Brain damage from anticancer treatments in adults

Ricard, Damien; Taillia, H.; Renard, Jean-Luc

doi:10.1097/cco.0b013e328330c669

Cited by 39 publications

(18 citation statements)

References 32 publications

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“…5 However, clinical symptoms usually occur several months after radiation therapy and till date, there is no reliable neurobehavioral assay to measure the subacute effects of radiation induced injury. 6 Therefore, there is a critical need for objective and quantitative methods to assess early treatment-induced damage due to WBRT to ascertain the riskto-benefit ratio and dose determination so that the radiation beam can be specifically tailored to limit damage to the normal brain. 1 H MRS has been used to demonstrate abnormal metabolite pattern from the normal brain, secondary to irradiation.…”

Section: Introductionmentioning

confidence: 99%

Radiation Injury to the Normal Brain Measured by 3D‐Echo‐Planar Spectroscopic Imaging and Diffusion Tensor Imaging: Initial Experience

Chawla

Wang

Kim

et al. 2013

Journal of Neuroimaging

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Section: Introductionmentioning

confidence: 99%

Radiation Injury to the Normal Brain Measured by 3D‐Echo‐Planar Spectroscopic Imaging and Diffusion Tensor Imaging: Initial Experience

Chawla

Wang

Kim

et al. 2013

Journal of Neuroimaging

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“…The main advantage of GKRS is the preservation of cognitive function, which is one of the main complications of WBRT 6,14,17,18) . GKRS with WBRT is another emerging treatment modality for metastatic brain tumors, especially multiple lesions.…”

Section: B Amentioning

confidence: 99%

Therapeutic Effect of Gamma Knife Radiosurgery for Multiple Brain Metastases

Lee

Cho

et al. 2011

J Korean Neurosurg Soc

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. Therefore, we aimed to study the therapeutic effects of SRS in patients with multiple (4 or more) brain metastases, and to investigate prognostic factors related to treatment outcomes. MATERIALS AND METHODS Patient characteristicsThirty-six patients with 4 or more brain metastases underwent gamma knife radiosurgery (GKRS) for 264 lesions in our department between August 2008 and April 2011. We retrospectively reviewed the clinical records, radiological studies and dosimetric data of those patients. The mean age at the time of GKRS was 60 years (range, 36-76 years) and the mean number of brain metastases was 7 (range, 4-14). There were 18 men and 18 women. The median Karnofsky performance scale (KPS) score were 90 (range, 60-100). The primary tumor sites were the lung (n=22), breast (n=7), gastrointestinal tract (n=3), liver (n=2), kidney (n=1) and unknown (n=1). The mode of onset was synchronous in 16 (44.4%) and metachronous in 20 (55.6%). The median interval between diagnosis of brain metastases and INTRODUCTIONUntil now, 3 randomized controlled studies have proved the beneficial effects of stereotactic radiosurgery (SRS) in the treatment of oligometastatic brain tumors 1,2,9) . The Pittsburgh group and Radiation Therapy Oncology Group showed improved local tumor control in the SRS with whole brain radiation therapy (WBRT) group, compared to the WBRT only group, and prolonged survival in a subset of patients with a single lesion 1) . Aoyama et al.2) reported that there was no significant difference in overall survival time and neurological deterioration between WBRT combined with SRS and SRS only. These results suggest that WBRT may be deferred until development of multiple new metastases after SRS.However, until the present time, relatively little has been pub- Department of Neurosurgery, Gamma Knife Center, Ajou University School of Medicine, Suwon, KoreaObjective : The aim of this study is to evaluate the therapeutic effects of gamma knife radiosurgery (GKRS) in patients with multiple brain metastases and to investigate prognostic factors related to treatment outcome. Methods : We retrospectively reviewed clinico-radiological and dosimetric data of 36 patients with 4-14 brain metastases who underwent GKRS for 264 lesions between August 2008 and April 2011. The most common primary tumor site was the lung (n=22), followed by breast (n=7). At GKRS, the median Karnofsky performance scale score was 90 and the mean tumor volume was 1.2 cc (0.002-12.6). The mean prescription dose of 17.8 Gy was delivered to the mean 61.1% isodose line. Among 264 metastases, 175 lesions were assessed for treatment response by at least one imaging follow-up.Results : The overall median survival after GKRS was 9.1±1.7 months. Among various factors, primary tumor control was a significant prognostic factor (11.1±1.3 months vs. 3.3±2.4 months, p=0.031). The calculated local tumor control rate at 6 and 9 months after GKRS were 87.9% and 84.2%, respectively. Paddick's conformity index (>0.75) was significantly related to local tumor c...

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“…Hyperintense T2 signal in parietal and occipital lobe white matter, with cortical and subcortical edema on MRI, supports the diagnosis. It is thought to be reversible within 2 weeks if the offending agent is removed and hypertension is appropriately treated [1,[30][31][32]. Cisplatin, 5-fluorouracil, gemcitabine, cyclophosphamide, and methotrexate are among the most common chemotherapeutics associated with RPLS [33-37].…”

Section: Case Continuationmentioning

confidence: 99%

Case Files of the New York City Poison Control Center: Paradichlorobenzene-Induced Leukoencephalopathy

2010

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A 44-year-old man was brought to the emergency department by emergency medical services after he was discovered lying supine on his apartment floor. He was accompanied by his sister, who had decided to visit him after his absence from a family function. Worsening "bizarre" behavior had been noted by family members for 4 weeks, characterized by anorexia, social withdrawal, flat affect, and alogia. Prior to his illness, he was described as functional, independent, gainfully employed, and social.The patient had mild mental retardation and hypertension. There was no history of diagnosed psychiatric illness, although his family suspected pica. Medications included an unknown antihypertensive with which he was not compliant. He occasionally used marijuana and alcohol, without history of other abused drugs. The patient's sister reported significant weight loss over several months. There had been no apparent fevers, cough, vomiting, diarrhea, or convulsions. On physical examination, he appeared drowsy, was markedly cachectic, and emanated an atypical aromatic body odor. Initial vital signs were: blood pressure 154/90 mmHg, heart rate 98/min, respiratory rate 20/min, rectal temperature 37.4°C, and room air oxygen saturation 97%. Head, neck, chest, and abdominal examinations were unremarkable. He had dry, scaling, and ichthyotic skin. He was oriented to person and place, but not to time, date, or indication for hospitalization. Limited cranial nerve evaluation was normal. Pain and light-touch sensation were unaffected. Hyperreflexia (without clonus) and cogwheel rigidity were noted in both lower extremities; upper extremities were normal. Plantar reflexes were normal bilaterally. Muscle bulk, tone, and strength were normal. The patient was unable to stand without support and unable to ambulate, apparently due to impaired equilibrioception. He could follow simple one-step commands. He would speak a few words when asked simple questions, and he avoided eye contact.Serum electrolytes (sodium, potassium, chloride, calcium, and magnesium) and serum glucose were normal. Tests of hepatic and renal function were: AST 53

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Brain damage from anticancer treatments in adults

Cited by 39 publications

References 32 publications

Radiation Injury to the Normal Brain Measured by 3D‐Echo‐Planar Spectroscopic Imaging and Diffusion Tensor Imaging: Initial Experience

Radiation Injury to the Normal Brain Measured by 3D‐Echo‐Planar Spectroscopic Imaging and Diffusion Tensor Imaging: Initial Experience

Therapeutic Effect of Gamma Knife Radiosurgery for Multiple Brain Metastases

Case Files of the New York City Poison Control Center: Paradichlorobenzene-Induced Leukoencephalopathy

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