文章：

质子束治疗后儿童与成人患者肾脏体积与功能的远期变化：儿童呈现显著肾脏萎缩，但两组长期肾功能恶化均轻微

Late Changes in Renal Volume and Function after Proton Beam Therapy in Pediatric and Adult Patients: Children Show Significant Renal Atrophy but Deterioration of Renal Function Is Minimal in the Long-Term in Both Groups

原文发布日期：24 April 2024

DOI: 10.3390/cancers16091634

类型: Article

开放获取: 是

英文摘要：

To compare late renal effects in pediatric and adult patients with malignancies after PBT involving part of the kidney. A retrospective study was conducted to assess changes in renal volume and function in 24 patients, including 12 children (1–14 years old) and 12 adults (51–80 years old). Kidney volumes were measured from CT or MRI images during follow-up. Dose-volume histograms were calculated using a treatment planning system. In children, the median volume changes for the irradiated and control kidneys were −5.58 (−94.95 to +4.79) and +14.92 (−19.45 to +53.89) mL, respectively, with a relative volume change of −28.38 (−119.45 to −3.87) mL for the irradiated kidneys. For adults, these volume changes were −22.43 (−68.7 to −3.48) and −21.56 (−57.26 to −0.16) mL, respectively, with a relative volume change of −5.83 (−28.85 to +30.92) mL. Control kidneys in children exhibited a marked increase in size, while those in adults showed slight volumetric loss. The percentage of irradiated volume receiving 10 Gy (RBE) (V10) and 20 Gy (RBE) (V20) were significantly negatively associated with the relative volume change per year, especially in children. The CKD stage based on eGFR for all patients ranged from 1 to 3 and no cases with severe renal dysfunction were found before or after PBT. Late effects on the kidneys after PBT vary among age groups. Children are more susceptible than adults to significant renal atrophy after PBT. V10 and V20 might serve as predictors of the degree of renal atrophy after PBT, especially in children. PBT has a minimal impact on deterioration of renal function in both children and adults.

摘要翻译： 

比较儿童与成人恶性肿瘤患者接受部分肾脏质子束治疗（PBT）后的远期肾脏影响。本研究通过回顾性分析评估了24例患者（包括12例1-14岁儿童和12例51-80岁成人）的肾脏体积与功能变化。通过随访期间的CT或MRI影像测量肾脏体积，并利用治疗计划系统计算剂量-体积直方图。儿童组受照射肾脏与对照肾脏的中位体积变化分别为−5.58（−94.95至+4.79）mL与+14.92（−19.45至+53.89）mL，受照肾脏相对体积变化为−28.38（−119.45至−3.87）mL；成人组则分别为−22.43（−68.7至−3.48）mL与−21.56（−57.26至−0.16）mL，相对体积变化为−5.83（−28.85至+30.92）mL。儿童对照肾脏体积显著增大，而成人对照肾脏呈现轻度体积减少。受照体积中接受10 Gy（RBE）（V10）与20 Gy（RBE）（V20）的百分比与每年相对体积变化呈显著负相关，在儿童群体中尤为明显。所有患者基于估算肾小球滤过率（eGFR）的慢性肾脏病分期均为1-3期，PBT前后均未发现严重肾功能不全病例。PBT对肾脏的远期影响存在年龄差异：儿童比成人更易出现显著的肾脏萎缩；V10与V20可作为PBT后肾脏萎缩程度的预测指标，尤其适用于儿童群体；PBT对儿童及成人肾功能恶化影响均较轻微。

原文链接：

Late Changes in Renal Volume and Function after Proton Beam Therapy in Pediatric and Adult Patients: Children Show Significant Renal Atrophy but Deterioration of Renal Function Is Minimal in the Long-Term in Both Groups