Standard chemoradiation for glioblastoma results in progressive brain volume loss

Abstract

We present evidence of significant and progressive treatment-associated structural brain changes in patients with glioblastoma treated with standard chemoradiation. Future studies using longitudinal neuropsychological evaluation are needed to characterize the functional consequences of these structural changes.

Bone marrow drives central nervous system regeneration after radiation injury

“…Moreover, there are currently no available treatment options for patients who develop radiation-associated structural brain changes (15), and impaired cognition and mood changes are among the most important reasons for treatment-related morbidity and impaired quality of life in cancer patients (16,51). The ability to improve cognitive deficits in patients treated with brain irradiation would be of considerable clinical impact for patients and their families.…”

“…One common form of CNS injury is caused by cranial irradiation, which is well known to damage cerebral white matter, to disrupt the neurovascular niche (10)(11)(12)(13)(14), and to result in progressive brain volume loss (15). Importantly, delayed neurologic complications of cranial irradiation have been a major concern for long-term cancer survivors, such as children treated for leukemia or brain tumors (16,17).…”

Radiation Toxicity in the Central Nervous System: Mechanisms and Strategies for Injury Reduction

“…Functional toxicities are believed correlated to observed changes in the entire brain, including gray matter, white matter, ventricles, and combinations among them 27–28 . Hallmarks of normal tissue toxicity include vascular injury 29 .…”

“…Radiographic definitions are lacking as conventional magnetic resonance imaging (MRI) has a limited ability to distinguish normal tissue injury from treatment related changes, such radiation necrosis or vascular changes 33 . Structural changes may be present on scans in previously irradiated patients but may have no bearing on patient function, while conversely, patient function may be compromised in the absence of structural changes 28 .…”

Foods as a Novel Treatment for Glioblastoma

“…[6] Progressive brain volume loss have been observed with classic radio chemotherapy treatment resulting to neuropsychological changes in patients with glioblastoma. [7] Although different types of cancer therapy have been applied for glioblastoma, the 5-year survival rate of patient is less than 10% because of heterogeneous complex tissue of glioblastoma, genetic mutations, and abnormal signal pathways. [8,9] Recently, novel therapeutic approaches evaluated the molecular characteristics of glioblastoma by setting of Glio-Tex project (GBM and Experimental Therapeutics) a GBM patient-derived cell line (GBM-PDCL) library.…”