Radiation-induced bilateral cystic temporal lobe necrosis: reversal of memory deficit after fenestration and internal shunting

1990 ◽  
Vol 72 (3) ◽  
pp. 503-505 ◽  
Author(s):  
Joshua B. Bederson ◽  
Griffith R. Harsh ◽  
John A. Walker ◽  
Charles B. Wilson
Keyword(s):  
Temporal Lobe ◽  
Neuropsychological Testing ◽  
Memory Deficit ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Content Type ◽  
Temporal Lobe Necrosis ◽  
Radiation Induced ◽  
Fine Print

✓ The authors report a case in which bilateral cystic temporal lobe necrosis developed after treatment of nasopharyngeal lymphoepithelioma with 7000 cGy of external beam radiation. The patient presented with an isolated memory deficit that was documented by neuropsychological testing. After fenestration and internal shunting of both cysts, there was striking resolution of the lesions and of the memory deficit.

Glioblastoma multiforme occurring in a patient treated with gamma knife surgery

2001 ◽  
Vol 94 (5) ◽  
pp. 816-821 ◽  
Author(s):  
Abdalla Shamisa ◽  
Manohar Bance ◽  
Sukriti Nag ◽  
Charles Tator ◽  
Shun Wong ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Stereotactic Radiosurgery ◽  
Gamma Knife ◽  
Temporal Lobe ◽  
Gamma Knife Surgery ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Content Type ◽  
Radiation Induced ◽  
Fine Print

✓ Stereotactic radiosurgery is being increasingly advocated as the primary modality for treatment of vestibular schwannomas (VS). This modality has been shown to arrest tumor growth, with few associated short-term morbidities, and with possibly better hearing and facial nerve preservation rates than microsurgery. Radiation-induced oncogenesis has long been recognized, although stereotactic radiosurgery de novo induction of a secondary tumor has never been clearly described. The authors report on a patient with a VS who did not have neurofibromatosis Type 2 and who underwent gamma knife surgery (GKS). This patient required microsurgical removal of the VS within 8 months because of development of a tumor cyst with associated brainstem compression and progressive hydrocephalus. The operation resulted in clinical stabilization and freedom from tumor recurrence. Seven and a half years after undergoing GKS, the patient presented with symptoms of raised intracranial pressure. Magnetic resonance imaging demonstrated a new ring-enhancing lesion in the inferior temporal lobe adjacent to the area of radiosurgery, which on craniotomy was confirmed to be a glioblastoma multiforme (GBM). Despite additional conventional external-beam radiation to the temporal lobe, the GBM has progressed. Whereas this first reported case of a GBM within the scatter field of GKS does not conclusively prove a direct causal link, it does fulfill all of Cahan's criteria for radiation-induced neoplasia, and demands increased vigilance for the potential long-term complications of stereotactic radiosurgery, and reporting of any similar cases.

Radiotherapy in the treatment of benign meningioma of the skull base

1999 ◽  
Vol 90 (5) ◽  
pp. 823-827 ◽  
Author(s):  
Christopher Nutting ◽  
Michael Brada ◽  
Lucy Brazil ◽  
Ahmen Sibtain ◽  
Frank Saran ◽  
...  
Keyword(s):  
Skull Base ◽  
Performance Status ◽  
External Beam Radiation ◽  
Tumor Control ◽  
External Beam ◽  
Beam Radiation ◽  
Content Type ◽  
Skull Base Meningioma ◽  
Fine Print

Object. This study was undertaken to assess the long-term efficacy and toxicity of conventional fractionated external-beam radiation in the treatment of benign skull base meningioma.Methods. This is a retrospective study of 82 patients with histologically verified benign skull base meningioma treated by surgery followed by fractionated external-beam radiation at the Royal Marsden Hospital between 1962 and 1992. The 5- and 10-year progression-free survival (PFS) rates were 92% and 83%, respectively, with the site of disease being the only independent prognostic factor for tumor control according to multivariate analysis. The 10-year PFS rate for patients with sphenoid ridge meningiomas was 69% compared with 90% for those with tumors in the parasellar region. The overall 10-year survival rate was 71%, with performance status and patient age found to be significant independent prognostic factors. Six patients had worsening vision, which was due to cataract in five cases and retinopathy in one. There were no recorded cases of cranial nerve neuropathy.Conclusions. The excellent long-term tumor control and length of survival with minimal toxicity associated with conventional external-beam radiation should serve as a baseline for evaluation of new treatment strategies such as radiosurgery and skull base surgery.

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.

Comprehensive Analysis of the Kinetics of Radiation-Induced Lymphocyte Loss in Patients Treated with External Beam Radiation Therapy

2019 ◽  
Vol 193 (1) ◽  
pp. 73 ◽  
Author(s):  
Susannah G. Ellsworth ◽  
Anirudh Yalamanchali ◽  
Hong Zhang ◽  
Stuart A. Grossman ◽  
Robert Hobbs ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
External Beam Radiation Therapy ◽  
Comprehensive Analysis ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Radiation Induced ◽  
Kinetics Of

Radiation-induced intracranial malignant gliomas

1989 ◽  
Vol 71 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Scott Shapiro ◽  
John Mealey ◽  
Carl Sartorius
Keyword(s):  
Central Nervous System ◽  
Radiation Necrosis ◽  
External Beam Radiotherapy ◽  
Malignant Gliomas ◽  
Interstitial Brachytherapy ◽  
External Beam ◽  
Glial Tumor ◽  
Content Type ◽  
Radiation Induced ◽  
Fine Print

✓ The authors present seven cases of malignant gliomas that occurred after radiation therapy administered for diseases different from the subsequent glial tumor. Included among these seven are three patients who were treated with interstitial brachytherapy. Previously reported cases of radiation-induced glioma are reviewed and analyzed for common characteristics. Children receiving central nervous system irradiation appear particularly susceptible to induction of malignant gliomas by radiation. Interstitial brachytherapy may be used successfully instead of external beam radiotherapy in previously irradiated, tumor-free brain, and thus may reduce the risk of radiation necrosis.

Malignant astrocytomas: focal tumor recurrence after focal external beam radiation therapy

1991 ◽  
Vol 75 (4) ◽  
pp. 559-563 ◽  
Author(s):  
Bertrand C. Liang ◽  
Allan F. Thornton ◽  
Howard M. Sandler ◽  
Harry S. Greenberg
Keyword(s):  
Radiation Therapy ◽  
Tumor Recurrence ◽  
Treatment Protocol ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Content Type ◽  
Whole Brain Radiation ◽  
Malignant Astrocytomas ◽  
Brain Radiation ◽  
Fine Print

✓ Hochberg and Pruitt have reported glioblastomas recurring within 2 cm of the primary site in 90% of patients after whole-brain radiation therapy. They suggested that computerized tomography (CT) scan accuracy would permit smaller radiation fields. A treatment protocol with smaller-field focal brain irradiation following surgical resection is reported. The first 4500 cGy of radiation is focused to within a 3-cm margin around the tumor, with a 1500-cGy boost within a 1.5-cm margin. Forty-two patients with grade III or IV astrocytoma, treated with focal brain radiation therapy were reviewed retrospectively to assess patterns of tumor recurrence. Thirty patients received intra-arterial bromodeoxyuridine (BUdR) radiosensitization with focal brain radiation therapy, and 12 patients underwent conventional focal brain radiation therapy. Tumor margin was defined on preoperative and recurrence CT scans as the contrast-enhanced area; these were traced on acetate templates and compared with each other and with the actual scans. In all 42 patients, the lesion recurred within a 2-cm margin of the original tumor. Four patients had two recurrent areas: the second area was within the 2-cm margin in two, and outside this margin in two. These results are similar to those of Hochberg and Pruitt. It is suggested that focal irradiation is now the optimal treatment for malignant astrocytoma. Since recurrences continue to be within the irradiated volumes, it appears that higher focal doses of radiation are appropriate for clinical treatment trials of malignant astrocytomas.

scholarly journals COMPLICATIONS OF NEOADYAVANT THERAPY FOR CANCER OF THE HEAD OF THE PANCREAS

2019 ◽  
Vol 18 (3) ◽  
pp. 20-25
Author(s):  
R. I. Rasulov ◽  
M. V. Zemko ◽  
A. V. Shelekhov ◽  
K. G. Zubrinckiy ◽  
G. I. Songolov
Keyword(s):  
Radiation Therapy ◽  
Pancreatic Head ◽  
External Beam Radiation Therapy ◽  
Gastroduodenal Artery ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Pancreatic Head Cancer ◽  
Radiation Induced ◽  
Head Of The Pancreas

Aim: to study complications of preoperative chemoembolization of the gastroduodenal artery and external beam radiation therapy in patients with pancreatic head cancer.Material and Methods. Sixty patients underwent chemoembolization of the gastroduodenal artery and external beam radiation therapy. Femoral artery angiography was performed using the Seldinger’s technique. Lipiodol 5–7 ml and gemcitabine 400 mg/m2 were used for transarterial chemoembolization. Radiation therapy was given at a total dose of 50 Gy (2 Gy/fraction, 5 times a week, over 5 weeks) using AGAT -R apparatus.Results. Complications after chemoembolization of the gastroduodenal artery were observed in 18.3 % of patients: abdominal pain in 3.3 % of patients; pain and nausea in 3.3 %; pain, nausea and fever in 6.7 %; pain, nausea and increased blood amylase in 1.7 %; pain, nausea and fever, blood amylase in 1.7 %; nausea, fever and blood amylase in 1.7 %. Radiation-induced injuries were observed in 23.3 % of patients: erythema in 18.3 %, grade 1 leukopenia in 1.7% and grade 2 leukopenia in 3.3 %.Conclusion. Complications of neoadjuvant therapy in terms of frequency and severity were consistent with literature data, were manageable with conservative treatment, and did not increase the duration of the preoperative period.

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