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Brain Irradiation

Irradiation of whole Brain


Presentation

  • A hypothalamic metastasis was demonstrated by computed tomography in a 71-year-old patient, with previously unknown small cell lung cancer, who presented with diabetes insipidus and biological signs of hypothyroidism and hypogonadism.[ncbi.nlm.nih.gov]
  • Presented at: 17th World Lung Cancer Conference, the Annual Meeting of the International Association for the Study of Lung Cancer (IASLC), Vienna.[targetedonc.com]
High Fever
  • Over the next few days, high fever and refractory seizures developed and the patient was diagnosed with Herpes simplex-associated encephalitis after detection of viral DNA in the cerebrospinal fluid via polymerase chain reaction.[ncbi.nlm.nih.gov]
Chills
  • Likely • Scalp redness or soreness • Hair loss • Dry mouth or altered taste • Fatigue, sleepiness • Muffled hearing (temporary) Less Likely • Fever, chills, heavy sweating • Upset stomach, nausea and/or vomiting • Loss of appetite, taste changes • Headaches[aboutcancer.com]
Noncompliance
  • The finding teetered on the edge of statistical significance ( P .059), however, because only one-third of patients (32%) completed the 24 weeks of drug therapy, due to death (survival was poorer than expected), disease progression, or noncompliance,[mdedge.com]
Productive Cough
  • She returned 2 months later due to right pneumonia with fever and productive cough. Surprisingly, her left lung mass had markedly regressed even though she had not received any additional systemic anticancer therapy.[ncbi.nlm.nih.gov]
Aspiration
  • […] eligibility information Ages Eligible for Study: up to 120 Years (Child, Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No DISEASE CHARACTERISTICS: Histologically or cytologically confirmed small cell lung cancer by fine needle aspiration[clinicaltrials.gov]
Liver Dysfunction
  • Backward stepwise regression analysis was used to evaluate the relationship between signal intensity grades and the following clinical factors: sex, age, the interaction between age and sex, hypertension, dyslipidemia, diabetes mellitus, liver dysfunction[ncbi.nlm.nih.gov]
Alopecia
  • Symptoms and signs include 4 : fatigue nausea and vomiting loss of appetite cerebral edema Radiation-induced alopecia and dermatitis are also sometimes encountered 4 .[radiopaedia.org]
  • Although this does not prevent transient alopecia in most of the treated patients, it may be of benefit for those with a priori risk factor for increased alopecia (e.g., previous or concomitant chemotherapy).[tlcr.amegroups.com]
  • Adverse effects of brain irradiation include fatigue, nausea, cognitive decline, ataxia and alopecia. These side effects may be mild and transient, but can also be progressive and even persistent with structural brain damage on MRI scanning.[jcmtjournal.com]
Neglect
  • The results might be biased by the neglected patients with asymptomatic BM before enrollment and after treatment. In our study, only 38.9% patients were diagnosed BM with symptoms, the other 60.1% were revealed asymptomatic BM by cranial imaging.[nature.com]
Nystagmus
  • Seesaw Nystagmus Following Whole Brain Irradiation and Intrathecal Methotrexate Page Metadata Title Seesaw Nystagmus Following Whole Brain Irradiation and Intrathecal Methotrexate Creator Epstein, JA; Moster, ML; Spiritos, M Affiliation Department of[collections.lib.utah.edu]
Polyuria
  • Brain irradiation resulted in resolution of polyuria, elevation of thyroid hormones, improvement of pituitary responsiveness to hypothalamic releasing hormones, and complete disappearance of contrast-enhanced suprasellar metastasis.[ncbi.nlm.nih.gov]

Workup

Dyslipidemia
  • Backward stepwise regression analysis was used to evaluate the relationship between signal intensity grades and the following clinical factors: sex, age, the interaction between age and sex, hypertension, dyslipidemia, diabetes mellitus, liver dysfunction[ncbi.nlm.nih.gov]

Treatment

  • The tentative conclusion is that single-session whole-brain irradiation affords a possibility of palliative treatment of brain metastases.[ncbi.nlm.nih.gov]

Prognosis

  • On multivariate analysis, good prognosis was associated with non-TN status, lower graded prognosis assessment class, and nonexistence of active extracranial metastases.[ncbi.nlm.nih.gov]
  • Although a radical local treatment of BM may be possible with radiosurgery or resection, the prognosis often remains poor. In order to improve QoL as well as OS, there is an unmet need to prevent the occurrence of BM ( 4 ).[frontiersin.org]

Etiology

  • ; Optic Chiasm/drug effects/radiation effects; Optic Nerve/drug effects/radiation effects; Radiation Injuries/etiology; Visual Fields Abstract A patient developed pendular seesaw nystagmus after receiving radiation and intrathecal methotrexate treatment[collections.lib.utah.edu]
  • The integrity of the h-p axis and GH neuroregulation is fundamentally preserved in irradiated GH-deficient patients with a GH secretory pattern similar to that observed in normal subjects and those with GH deficiency due to other etiologies.[ncbi.nlm.nih.gov]
  • The etiology of T2D involves genetic predisposition, life-style and environmental factors, all of them interacting in a complex and yet poorly understood manner.[helmholtz-muenchen.de]
  • Complications from irradiation are various and differ in their etiology and time at which they become apparent. They can best be divided according to when they occur into acute, early-delayed and late 4 .[radiopaedia.org]
  • The likely etiology is a combination of tumor response and peritumoral edema or demyelination; corresponding imaging changes can include focally increased enhancement as a result of blood-brain barrier disruption.[aboutcancer.com]

Epidemiology

  • Brain metastases: Epidemiology and pathophysiology. J Neurooncol. 2005; 75 :5–14. [ PubMed ] [ Google Scholar ] 32. Ghia A, Tome WA, Thomas S, Cannon G, Khuntia D, Kuo JS, et al.[ncbi.nlm.nih.gov]
  • Declarations Acknowledgements The authors acknowledge the important input of Sanne Schagen, Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.[jcmtjournal.com]
  • Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the Surveillance, Epidemiologic, and End Results database. J Clin Oncol 2006 ;24: 4539 - 4544 2. Seute T, Leffers P, ten Velde GPM, Twijnstra A.[nejm.org]
Sex distribution
Age distribution

Pathophysiology

  • Dynamic perfusion tomography provides insight into the pathophysiological processes taking place and allows correlation with patient symptomatology.[ncbi.nlm.nih.gov]
  • Very little is known in regard to the evolution of radiation induced pathophysiology in the context of peripherally derived macrophage accumulation or inflammation, and how this relates to altered synaptic and cognitive function.[grantome.com]
  • Small SA, Schobel SA, Buxton RB et al (2011) A pathophysiological framework of hippocampal dysfunction in ageing and disease. Nat Rev Neurosci 12:585–601 CrossRef PubMedCentral PubMed Google Scholar 18.[link.springer.com]
  • The pathophysiology and neurobiology of this disease entity are not yet completely understood by the medical and scientific community. Delayed symptom onset was found to be a strong risk factor for the development of PCS in this study population.[surgicalneurologyint.com]
  • Pathophysiology of Radiation-induced Injury The events leading to radiation-induced injury are the result of a complex, dynamic interplay between the various cells within the irradiated volume (tumoral, endothelial and glial cells). 6 Endothelial Cell[touchneurology.com]

Prevention

  • A recent study demonstrated that treatment with the angiotensin II type 1 receptor antagonist (AT(1)RA) L-158,809 before, during and after fractionated whole-brain irradiation prevents or ameliorates radiation-induced cognitive deficits in adult rats.[ncbi.nlm.nih.gov]
  • In order to improve QoL as well as OS, there is an unmet need to prevent the occurrence of BM ( 4 ).[frontiersin.org]
  • Aim 3 : Determine if temporary depletion of myeloid cells prevent the loss of synaptic function and cognition after single and hypofractionated doses of radiation.[grantome.com]
  • Emphasis is also given to early detection, screening, prevention, and new imaging techniques.[books.google.de]
  • Keywords Adult — Aged — Antineoplastic Combined Chemotherapy Protocols/therapeutic use — Brain Neoplasms/*prevention & control/radiotherapy/*secondary — Combined Modality Therapy — Female — Humans — Kaplan-Meier Estimate — Lung Neoplasms/drug therapy[archive-ouverte.unige.ch]

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