Progressive Deterioration of Intellect and Motor Function Occurring Several Decades After Cranial Irradiation

Duffey, Philip

doi:10.1001/archneur.1996.00550080140022

Cited by 28 publications

(9 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1,2,6 The rationale supporting the use of this approach relies on the demonstration that it has a high potency of controlling neurological symptoms. 18 However, survival improvement is modest, ranging from 3 to 5 months. 3,5 This survival has not been altered despite 3 decades of clinical research aimed at improving outcome for these patients.…”

Section: Discussionmentioning

confidence: 99%

Enhanced chemotherapy delivery by intraarterial infusion and blood‐brain barrier disruption in the treatment of cerebral metastasis

Fortin

Gendron

Boudrias

et al. 2007

Cancer

View full text Add to dashboard Cite

Cationic polyurethane‐fluorinated acrylate hybrid dispersions (PUFA) were prepared by the copolymerization of styrene, butyl acrylate, and 2,2,3,4,4,4‐hexafluorobutyl methacrylate in the medium of crosslinked polyurethane via phase inversion polymerization. The said polyurethane was synthesized in acetone from 2,4‐tolyene diisocyanate, N‐methyldiethanolamine, trimethylolpropane, and soft polyester diol block. The influences of hydrophilic monomer on the surface properties, immersion behaviors, particle size and, zeta potential of the dispersions were investigated. The results show that the addition of hydrophilic monomer can be advantaged to the stability of dispersions and yet will increase the surface free energy by more than 19.9%. The PUFA coating films cured at ambient conditions have the lower surface free energy (less than 0.02033 J/m2). At the same time, there is an obvious mobility of fluorinated groups in fluorinated polymer films. © 2005 Wiley Periodicals, Inc. J Appl Polym Sci, 2006

show abstract

Section: Discussionmentioning

confidence: 99%

Enhanced chemotherapy delivery by intraarterial infusion and blood‐brain barrier disruption in the treatment of cerebral metastasis

Fortin

Gendron

Boudrias

et al. 2007

Cancer

View full text Add to dashboard Cite

show abstract

“…Because of the previous local radiation, frontal seeds implant, and the translucent white matter of the frontal lobes, we initially attributed the mental change to a delayed radiation encephalopathy (Gütling et al ., 1992). However, radiation induced encephalopathy is reported to be a slowly progressive syndrome and is not characterized by an acute onset (Duffey et al ., 1996).…”

Section: Discussionmentioning

confidence: 99%

Akinetic mutism caused by bilateral infiltration of the fornix in a patient with astrocytoma

Oberndorfer¹,

Urbanits²,

Lahrmann³

et al. 2002

Euro J of Neurology

View full text Add to dashboard Cite

In a 59-year-old female patient, a World Health Organization (WHO) grade II astrocytoma had been diagnosed 16 years ago, which finally progressed into WHO grade III. Several right frontal neurosurgical resections, local radiation and a local radioimplant had been applied. Despite this long record, she was reported alert with a Karnofsky index of 90% until admission. Within a few weeks she rapidly developed akinetic mutism. Upon admission, computed tomography (CT) scan showed a large cystic right frontal defect and a suggested small tumor recurrence. White matter of the frontal lobe appeared to be translucent and compatible with previous radiation. The severe mental changes were initially attributed to a delayed radiation encephalopathy. Neuropathologically, the white matter of the frontal lobe showed mild elevated cell density consistent with gliosis; however, a tumor recurrence invading the tip of the corpus callosum and invading the entire length both fornices appeared. From the neuropathological findings of massive local tumor recurrence in both fornices, together with the acute clinical onset, it seems unlikely that the sequel of radiotherapy caused akinetic mutism, but the symmetric and severe involvement of the limbic system. We conclude that the rapid progression from a state of alertness to a full clinical picture of akinetic mutism was because of infiltration of both fornices.

show abstract

“…Neurocognitive degeneration induced by radiation therapy follows a well-documented biphasic pattern beginning with a transient decline in mental functioning at around 4 months posttreatment, followed by an improvement in neurocognitive functioning, and then an ultimate irreversible return of impairment months to years later;[4] some cases have been reported to occur as late as 33 years after therapy. [21] Although the prevalence of these effects in patients treated with WBRT has been difficult to quantify due to confounding variables such as persistent brain metastases, paraneoplastic neurocognitive dysfunction, and possible chemotherapy-induced neurocognitive decline, there seems to be sufficient evidence to suggest that it is common enough to be a necessary consideration in the development of a WBRT dose-fractionation schedule appropriate for favorable-prognosis patients.…”

Section: Late Toxicitymentioning

confidence: 99%

Whole brain radiotherapy for brain metastasis

McTyre

Scott²,

Chinnaiyan³

2013

Surg Neurol Int

103

View full text Add to dashboard Cite

Whole brain radiotherapy (WBRT) is a mainstay of treatment in patients with both identifiable brain metastases and prophylaxis for microscopic disease. The use of WBRT has decreased somewhat in recent years due to both advances in radiation technology, allowing for a more localized delivery of radiation, and growing concerns regarding the late toxicity profile associated with WBRT. This has prompted the development of several recent and ongoing prospective studies designed to provide Level I evidence to guide optimal treatment approaches for patients with intracranial metastases. In addition to defining the role of WBRT in patients with brain metastases, identifying methods to improve WBRT is an active area of investigation, and can be classified into two general categories: Those designed to decrease the morbidity of WBRT, primarily by reducing late toxicity, and those designed to improve the efficacy of WBRT. Both of these areas of research show diversity and promise, and it seems feasible that in the near future, the efficacy/toxicity ratio may be improved, allowing for a more diverse clinical application of WBRT.

show abstract

Progressive Deterioration of Intellect and Motor Function Occurring Several Decades After Cranial Irradiation

Cited by 28 publications

References 35 publications

Enhanced chemotherapy delivery by intraarterial infusion and blood‐brain barrier disruption in the treatment of cerebral metastasis

Enhanced chemotherapy delivery by intraarterial infusion and blood‐brain barrier disruption in the treatment of cerebral metastasis

Akinetic mutism caused by bilateral infiltration of the fornix in a patient with astrocytoma

Whole brain radiotherapy for brain metastasis

Contact Info

Product

Resources

About