications is the main rationale for the treatment of CE. Surgery has long been considered as the gold standard treatment. However, a meta-analysis comparing the clinical outcomes of patients treated with PT with those of a control group treated with surgery found PT to be more effective, safer, and cheaper. Medical therapy is considered to be ineffective when the criterion of success is defined as the disappearance of the lesion. However, medical therapy seems to be effective when the goal of therapy is defined as the prevention of complications in asymptomatic patients. We propose an algorithm for therapy planning in CE where the first line of therapy for patients with active lesions is PT. Patients with lesions unsuitable for PT are directed to surgery if they are symptomatic, have complicated lesions or have lesions that are prone to rupture. Asymptomatic patients with uncomplicated lesions are directed to medical therapy. Medical therapy failures are redirected to surgery.     

Graves' disease nd toxic nodular goiter--radioiodine therapy

At the 15th conference on the human thyroid in Heidelberg in 2001 the following aspects of the radioiodine therapy of benign thyroid disorders were presented: General strategies for therapy of benign thyroid diseases, criterions for conservative or definitive treatment of hyperthyroidism as first line therapy and finally preparation, procedural details, results, side effects, costs and follow-up care of radioiodine therapy as well as legal guidelines for hospitalization in Germany. The diagnosis Graves' hyperthyroidism needs the decision, if rather a conservative treatment or if primary radioiodine therapy is the best therapeutic approach. In the USA 70-90% of these patients are treated with radioiodine as first line therapy, whereas in Germany the conservative therapy for 1-1.5 years is recommended for 90%. This review describes subgroups of patients with Graves' disease showing a higher probability to relapse after conservative treatment. Comparing benefits, adverse effects, costs, and conveniences of both treatment strategies the authors conclude that radioiodine therapy should be preferred as first line therapy in 60-70% of the patients with Graves' hyperthyroidism.     

Contact dermatitis: an approach used by a medical officer

The article deals with contact dermatitis issues, that are of interest not only for dermatologists and specialists in professional pathology, but as well as for general practitioners. Issues of contact dermatitis classification, pathogenic peculiarities of the disease main forms and their basic causes are discussed. Clinical manifestations of irritative and allergic contact dermatitis are described in detail, aspects of differential diagnostics analysed. A detailed consideration is given to allergic diagnostics of contact dermatitis using application test-systems with the most common contact allergens. Main principles of contact dermatitis treatment are outlined in the article. The necessity of a complex approach to this disease therapy that requires not only external therapy, but the compliance with an appropriate treatment regimen, diet as well as application of a particular system therapy is shown. Recommendations for contact dermatitis prophylaxis are given.     

Current status of cancer therapy with radiolabeled monoclonal antibody

Molecular targeting therapy has become a relevant therapeutic strategy for cancer. There are several monoclonal antibodies used for the treatment of malignant tumors. Radioimmunoconjugate is composed of antibody and radionuclide showing a synergistic effect of radiation and immunemediated cellular toxicity and thereby enabling increased efficacy and minimizing toxicity. Radioimmunotherapy using 131I- and 90Y-labeled anti-CD20 monoclonal antibodies is now indicated for the treatment of patients with CD20 antigen-expressing relapsed or refractory, low-grade or transformed non-Hodgkin's lymphoma (NHL), including patients who are refractory to anti-CD20 monoclonal antibody (rituximab) therapy in the United States. It has been exhibiting favorable anti-tumor efficacy in patients with NHL as compared with rituximab. Myelosuppression is the main side effect associated with the radioimmunotherapy but is usually reversible, and nonhematologic adverse reactions are mild to moderate. Following the impressive results of therapy using radiolabeled monoclonal antibodies for NHL, radioimmunotherapy for solid tumors has been examined; however, the results were unfavorable and did warrant further clinical trials as a single agent. Future studies on radioimmunotherapy for solid tumors should focus on the new strategies of targeting such as locoregional administration for intraperitoneal dissemination, and combination therapy with chemotherapy or cytostatic therapy. Although radioimmunotherapy for NHL has shown excellent results comparable to aggressive chemotherapy without severe adverse effects, additional clinical trials should be performed to define the proper role of radioimmunoconjugates as a relevant strategy for cure of NHL.     

Neurological changes following radiation therapy for head and neck tumours

Radiation therapy is widely used in the treatment of head and neck tumours either as a primary form of treatment or a supplementary modality. Although the benefits of radiation therapy are well established, this treatment modality is not without untoward consequences and complications. The intent of this paper is to highlight the neurological complications that may follow the treatment for head and neck malignancies, in particular, following radiation therapy for nasopharyngeal carcinoma.     

颅内静脉窦血栓形成的抗血栓治疗方案研究进展

颅内静脉窦血栓形成（CVST）是一种特殊类型的脑卒中,其危险因素及临床症状多样,易被漏诊或误诊。目前尚无关于CVST的治疗指南,其最佳治疗方法仍存在争议。抗凝治疗是该病的重要治疗手段,同时该病较高的致残率和致死率促进了血管内介入治疗的发展。本文就该病临床中抗血栓治疗的抗凝治疗方案、血管内介入治疗方案（溶栓治疗及机械取栓治疗）进展进行综述,以提高对治疗的认识,降低致死率、致残率。     

Photodynamic therapy for treatment of bacterial keratitis

Microbial keratitis is the main cause of corneal opacification and the fourth leading cause of blindness worldwide, with bacteria the major infectious agent. Recently, bacterial keratitis has become a serious threat due to routine use of antibiotics leading to selection of resistant and multidrug-resistant bacteria strains. New approaches for treatment of bacterial keratitis are necessary to outcome the increasing antibiotic resistance. Antimicrobial photodynamic therapy is based on three agents: photosensitizer, oxygen, and light radiation. This therapy has been successful for treatment of infections in different tissues and organs as well as against different type of infectious agents and no resistance development. Also, new photosensitizers are being developed that has increased the spectrum of therapeutic protocols for treatment of a number of infectious diseases. Thus, antimicrobial photodynamic therapy has an extraordinary potential for treatment of those bacterial keratitis cases that actually are not solved by traditional antibiotic therapy.     

Primary hyperthyroidism--diagnosis and treatment. Indications and contraindications for radioiodine therapy

Isotope therapy is one of the methods used in primary hyperthyroidism. The therapy is based on short-range beta radiation emitted from radioactive iodine. Radioiodine administration must always be preceded by pharmacological normalization of thyroid function. Otherwise, post-radiation thyrocyte destruction and thyroid hormones release may lead to hyperthyroidism exacerbation. Indications for radioiodine therapy in Graves-Basedow disease include recurrent hyperthyroidism after thyrostatic treatment or thyroidectomy and side-effects observed during thyrostatic treatment. In toxic nodule, isotope therapy is the first choice therapy. Radioiodine is absorbed only in autonomous nodule. Therefore, it destroys only this area and does not damage the remaining thyroid tissue. In toxic goitre, radioiodine is used mostly in recurrent nodules. Absolute contraindications for radioiodine treatment are pregnancy and lactation. Relative contraindications are thyroid nodules suspected of malignancy and age under 15 years. In patients with thyroid nodules suspected of malignancy, radioiodine treatment may be applied as a preparation for surgery, if thyrostatic drugs are ineffective or contraindicated. In children, radioiodine therapy should be considered in recurrent toxic goitre and when thyrostatic drugs are ineffective. In patients with Graves-Basedow disease and thyroid-associated orbitopathy, radioiodine treatment may increase the inflammatory process and exacerbate the ophthalmological symptoms. However, thyroid-associated orbitopathy cannot be considered as a contraindication for isotope therapy. The potential carcinogenic properties of radioiodine, especially associated with tissues with high iodine uptake (thyroid, salivary glands, stomach, intestine, urinary tract, breast), have not been confirmed.     

Imaging findings in radiation therapy complications of the central nervous system

Radiation therapy is a useful treatment for tumors and vascular malformations of the central nervous system. Radiation therapy is associated with complications, including leukoencephalopathy, radiation necrosis, vasculopathy, and optic neuropathy. Secondary tumors are also often seen long after radiation therapy. Secondary tumors are often benign tumors, such as hemangiomas and meningiomas, but sometimes malignant gliomas and soft tissue sarcomas emerge. We review the imaging findings of complications that may occur after brain radiation therapy.     

Future perspective of radiation therapy for superficial esophageal cancer

Superficial esophageal cancer (SEC) is defined as esophageal cancer limited to the submucosal layer, and includes mucosal and submucosal cancer. Based on the criteria of the Japanese Society for Esophageal Disease, mucosal and submucosal cancer are classified according to location: epithelial layer (m1); proper mucosal layer (m2); muscularis mucosa (m3); upper third of the submucosal level (sm1); middle third of the submucosal layer (sm2); and lower third of the submucosal level (sm3). Irrespective of the treatment method, the depth of invasion is one of the most important prognostic factors of SEC because lymph node metastasis markedly increases in lesions infiltrating the lamina muscularis mucosa (m3). The best management technique for small m1 and m2 esophageal cancers is generally endoscopic mucosal resection (EMR). For m3-sm3 SEC, extensive lymph node dissection has been the most widely used form of treatment. However, a recent study has shown that for m3 and sm1 cancer, EMR seems to be as effective as surgery. Therefore, EMR may become the standard therapy for m3 and sm1 cancer. The role of radiation therapy in the treatment of SEC has not been established, and radiation therapy has tended to be used for SEC patients who are not suitable for EMR or surgery. The treatment outcomes of radiation therapy are encouraging and seem to be comparable with those of other treatment modalities. Radiation therapy is a promising method for treating SEC and may become standard therapy for certain subgroups of SEC. However, many problems concerning radiation therapy, including optimal radiation dose, optimal radiation field, and the role of intracavitary irradiation, remain to be solved. Thus, standardization of radiotherapy is an urgent issue.