随着体重管理年的提出,肥胖话题引起了广泛讨论。 尽管肥胖是多种肿瘤的明确风险因素,但其与放射治疗(简称 放疗)疗效的关系呈现矛盾现象,即肿瘤放疗的“肥胖悖论”。 这一悖论对传统的公共卫生认知提出了挑战。 部分研究揭 示,肥胖患者可能展现出更高的放疗敏感性,但肥胖可能通过改变肿瘤微环境和影响放疗相关不良反应等途径,影响治疗效 果。 此外,除了体质指数,基于计算机断层扫描的更加精细的身体成分分析也能评估肥胖。 身体各部分脂肪分布情况与肥胖 肿瘤放疗患者的预后也呈现矛盾的关系。 因此,深入理解这些复杂的相互作用对于优化肿瘤放疗方案和改善患者预后具有 至关重要的意义。 本综述旨在探讨肥胖悖论对肿瘤放疗效果的影响,为临床医师提供应对肥胖悖论的策略,并为未来的研究 提供参考方向。

The designation of " Weight Management Year " has stimulated substantial discourse on obesity. While obesity constitutes an established risk factor for various malignancies its association with radiotherapeutic efficacy manifests a paradoxical phenomenon termed the " obesity paradox" in oncologic radiotherapy. This paradox poses a challenge to traditional public health perceptions. Emerging evidence indicates that obese patients may demonstrate enhanced radiosensitivity. Yet obesity can adversely influence therapeutic outcomes through alterations in the tumor microenvironment and modulation of radiotherapy - related adverse effects. In addition to the body mass index which is a conventional clinical indicator used to define obesity more detailed body composition analyses based on computed tomography scans can also be employed to assess obesity. Emerging evidence suggests that the distribution of adipose tissue in different regions of the body may have a complex and sometimes contradictory relationship with the prognosis of obese cancer patients undergoing radiotherapy. Consequently a comprehensive elucidation of these complex interactions is imperative for optimizing radiotherapy protocols and improving patient prognoses. This review aims to evaluate the impact of the obesity paradox on radiotherapeutic efficacy formulate clinical strategies for addressing the obesity paradox and delineate future research directions.