Neurologic Complications of Radiation Therapy and Chemotherapy

2021 ◽  
pp. 967-973
Author(s):  
Gretchen E. Schlosser Covell ◽  
Akanksha Sharma ◽  
Alyx B. Porter
Keyword(s):  
Radiation Therapy ◽  
Adverse Effects ◽  
Pituitary Tumors ◽  
High Grade Glioma ◽  
External Beam Radiation ◽  
Benign Tumors ◽  
Beam Radiation ◽  
Brain And Spinal Cord ◽  
Malignant And Benign Tumors ◽  
The Brain

Separate from neurosurgery, radiation and chemotherapy have been used in the treatment of malignant and benign tumors of the brain and spinal cord. Although effective, the treatments can be associated with serious neurologic adverse effects. This chapter reviews the adverse effects of these treatments. External beam radiation therapy (RT) is a common mode of radiation and is most effective for high-grade glioma. Intensity-modulated RT and stereotactic radiosurgery are usually reserved for pituitary tumors, skull-base masses, metastatic disease, and primary parenchymal tumors.

scholarly journals Strategies to Minimize Late Effects From Pelvic Radiotherapy

2021 ◽  
pp. 158-168
Author(s):  
Ammoren Dohm ◽  
Julian Sanchez ◽  
Eden Stotsky-Himelfarb ◽  
Field F. Willingham ◽  
Sarah Hoffe
Keyword(s):  
Radiation Therapy ◽  
Adverse Effects ◽  
Late Effects ◽  
Radiation Treatment ◽  
External Beam Radiation ◽  
High Dose ◽  
Pelvic Radiotherapy ◽  
Beam Radiation ◽  
True Incidence ◽  
Pelvic Malignancies

During the past 30 years, radiation treatment techniques have significantly improved, from conventional external-beam radiation therapy, to three-dimensional conformal radiation therapy, to current intensity-modulated radiation therapy, benefiting patients who undergo treatment of pelvic malignancies. Modern treatment options also include proton beam irradiation as well as low and high dose rate brachytherapy. Although the acute adverse effects of these modalities are well documented in clinical trials, less well known are the true incidence and optimal management of those late adverse effects that can occur months to years later. In a population of survivors of cancer that is steadily increasing, with many such patients receiving radiotherapy at some time during their disease course, these late effects can become a considerable management and quality-of-life issue. This review will examine the range of late toxicities that can occur from pelvic radiotherapy and explore strategies to prevent and mitigate them.

scholarly journals Intra-operative Radiation Therapy versus Whole Breast External Beam Radiotherapy: A Comparison of Patient-Reported Outcomes

2021 ◽  
Vol 14 ◽  
pp. 170-175
Author(s):  
Jordan Leatherman ◽  
Christina Nicholas ◽  
Therese Cusick ◽  
Ellen Cooke ◽  
Elizabeth Ablah ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Adverse Effects ◽  
Patient Reported Outcomes ◽  
External Beam Radiotherapy ◽  
Well Being ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Patient Reported ◽  
Effects Of Radiation

Introduction. This project sought to compare patient-reported outcomes between patients who received intra-operative radiation therapy (IORT) and those who qualified for IORT but received whole-breast external beam radiation therapy (EBRT) following breast-conserving surgery (BCS). Methods. Three scales from the BREAST-Q Breast Cancer BCT Module Version 2.0 questionnaire were used to collect patient-reported outcomes regarding post-operative physical well-being of the chest, post-operative satisfaction with breast cosmesis and post-operative adverse effects of radiation. Results. Patients who received EBRT travelled farther on average than patients who received IORT to complete treatment. Respondents who received IORT reported better physical well-being of the chest than those who received EBRT. Regression reveals that the respondent’s age was the determining factor in the difference between IORT and EBRT post-operative physical well-being scores, where younger patients report poorer well-being. There was no difference in patient-reported outcomes regarding post-operative satisfaction with breast cosmesis or adverse effects of radiation. Conclusions. This study suggests that patients who received IORT report better physical well-being of the chest than patients who received EBRT. There appears to be a relationship between age and physical well-being of chest. This study suggests that there is no difference in patient-reported outcomes concerning post-operative satisfaction with breast cosmesis or post-operative adverse effects of radiation between patients who received IORT and those who received EBRT.

scholarly journals Radiation Dose Enhancement in Megavoltage Radiation Therapy using Au, Gd, Pt, Ag, and Bi Nanoparticles of Various Concentration Level

2021 ◽  
Vol 12 (2) ◽  
pp. 2404-2414
Keyword(s):  
Radiation Therapy ◽  
Tumor Volume ◽  
Concentration Level ◽  
Tumour Volume ◽  
External Beam Radiation ◽  
Average Dose ◽  
Dose Enhancement ◽  
Beam Radiation ◽  
Irradiation Geometry ◽  
The Brain

A digital phantom was created from a CT scan of a patient’s head and employed together with GATE 8.2 Monte Carlo modeling of a linear accelerator of nominal 6 MV energy to simulate an irradiation geometry for a typical tumor volume centrally within the brain region. Although simplistic in arrangement, this setup was considered appropriate to demonstrate the dose enhancements that may be expected for megavoltage external beam radiation therapy for nanoparticles (NP) of different elemental composition and concentration. Ag, Gd, Pt, Au and Bi were modeled in concentrations varying from 15 mg NP / gram tissue to 70 mg NP / gram tissue. The maximum Average Dose Enhancement Factor (ADEF) to the Gross Tumour Volume (GTV) observed was 3 % for 70 mg NP / gram tissue of Bi.

Combined stereotactic split-course fractionated gamma knife radiosurgery and conventional radiation therapy for unfavorable gliomas: a phase I study

2000 ◽  
Vol 93 (supplement_3) ◽  
pp. 37-41 ◽  
Author(s):  
William F. Regine ◽  
Roy A. Patchell ◽  
James M. Strottmann ◽  
Ali Meigooni ◽  
Michael Sanders ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Disease Progression ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
External Beam Radiation ◽  
Low Grade ◽  
Beam Radiation ◽  
Content Type ◽  
Group B ◽  
Fine Print

Object. This investigation was performed to determine the tolerance and toxicities of split-course fractionated gamma knife radiosurgery (FSRS) given in combination with conventional external-beam radiation therapy (CEBRT). Methods. Eighteen patients with previously unirradiated, gliomas treated between March 1995 and January 2000 form the substrate of this report. These included 11 patients with malignant gliomas, six with low-grade gliomas, and one with a recurrent glioma. They were stratified into three groups according to tumor volume (TV). Fifteen were treated using the initial FSRS dose schedule and form the subject of this report. Group A (four patients), had TV of 5 cm3 or less (7 Gy twice pre- and twice post-CEBRT); Group B (six patients), TV greater than 5 cm3 but less than or equal to 15 cm3 (7 Gy twice pre-CEBRT and once post-CEBRT); and Group C (five patients), TV greater than 15 cm3 but less than or equal to 30 cm3 (7 Gy once pre- and once post-CEBRT). All patients received CEBRT to 59.4 Gy in 1.8-Gy fractions. Dose escalation was planned, provided the level of toxicity was acceptable. All patients were able to complete CEBRT without interruption or experiencing disease progression. Unacceptable toxicity was observed in two Grade 4/Group B patients and two Grade 4/Group C patients. Eight patients required reoperation. In three (38%) there was necrosis without evidence of tumor. Neuroimaging studies were available for evaluation in 14 patients. Two had a partial (≥ 50%) reduction in volume and nine had a minor (> 20%) reduction in size. The median follow-up period was 15 months (range 9–60 months). Six patients remained alive for 3 to 60 months. Conclusions. The imaging responses and the ability of these patients with intracranial gliomas to complete therapy without interruption or experiencing disease progression is encouraging. Excessive toxicity derived from combined FSRS and CEBRT treatment, as evaluated thus far in this study, was seen in patients with Group B and C lesions at the 7-Gy dose level. Evaluation of this novel treatment strategy with dose modification is ongoing.

Diode in Vivo Dosimetry for Patients Receiving External Beam Radiation Therapy

10.37206/88 ◽  
2005 ◽  
Author(s):  
Ellen Yorke ◽  
Rodica Alecu ◽  
Li Ding ◽  
Doracy Fontenla ◽  
Andre Kalend ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
External Beam Radiation Therapy ◽  
External Beam Radiation ◽  
In Vivo Dosimetry ◽  
External Beam ◽  
Beam Radiation
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