Large animal normal tissue tolerance with boron neutron capture

Gavin, Patrick R.; Kraft, Susan L.; DeHaan, C. E.; Swartz, Carol D.; Griebenow, M.L.

doi:10.1016/0360-3016(94)90483-9

Cited by 29 publications

(12 citation statements)

References 10 publications

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“…Demyelination and necrosis (malacia) are consistently the dominant morphologic features of clinical and experimentally induced radiation myelopathy [21]. Explanations of the pathogenesis of radiation myelitis generally conclude with a dual focus on changes in nerve fibers and the intramedullary vasculature; recently, however, authors have published evidence supporting microvascular injury as a critical event in radiation [18,22,23]. In our experience, histologic findings gave signs of edema and necrotic areas surrounded by glial proliferation in white matter.…”

Section: Discussionmentioning

confidence: 80%

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Radiation myelopathy in over-irradiated patients: MR imaging findings

et al. 1997

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The objective of this work is to report the MRI findings in patients with radiation myelopathy due to accidental local over-irradiation syndrome. Eight patients (seven males and one female) were suffering from over-irradiation syndrome as a result of treatments from a malfunctioning linear electron accelerator. The mean accidental estimated dose was 136 Gy delivered to the "open-neck" (seven cases) and to the thoracic wall (one case), during a mean of 5.4 sessions (range 1-9 sessions). Paresthesia and weakness in the upper extremities were the earliest symptoms (87.5 %), with evolution to paralysis in all patients. No patient is alive (mean survival time 64 days). In all cases MRI was negative for neurologic lesions in the acute phase ( < 90 days from irradiation; Radiation Therapy Oncology Group scoring system). Late signs of radiation myelitis manifested as high-intensity signals on T2-weighted images in three patients, and as Gd-DTPA enhancement of T1-weighted images in one case. Autopsies performed on four patients who died in acute phase showed morphologic alterations in white matter: edema in 75 %, and necrosis and glial reaction as well as obliterative vasculitis in all cases. In cases of over-irradiation, MRI may be normal in acute phase even if the patients have severe neurologic deficit, as positive MRI findings appear only in delayed radiation myelitis.

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Section: Discussionmentioning

confidence: 80%

“…Gavin et al [18] provided data on normal CNS tissue tolerance in large animals with radiation necrosis. At the peak dose level of 27 Gy, abnormal MRI was noted and coincided with areas of hemorrhagic necrosis after 154-252 days post irradiation.…”

Section: Discussionmentioning

confidence: 98%

Radiation myelopathy in over-irradiated patients: MR imaging findings

et al. 1997

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“…The results reported by Gavin et al (22) indicate, however, that despite their use of blood-'"B monitoring, differences between intended and obtained mean blood-'"B concentration during irradiation occurred which, considering the expected steepness of the doseresponse curves, are undesirable for a dose-response study at a predefined boron level and would be unacceptable for clinical trials. To some extent a comparison is possible between our results and the actual data obtained in the Brookhaven study (22). From the data presented in that paper, a standard deviation in the mean '"B concentration during irradiation of about 18% for the 25 pg/g and 50 p g / g groups can be deduced.…”

Section: Discussionmentioning

confidence: 67%

“…The proportions of the components change with "B concentration and subsequent irradiation time. Due to the uncertainties in the applied RBE values and the not fully understood interrelationship of blood-"'B levels and irradiation time (22). uncertainties are introduced when comparing irradiations at different blood-'"B levels.…”

Section: Discussionmentioning

confidence: 99%

“…PGRA and DCP-AES, have both been used in support of a large animal healthy tissue tolerance study in Brookhaven (19,22). The results reported by Gavin et al (22) indicate, however, that despite their use of blood-'"B monitoring, differences between intended and obtained mean blood-'"B concentration during irradiation occurred which, considering the expected steepness of the doseresponse curves, are undesirable for a dose-response study at a predefined boron level and would be unacceptable for clinical trials.…”

Section: Discussionmentioning

confidence: 99%

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