Reversible neurotoxicity following hyperfractionated radiation therapy of brain stem glioma

Journal Article · Tue Jan 01 00:00:00 EST 1991 · Medical and Pediatric Oncology; (United States)

DOI:https://doi.org/10.1002/mpo.2950190307· OSTI ID:5396865

Griebel, M; Friedman, H S; Halperin, E C; Wiener, M D; Marks, L; Oakes, W J; Hoffman, J M; DeLong, G R; Schold, S C; Hockenberger, B ^[1]

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1. Duke Univ. Medical Center, Durham, NC (USA)

Two patients with brain stem gliomas were treated with hyperfractionated radiation therapy (HFR) (7,020 and 7,560 cGy, respectively). Despite initial clinical improvement during irradiation, both patients demonstrated clinical deterioration approximately 3 weeks after completion of radiotherapy. Cranial magnetic resonance imaging (MRI) revealed a progressive increase in distribution of abnormal brain stem signal consistent with either tumor or edema. {sup 18}FDG positron emission tomography (PET) was obtained in one patient and demonstrated a hypermetabolic lesion at diagnosis and a hypometabolic lesion at the time of clinical deterioration postirradiation. Management with a tapering dose of dexamethasone alone resulted in marked clinical (both patients) and radiographic (one patient) improvement, allowing reduction or discontinuation of this medication. These results suggest that patients with brain stem tumors demonstrating clinical and radiographic evidence of progressive tumor shortly after completion of HFR should be initially managed conservatively with dexamethasone, since these findings may be manifestations of reversible radiation-related neurotoxicity.

• OSTI ID: 5396865
• Journal Information: Medical and Pediatric Oncology; (United States), Vol. 19:3; ISSN 0098-1532
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BRAIN
NEOPLASMS
GLIOMAS
COMBINED THERAPY
RADIOINDUCTION
RADIOTHERAPY
TOXICITY
DEXAMETHASONE
FLUORINE 18
FRACTIONATED IRRADIATION
NMR IMAGING
PATIENTS
POSITRON COMPUTED TOMOGRAPHY
POST-IRRADIATION EXAMINATION
RADIATION DOSES
ADRENAL HORMONES
BETA DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
BODY
CENTRAL NERVOUS SYSTEM
COMPUTERIZED TOMOGRAPHY
CORTICOSTEROIDS
DIAGNOSTIC TECHNIQUES
DISEASES
DOSES
EMISSION COMPUTED TOMOGRAPHY
FLUORINE ISOTOPES
GLUCOCORTICOIDS
HORMONES
HOURS LIVING RADIOISOTOPES
HYDROXY COMPOUNDS
IRRADIATION
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
KETONES
LIGHT NUCLEI
MEDICINE
NANOSEC LIVING RADIOISOTOPES
NERVOUS SYSTEM
NUCLEAR MEDICINE
NUCLEI
ODD-ODD NUCLEI
ORGANIC COMPOUNDS
ORGANS
PREGNANES
RADIOISOTOPES
RADIOLOGY
STEROIDS
THERAPY
TOMOGRAPHY
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