近年,随着脑放疗设备的开发和进步,由γ射线、直线加速器、质子武装起来的放射线外科等的出现,使脑疾病放疗适应证由神经胶质瘤、实质性脑转移瘤、髓膜瘤,以及垂体瘤、听神经瘤等脑实质外肿瘤,扩大到脑动静脉畸型(AVM)之类的血管性疾病。可以预料,与脑放疗相伴的副作用出现率很高,其代表病状是“脑放射线坏死”,这一疾病组如何与肿瘤再发鉴别,常常成为问题,且在脑外科范围成为独立的临床疾病。重视本病的另一个原因是生活质量的显著下降。近年来在标定病灶准确照射不伤及周围正常脑组织上下了工夫。但对深部病灶的放疗不得不通过正常脑组织,故仍存在着内在危险性。一、正常脑组织和放射生物学 In recent years, with the development and progress of brain radiotherapy equipment, the emergence of radiation surgery armed with γ-rays, linear accelerators and protons has made the indication of radiotherapy for brain diseases caused by glioma, substantial brain metastases, , As well as extraparenchymal tumors of the pituitary and acoustic neuroma, expanding to vascular diseases such as cerebral arteriovenous malformations (AVMs). It can be expected that the high incidence of side effects associated with brain-based radiotherapy, which represent the pathological condition of “brain radiation necrosis,” is often a problem in how the disease group re-identifies with the tumor and becomes an independent clinical disease in the area of ​​brain surgery. Another reason to pay attention to this disease is the significant drop in quality of life. In recent years, accurate lesions in the calibration does not hurt the surrounding normal brain tissue up and down time. However, the deep lesions of radiotherapy had to pass through normal brain tissue, so there is still inherent risk. First, normal brain tissue and radiobiology