The Management of Radiation-Induced Brain Injury

Shaw, Edward G.; Robbins, Mike E.

doi:10.1007/0-387-25354-8_2

Cited by 39 publications

(27 citation statements)

References 83 publications

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“…Probably both factors were implicated in the ischemic and metabolic alterations in this patient. The existing high blood pressure and diabetes were risk factors for vascular diseases and also for RBI, while brain irradiation increases the risk of cerebrovascular diseases and stroke [14].…”

Section: Discussionmentioning

confidence: 99%

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Brain Ischemia and Hypometabolism Treated by Ozone Therapy

Clavo

Suárez

Aguilar

et al. 2011

Forsch Komplementmed

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Background: Radiation-induced brain injury (RBI) and low-perfusion brain syndromes are mediated by ischemia and hypometabolism and have limited treatment options. Ozone therapy as treatment in vascular diseases has been described, but the effects on brain tissue have not been well documented. Case Report: We describe a 75-year-old patient with vascular risk factors and meningioma who was treated with stereotactic radiosurgery. 14 months later the patient presented with progressive clinical impairment despite the use of acetylsalicylic acid and corticosteroids. Clinical and imaging evaluations before/after ozone therapy were done by magnetic resonance imaging (MRI), computed tomography (CT), single photon emission computed tomography (SPECT), and positron emission tomography (PET); performance status assessment was done using Barthel Index and World Health Organization/Eastern Cooperative Oncology Group Scale (WHO/ECOG Scale). Ozone therapy was performed by autohemotransfusion. Results: Basal images showed brain areas with ischemia and hypometabolism compatible with ischemic processes and/or RBI. There were no changes in MRI or CT scan images following ozone therapy. However, improvements in brain perfusion and metabolism were demonstrable with SPECT and PET; they correlated with clinical development and performance status scales. Conclusion: This report supports our previous works about the effect of ozone therapy in cerebral blood flow, and it suggests the use of ozone therapy in ischemic and hypometabolic brain syndromes such as stroke or RBI.

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Section: Discussionmentioning

confidence: 99%

“…RBI is also mediated by vascular, inflammatory and degenerative changes, including demyelization and leukoencephalopathy [14]. Limited approaches are available for RBI when symptoms are progressive and lesions are not suitable for surgery.…”

Section: Disclosure Statementmentioning

confidence: 99%

Brain Ischemia and Hypometabolism Treated by Ozone Therapy

Clavo

Suárez

Aguilar

et al. 2011

Forsch Komplementmed

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“…A contemporary view of radiation-induced brain injury [44], as can occur with PCI, suggests that it can be partially prevented and/or treated by the application of therapies similar to those used in Alzheimer's disease. In a prospective phase II trial, donepezil, an acetyl cholinesterase inhibitor, significantly improved the cognitive functioning, mood, and health-related quality of life for patients with low-grade gliomas receiving radiotherapy [45].…”

Section: Pcimentioning

confidence: 99%

Small Cell Lung Cancer: Have We Made Any Progress Over the Last 25 Years?

Lally¹,

Urbanic²,

Blackstock³

et al. 2007

The Oncologist

184

157

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After completing this course, the reader will be able to:1. Discuss the currently available SCLC treatment options.2. Describe the benefits of integrating thoracic radiotherapy into SCLC treatment.3. Identify the limitations of current SCLC treatment options and explain how future clinical trials are addressing these limitations.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTTwenty-five years ago, small cell lung cancer was widely considered to be the next cancer added to the list of "curable cancers." This article attempts to summarize the progress made toward that goal since then. Clinical trials have provided landmarks in the therapy of limited-stage small cell lung cancer (LS-SCLC). These are: (a) the proof that thoracic radiation therapy adds to systemic chemotherapy, (b) the superiority of twice-daily radiation therapy over daily fractionation, and (c) the need for prophylactic central nervous system radiation (prophylactic cranial irradiation). Each of these innovations adds about 5%-10% to the overall survival rate. In extensive-stage disease, irinotecan plus cisplatin may be a possible alternative to the "standard" etoposide-cisplatin chemotherapy doublet, but there has been little progress otherwise. It is imperative that, whenever possible, patients be given the opportunity to participate in future clinical trials so that the survival for these patients can continue to improve. The Oncologist 2007;12:1096 -1104

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“…Approximately 170,000 of these patients will survive ≥ 6 months (Khuntia et al 2006); 50–90% of these are at risk of developing radiation-induced cognitive impairments that severely impact their quality of life (QOL) (Crossen et al 1994, Shaw and Robbins 2006). The hallmarks of radiation-induced cognitive impairment include impairments in verbal memory, spatial memory, attention, and novel problem-solving (Twijnstra et al 1987, Roman and Sperduto 1995); the incidence and severity of these cognitive impairments increase over time (Nieder et al 1999).…”

Section: Introductionmentioning

confidence: 99%

“…The hallmarks of radiation-induced cognitive impairment include impairments in verbal memory, spatial memory, attention, and novel problem-solving (Twijnstra et al 1987, Roman and Sperduto 1995); the incidence and severity of these cognitive impairments increase over time (Nieder et al 1999). Often these cognitive impairments occur without clinical or radiographic evidence of demyelination or white matter necrosis (Dropcho 1991, Shaw and Robbins 2006). To overcome these QOL issues requires research in translatable pre-clinical models to study the mechanisms of fWBI-induced cognitive impairment, and test therapeutics that target these mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Cellular response of the rat brain to single doses of¹³⁷Cs γ rays does not predict its response to prolonged ‘biologically equivalent’ fractionated doses

Greene-Schloesser

Kooshki

Payne

et al. 2014

International Journal of Radiation Biology

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Purpose To determine if the brain’s response to single doses predicts its response to ‘biologically equivalent’ fractionated doses. Methods Young adult male Fischer 344 rats were whole-brain irradiated with either single 11, 14, or 16.5 Gy doses of 137Cs γ rays or their ‘biologically equivalent’ 20, 30, or 40 Gy fractionated doses (fWBI) delivered in 5 Gy fractions, twice/week for 2, 3, or 4 weeks, respectively. At 2 months post-irradiation, cellular markers of inflammation (total, activated, and newborn microglia) and neurogenesis (newborn neurons) were measured in 40 µm sections of the dentate gyrus (DG). Results Although the total number of microglia in the DG/hilus was not significantly different (p > 0.7) in unirradiated, single dose, and fWBI rats, single doses produced a significant (p < 0.003) increase in the percent-activated microglia; fWBI did not (p > 0.1). Additionally, single doses produced a significant (p < 0.002) dose-dependent increase in surviving newborn microglia; fWBI did not (p < 0.8). Although total proliferation in the DG was reduced equally by single and fWBI doses, single doses produced a significant dose-dependent (p < 0.02) decrease in surviving newborn neurons; fWBI did not (p > 0.6). Conclusions These data demonstrate that the rat brain’s cellular response to single doses often does not predict its cellular response to ‘biologically equivalent’ fWBI doses.

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The Management of Radiation-Induced Brain Injury

Cited by 39 publications

References 83 publications

Brain Ischemia and Hypometabolism Treated by Ozone Therapy

Brain Ischemia and Hypometabolism Treated by Ozone Therapy

Small Cell Lung Cancer: Have We Made Any Progress Over the Last 25 Years?

Cellular response of the rat brain to single doses of¹³⁷Cs γ rays does not predict its response to prolonged ‘biologically equivalent’ fractionated doses

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The Management of Radiation-Induced Brain Injury

Cited by 39 publications

References 83 publications

Brain Ischemia and Hypometabolism Treated by Ozone Therapy

Brain Ischemia and Hypometabolism Treated by Ozone Therapy

Small Cell Lung Cancer: Have We Made Any Progress Over the Last 25 Years?

Cellular response of the rat brain to single doses of137Cs γ rays does not predict its response to prolonged ‘biologically equivalent’ fractionated doses

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Cellular response of the rat brain to single doses of¹³⁷Cs γ rays does not predict its response to prolonged ‘biologically equivalent’ fractionated doses