Radiological and clinical assessment of long-term brain tumour survivors after radiotherapy

Johannesen, Tom Børge; Lien, H. H.; Hole, Knut Håkon; Lote, Knut

doi:10.1016/s0167-8140(03)00192-0

Cited by 124 publications

(84 citation statements)

References 43 publications

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“…10 There is growing concern regarding the cognitive consequences of whole-brain irradiation for longterm survivors of cancer. 16 Previous animal studies have addressed whole-brain irradiation-induced cognitive impairment after both single and fractionated radiation dose schedules by use of x-ray and cobalt 60 as the source of radiation. 17,18 As the linear accelerator becomes more and more widely applied, protocols with use of a linear accelerator as the source of radiation are getting more and more similar to conventional radiation therapy protocols used for patients in the clinic.…”

Section: Discussionmentioning

confidence: 99%

An Experimental Study of Acute Radiation-Induced Cognitive Dysfunction in a Young Rat Model

Liu¹,

Xiao²,

Liu³

et al. 2009

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

An Experimental Study of Acute Radiation-Induced Cognitive Dysfunction in a Young Rat Model

Liu¹,

Xiao²,

Liu³

et al. 2009

AJNR Am J Neuroradiol

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“…Nevertheless, higher radiation doses, fraction sizes above 2 Gy, large radiation volumes, and the use of chemotherapy have been shown to increase the risk of late radiation effects. ( 54 – 56 ) Specifically, the risk of brain necrosis is 5% at 60 Gy (31) . Radiation necrosis causes significant morbidity from persistent cerebral edema, and neurologic deficits may require steroid treatment or surgical management.…”

Section: Discussionmentioning

confidence: 99%

Intensity modulated radiation therapy versus three‐dimensional conformal radiation therapy for the treatment of high grade glioma: a dosimetric comparison

MacDonald

Ahmad

Kachris

et al. 2007

J Applied Clin Med Phys

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The present study compared the dosimetry of intensity‐modulated radiation therapy (IMRT) and three‐dimensional conformal radiation therapy (3D‐CRT) techniques in patients treated for high‐grade glioma. A total of 20 patients underwent computed tomography treatment planning in conjunction with magnetic resonance imaging fusion. Prescription dose and normal‐tissue constraints were identical for the 3D‐CRT and IMRT plans. The prescribed dose was 59.4 Gy delivered at 1.8 Gy per fraction using 4 – 10 MV photons. Normal‐tissue dose constraints were 50 – 54 Gy for the optic chiasm and nerves, and 55 – 60 Gy for the brainstem.The IMRT plan yielded superior target coverage as compared with the 3D‐CRT plan. Specifically, minimum and mean planning target volume cone down doses were 54.52 Gy and 61.74 Gy for IMRT and 50.56 Gy and 60.06 Gy for 3D‐CRT (p≤0.01). The IMRT plan reduced the percent volume of brainstem receiving a dose greater than 45 Gy by 31% (p=0.004) and the percent volume of brain receiving a dose greater than 18 Gy, 24 Gy, and 45 Gy by 10% (p=0.059), 14% (p=0.015), and 40% (p≤0.0001) respectively. With IMRT, the percent volume of optic chiasm receiving more than 45 Gy was also reduced by 30.40% (p=0.047). As compared with 3D‐CRT, IMRT significantly increased the tumor control probability (p≤0.005) and lowered the normal‐tissue complication probability for brain and brainstem (p<0.033).Intensity‐modulated radiation therapy improved target coverage and reduced radiation dose to the brain, brainstem, and optic chiasm. With the availability of new cancer imaging tools and more effective systemic agents, IMRT may be used to intensify tumor doses while minimizing toxicity, therefore potentially improving outcomes in patients with high‐grade glioma.PACs number: 87.53 Tf

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“…Some 50% of long-term survivors develop latedelayed cognitive deficits due to radiation-induced injury of normal brain tissue (1,2). Age is an important risk factor for the development and severity of cognitive dysfunction following WBI, with pediatric and elderly patients appearing to be more vulnerable to WBI-induced brain injury than young adults (3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Aging-Dependent Changes in the Radiation Response of the Adult Rat Brain

Schindler¹,

Forbes²,

Robbins³

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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Purpose-To assess the impact of aging on the radiation response in the adult rat brain.Methods and Materials-Male rats 8, 18, or 28 months of age received a single 10Gy dose of whole brain irradiation (WBI). The hippocampal dentate gyrus (DG) was analyzed one and ten weeks later for sensitive neurobiological markers associated with radiation-induced damage: changes in the density of proliferating cells, immature neurons, total microglia, and activated microglia.Results-A significant reduction in basal levels of proliferating cells and immature neurons and increased microglial activation occurred with normal aging. WBI induced a transient increase in proliferation that was greater in older animals. This proliferation response did not increase the number of immature neurons, which decreased following WBI in young rats but not in old rats. Total microglial number decreased following WBI at all ages but microglial activation increased markedly, particularly in older animals.Conclusions-Age is an important factor to consider when investigating the radiation response of the brain. In contrast to young adults, older rats show no sustained decrease in the number of immature neurons following WBI but have a greater inflammatory response. The latter may play an enhanced role in the development of radiation-induced cognitive dysfunction in older individuals.

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Radiological and clinical assessment of long-term brain tumour survivors after radiotherapy

Cited by 124 publications

References 43 publications

An Experimental Study of Acute Radiation-Induced Cognitive Dysfunction in a Young Rat Model

An Experimental Study of Acute Radiation-Induced Cognitive Dysfunction in a Young Rat Model

Intensity modulated radiation therapy versus three‐dimensional conformal radiation therapy for the treatment of high grade glioma: a dosimetric comparison

Aging-Dependent Changes in the Radiation Response of the Adult Rat Brain

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