nodgoРоссийский журнал детской гематологии и онкологии (РЖДГиО)Russian Journal of Pediatric Hematology and Oncology2311-12672413-5496LTD “Graphica”10.21682/2311-1267-2022-9-3-83-89nodgo-861Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSРадиационный некроз головного мозгаRadiation necrosis of the brainhttps://orcid.org/0000-0003-0786-5448ЩербенкоО. И.ShcherbenkoO. I.

Олег Ильич Щербенко, д.м.н., профессор, главный научный сотрудник научно-организационного отдела

117977, Москва, ул. Профсоюзная, 86

Dr. of Sci. (Med.), Professor, Chief Researcher of the Scientific and Organizational Department

86 Profsoyuznaya St., Moscow, 117977

sherbenko@mail.ruhttps://orcid.org/0000-0001-6125-2410КумироваЭ. В.KumirovaE. V.

д.м.н., профессор, главный научный сотрудник научно-исследовательского отдела комплексной диагностики заболеваний и радиотерапии; заместитель главного врача по онкологии; научный консультант

117977, Москва, ул. Профсоюзная, 86119049, Москва, 4-й Добрынинский пер., 1/9115478, Москва, Каширское шоссе, 23

Dr. of Sci. (Med.), Professor, Chief Researcher of the Research Department of Complex Diagnostics of Diseases and Radiotherapy; Chief of Pediatric Oncology Deputy Medical Director; Scientific Consultant of Scientific Research Institute of Pediatric Oncology and Hematology

86 Profsoyuznaya St., Moscow, 1179771/9 4th Dobryninskiy Per., Moscow, 11904923 Kashirskoe Shosse, Moscow, 115478

k_ella2004@mail.ruhttps://orcid.org/0000-0002-0219-7260РегентоваО. С.RegentovaO. S.

к.м.н., заведующая детским онкологическим отделением научно-исследовательского отдела комплексной диагностики заболеваний и радиотерапии

117977, Москва, ул. Профсоюзная, 86

Cand. of Sci. (Med.), Head of the Children's Oncology Department

86 Profsoyuznaya St., Moscow, 117977

olgagraudensh@mail.ruФГБУ «Российский научный центр рентгенорадиологии» Минздрава РоссииРоссияRussian Scientific Center of Roentgenoradiology, Ministry of Health of RussiaRussian FederationФГБУ «Российский научный центр рентгенорадиологии» Минздрава России; ГБУЗ «Морозовская детская городская клиническая больница Департамента здравоохранения города Москвы»; ФГБУ «НМИЦ онкологии им. Н.Н. Блохина» Минздрава РоссииРоссияRussian Scientific Center of Roentgenoradiology, Ministry of Health of Russia; Morozov Children’s Clinical Hospital, Department of Health in Moscow; N.N. Blokhin National Medical Research Centre of Oncology, Ministry of Health of RussiaRussian Federation202209112022938389Copyright © Щербенко О.И., Кумирова Э.В., Регентова О.С., 20222022Щербенко О.И., Кумирова Э.В., Регентова О.С.Shcherbenko O.I., Kumirova E.V., Regentova O.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nodgo.org/jour/article/view/861

Радионекроз мозга (РНМ) является наиболее частым и опасным ятрогенным осложнением лучевой терапии опухолей и неопухолевых заболеваний головного мозга и основания черепа. Риск его развития повышается с увеличением объемов облучения, разовых и суммарных доз и за счет синергизма с действием используемой адъювантной химиотерапии. В основе патогенеза РНМ лежит повреждение микроциркуляторного русла в опухоли и окружающих тканях с развитием отека и нарушением трофики нейроглии с ее некрозом, которые в большинстве случаев имеют необратимый характер. После лечения опухолей мозга дифференциальная диагностика РНМ проводится с возобновлением роста новообразования или его псевдопрогрессией и требует применения комплекса методов визуализации. Лечение РНМ у отдельных больных может заключаться в хирургическом удалении некротизированного участка, но у большинства пациентов возможно применение только лекарственной терапии кортикостероидными и анти-VEGF-препаратами, позволяющими затормозить развитие РНМ, улучшить качество жизни пациентов и продлить ее.

Radiation necrosis of the brain (BRN) is the most frequent and dangerous iatrogenic complication of radiation therapy of tumors and non-tumor diseases of the brain and the base of the skull. The risk of its development increases with an increase in the amount of radiation, single and total doses and due to synergy with the action of adjuvant chemotherapy used. The pathogenesis of BRN is based on damage to the microcirculatory bed in the tumor and surrounding tissues with the development of edema and impaired trophic neuroglia with its necrosis, which in most cases are irreversible. After treatment of brain tumors, differential diagnosis of BRN is carried out with the resumption of tumor growth or its pseudoprogression and requires the use of a set of imaging methods. Treatment of BRN in separate patients may consist of surgical removal of the necrotic area, but in most patients it is possible to carry out only drug therapy with corticosteroid and anti-VEGF drugs that allow to slow down the development of BRN, improve the quality of life and prolong its.

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The authors declare that there are no conflicts of interest present.