Changes in myelin basic protein and demyelination in the rat brain within 3 months of single 2-, 10-, or 30-Gy whole-brain radiation treatments

2008 ◽  
Vol 109 (5) ◽  
pp. 881-888 ◽  
Author(s):  
Ye Tian ◽  
Zhige Shi ◽  
Shu Yang ◽  
Yingzhu Chen ◽  
Shiyao Bao
Keyword(s):  
Myelin Basic Protein ◽  
Brain Tissue ◽  
Basic Protein ◽  
Enzyme Linked Immunosorbent Assay ◽  
Whole Brain ◽  
Whole Brain Radiation ◽  
Injured Brain ◽  
Brain Radiation ◽  
The Brain ◽  
Myelin Staining

Object The aim of this study was to determine the relation between changes in myelin basic protein (MBP) levels during the acute and subacute phases of central nervous system injury following whole-brain radiation and delayed demyelination in the radiation-injured brain tissue. Methods Adult Sprague–Dawley rats were treated with single fractions of 2, 10, or 30 Gy of whole-brain radiation. The authors measured MBP gene expression and protein levels in the brain tissue by using reverse transcription–polymerase chain reaction and enzyme-linked immunosorbent assay at 1 week and 1–3 months following irradiation to monitor myelin changes in the brain. Demyelination was determined with Luxol fast blue myelin staining and routine histopathological and electron microscopy examination of injured brain tissue. The changes in MBP levels in the different animal groups at specific time points were correlated with demyelination in corresponding dose groups. Results At 1 month after applying the 10 and 30 Gy of radiation, MBP mRNA expression showed a transient but significant decrease, followed by recovery to baseline levels at 3 months after treatment. The MBP levels were decreased by only 70–75% at 1 month after 10 and 30 Gy of radiation. At 2–3 months after applying the higher dose of 30 Gy, however, the MBP levels continued to decline, and typical demyelination changes were observed with myelin staining and ultrastructural examination. Conclusions The authors' results suggest that the early radiation-induced MBP changes between 1 and 3 months after single treatments of 10 and 30 Gy of radiation to the whole brain are indicative of permanent injury shown as demyelination of irradiated brain tissue.

Evaluation of clinical markup with CT simulation in whole brain radiation therapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 2043-2043
Author(s):  
Y. Wang ◽  
N. Makhani ◽  
M. Tsao
Keyword(s):  
Radiation Therapy ◽  
Frontal Lobe ◽  
Posterior Fossa ◽  
Temporal Lobe ◽  
Whole Brain Radiation Therapy ◽  
Whole Brain ◽  
Whole Brain Radiation ◽  
Ct Simulation ◽  
Brain Radiation ◽  
The Brain

2043 Background: Two types of clinical markup have been used for whole brain radiation therapy (WBRT), but the extent of dose coverage and sparing of the lens is unknown. This study is designed to evaluate clinical markup with CT simulation. Methods: CT simulation images of the brain from 20 random adult patients were included in this study. Two types of inferior field borders were generated to mimic the 2 types of clinical markup of WBRT: from superior orbital ridge (SOR) to tragus, and from SOR to inferior tragal notch (ITN). A field margin of 1 cm from contoured brain (along base of skull) was used in CT simulation, except near the orbital globe where 0.5 cm margin to eye shielding was used. Two opposed lateral fields with 6 MV photon were used to generate 3 WBRT plans in each patient: clinical markup with SOR to tragus, SOR to ITN, and CT simulation. Dose volume histograms of the brain and lens were generated. The primary end point was dose coverage of whole brain with clinical markup. The secondary end point was sparing of the lens. Results: Patients with clinical markup using SOR to tragus or SOR to ITN had significantly larger median brain volume receiving less than 95% of the prescribed dose, 37.0 mL and 7.8 mL (respectively) compared to CT simulation 0 mL (P < 0.001). All patients with SOR to tragus and most patients (95%) with SOR to ITN clinical markup had underdosing in the regions of inferior frontal lobe, temporal lobe and posterior fossa. There was no significant difference in the dose to the lens between CT simulation and clinical markup using SOR to tragus (P = 0.18) or SOR to ITN (P = 0.90). Conclusions: Whole brain radiation therapy with clinical markup using either SOR to tragus or SOR to ITN results in underdosing at the inferior frontal lobe, temporal lobe and posterior fossa. Sparing of the lens is adequately achieved with clinical markup. No significant financial relationships to disclose.

Results of Whole Brain Radiation Therapy in Patients with Brain Metastases from Colorectal Carcinoma

2005 ◽  
Vol 91 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Maurizio Amichetti ◽  
Giancarlo Lay ◽  
Marina Dessì ◽  
Silvia Orrù ◽  
Roberta Farigu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Radiation Therapy ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Survival Time ◽  
Whole Brain Radiation Therapy ◽  
Whole Brain ◽  
Whole Brain Radiation ◽  
Brain Radiation ◽  
The Brain

Aims and background Carcinoma of the colon-rectum is an infrequent cause of brain metastases, constituting 1-5% of all metastatic lesions to the brain. We reviewed our experience in the treatment of brain metastases from colorectal cancer to define the efficacy of whole brain radiation therapy as a palliative measure in this setting of patients. Methods Twenty-three consecutive cases of brain metastasis from colorectal cancer treated between 1999 and 2004 were identified in the files of the Division of Radiotherapy of the A Businco Regional Oncological Hospital, Cagliari. Their records were reviewed for patient and tumor characteristics and categorized according to the RTOG RPA classes. Results Fifteen patients (65%) had multiple metastases. Twenty-one patients (91%) showed extracranial metastases. Fourteen patients were classified as RTOG RPA class II and 9 class III. The median radiation dose delivered was 2000 cGy in 5 fractions in one week (range, 20-36 Gy). In 14 of 20 assessable patients (70%), symptomatic improvement was observed. The median follow-up and survival time for all the patients, 12 females and 11 males, was 3 months. In 3 patients only the cause of death was the brain metastasis. Conclusions Despite the disappointing survival time, external radiation therapy to the whole brain proved to be an efficacious palliative treatment for patients with multiple or inoperable brain metastasis from colorectal cancer.

Gamma knife treatment for multiple metastatic brain tumors compared with whole-brain radiation therapy

2000 ◽  
Vol 93 (supplement_3) ◽  
pp. 32-36 ◽  
Author(s):  
Toru Serizawa ◽  
Toshihiko Iuchi ◽  
Junichi Ono ◽  
Naokatsu Saeki ◽  
Katsunobu Osato ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Cerebral Metastases ◽  
Whole Brain Radiation Therapy ◽  
Whole Brain ◽  
Content Type ◽  
Whole Brain Radiation ◽  
Brain Radiation ◽  
Fine Print

Object. The purpose of this retrospective study was to compare the effectiveness of gamma knife radiosurgery (GKS) for multiple cerebral metastases with that of whole-brain radiation therapy (WBRT). Methods. Ninety-six consecutive patients with cerebral metastases from nonsmall cell lung cancer were treated between 1990 and 1999. The entry criteria were the presence of between one and 10 multiple brain lesions at initial diagnosis, no surgically inaccessible tumors with more than a 30-mm diameter, no carcinomatous meningitis, and more than 2 months of life expectancy. The patients were divided into two groups: the GKS group (62 patients) and the WBRT group (34 patients). In the GKS group, large lesions (> 30 mm) were removed surgically and all other small lesions (≤ 30 mm) were treated by GKS. New distant lesions were treated by repeated GKS without prophylactic WBRT. In the WBRT group, the patients were treated by the traditional combined therapy of WBRT and surgery. In both groups, chemotherapy was administered according to the primary physician's protocol. The two groups did not differ in terms of age, sex, initial Karnofsky Performance Scale (KPS) score, type, lesion number, and size of lesion, systemic control, and chemotherapy. Neurological survival and qualitative survival of the GKS group were longer than those of the WBRT group. In multivariate analysis, significant poor prognostic factors were systemically uncontrolled patients, WBRT group, and poor initial KPS score. Conclusions. Gamma knife radiosurgery without prophylactic WBRT could be a primary choice of treatment for patients with as many as 10 cerebral metastases from nonsmall cell cancer.

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