Somnolence after Prophylactic Cranial Irradiation in Children with Acute Lymphoblastic Leukaemia

Freeman, J E; Johnston, P. G. B.; Voke, J

doi:10.1136/bmj.4.5891.523

Cited by 183 publications

(49 citation statements)

References 9 publications

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“…It was first described by Druckmann [23] in 1929 who noted its development after radiation of the scalp in children for ringworm. In 1973. this phenomenon was described in children with acute lymphocytic leukemia (ALL) who had been prophylactically irradiated to the craniospinal axis [24]. Eighty percent of the children developed the syn drome to some degree (40% mild.…”

Section: Acute Reactionsmentioning

confidence: 99%

Short- and Long-Term Complications of Radiation Therapy for Pediatric Brain Tumors

Donahue

1992

Pediatr Neurosurg

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Brain tumors are the second most common malignancy of childhood after acute lymphocytic leukemia. Improvements in therapy have led to increased survival. It is estimated that by the year 2000 there will be approximately 200,000 survivors of childhood cancer. A proportion of these will have survived a central nervous system malignancy. As more children survive, complications of treatment are increasingly recognized. This paper reviews the spectrum of radiation-induced complications, both short- and long-term. Their frequency and characteristics will be reviewed as well as suggestions made to decrease their incidence.

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Section: Acute Reactionsmentioning

confidence: 99%

Short- and Long-Term Complications of Radiation Therapy for Pediatric Brain Tumors

Donahue

1992

Pediatr Neurosurg

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“…The recordings of the SEPs in our SR patients were with "total therapy" of childhood acute lymphocytic leukemia. as somnolence syndrome [35,36]. This was observed in 6.…”

Section: Table I Mean (Sd) Latencies (Ms) and The Mean Differences (mentioning

confidence: 94%

Chemotherapy for acute lymphoblastic leukemia may cause subtle changes of the spinal cord detectable by somatosensory evoked potentials

Vainionpää

Kovala

Tolonen

et al. 1997

Med. Pediatr. Oncol.

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“…5 It has generally become recognised as a condition affecting children with acute lymphocytic leukemia (ALL) after receiving prophylactic cranial irradiation. 6,7 However, studies have begun to report that somnolence also appears in adults after irradiation for primary brain tumours. 2,3 In the present study, we have found an incidence of excessive sleepiness (one of the symptoms of somnolence syndrome) in 60.86 % of the individuals, which is in concordance the 62.9% incidence reported by Parker et al 8 in children receiving cranial irradiation.…”

Section: Discussionmentioning

confidence: 99%

Epworth Sleepiness Scale- a novel tool to assess somnolence syndrome in patients receiving radiotherapy to the brain

Harjani

Janaki

Maheshwari

et al. 2014

Int J Cancer Ther Oncol

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Purpose: Radiation to brain causes early, early-delayed, and delayed side effects. There is paucity of literature regarding early-delayed effects like somnolence syndrome. Existing studies use general symptom assessment and visual analog scales. Epworth Sleepiness Scale (ESS) is a time tested tool to assess daytime sleepiness in various conditions. In this study, the ESS has been used to determine the occurrence of somnolence in patients receiving cranial radiotherapy for primary and metastatic brain tumors. Thus the ESS has been used in a novel setting in our study. The ESS is a simple to administer questionnaire and may be useful in grading the severity of somnolence. To our knowledge, this is the second study to determine post radiation somnolence using ESS. Methods: This prospective study was conducted in 23 patients with primary and metastatic brain tumor. Patient demographics and tumor type and grade was noted. Those with Karnofsky Performance Scale (KPS) less than 70 and with pre-existing sleep disorders were excluded. Radiotherapy regimen included palliative whole brain radiation for brain metastases and conformal adjuvant radiotherapy for primary brain tumors as per standard guidelines. All subjects included were administered ESS at baseline and weekly thereafter during and for 6 weeks after radiation. Results: All 23 patients (median age 50 years) completed the planned questionnaires until 6 weeks post radiation. Twenty (87%) patients had primary brain tumors whereas three (13%) patients had metastatic lesions in brain. Of the 23 patients, 14 patients (60.86%) had abnormal or increased daytime sleepiness; of which 3 had ESS scores greater than 16. Conclusion: Somnolence was noted in 60.86% of the patients, which is in accordance with existing literature. Epworth sleepiness scale is an effective tool to detect and quantify somnolence, However, it does not consider other symptoms of somnolence syndrome and hence should be combined with visual analog scale to get complete information.

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Somnolence after Prophylactic Cranial Irradiation in Children with Acute Lymphoblastic Leukaemia

Cited by 183 publications

References 9 publications

Short- and Long-Term Complications of Radiation Therapy for Pediatric Brain Tumors

Short- and Long-Term Complications of Radiation Therapy for Pediatric Brain Tumors

Chemotherapy for acute lymphoblastic leukemia may cause subtle changes of the spinal cord detectable by somatosensory evoked potentials

Epworth Sleepiness Scale- a novel tool to assess somnolence syndrome in patients receiving radiotherapy to the brain

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