Cerebral radionecrosis: incidence and risk in relation to dose, time, fractionation and volume

Journal Article · Sun Feb 01 04:00:00 EST 1981 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(81)90443-0· OSTI ID:6792776

Marks, J E; Baglan, R J; Prassad, S C; Blank, W F

The authors irradiated 152 patients with primary brain and pituitary tumors from 1974 to 1976. Seven of 139 patients (5%) who received 4500 rad or grater using 180 to 200 rad fractions, developed pathologically documented cerebral radioecrosis within a median time of 14 months after completion of irradiation. The necrosis was documented by autopsy in four patients, at reoperation in two and after needle biopsy in one. It was located in the brain, distant from the original tumor in three patients, adjacent to tumor in two, and within the tumor bed in two. The latter two were classified as radionecrosis because one patient died with only minimal tumor remaining and the other patient deteriorated neurologically and stabilized after removal of the necrotic mass. On clinical grounds, we suspect that two additional patients had radiation damage to the brain, because they deteriorated neurologically without neuroradiologic evidence of tumor. Study of computerized tomography (CT) scans and superimposed dose distributions showed that necrosis was not always within the zone of highest dose (3 patients). Risk of radionecrosis was greatest in the upper regions of dose but could not be associated with shorter time, larger fractions, or larger field size. Pathologically documented radionecrosis of brain did not develop below doses that were biologically equivalent to 5400 rad in 30 fractions over 42 days.

• Research Organization: Washington Univ. School of Medicine, St. Louis, MO
• OSTI ID: 6792776
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 7:2; ISSN IOBPD
• Country of Publication: United States
• Language: English

Related Subjects

560151* -- Radiation Effects on Animals-- Man
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BRAIN
CENTRAL NERVOUS SYSTEM
COMPUTERIZED TOMOGRAPHY
DATA
DATA COMPILATION
DIAGNOSTIC TECHNIQUES
DISEASES
DOSE-RESPONSE RELATIONSHIPS
ENDOCRINE DISEASES
ENDOCRINE GLANDS
EXPERIMENTAL DATA
FRACTIONATED IRRADIATION
GLANDS
INFORMATION
IRRADIATION
MEDICINE
MORTALITY
NECROSIS
NEOPLASMS
NERVOUS SYSTEM
NERVOUS SYSTEM DISEASES
NUCLEAR MEDICINE
NUMERICAL DATA
ORGANS
PATHOLOGICAL CHANGES
PATIENTS
PITUITARY GLAND
RADIATION EFFECTS
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
THERAPY
TIME DEPENDENCE
TOMOGRAPHY