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Radiation necrosis

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https://www.readbyqxmd.com/read/28817446/bevacizumab-as-an-effective-treatment-for-radiation-necrosis-after-radiotherapy-for-melanoma-brain-metastases
#1
Isabella C Glitza, Nandita Guha-Thakurta, Neil M D'Souza, Rodabe N Amaria, Susan L McGovern, Ganesh Rao, Jing Li
Radiation necrosis (RN) is a potential late complication of radiotherapy for intracranial malignancy, which is often associated with significant neurological morbidity. Prolonged treatment with high-dose corticosteroids or surgical resection has been the standard care for RN, but protracted steroid use can lead to significant side effects and surgical resection is not always feasible. The antivascular endothelial growth factor monoclonal antibody bevacizumab induces clinical and radiographic improvements in RN, with overall good tolerance...
August 16, 2017: Melanoma Research
https://www.readbyqxmd.com/read/28816142/vorinostat-and-concurrent-stereotactic-radiosurgery-for-non-small-cell-lung-cancer-brain-metastases-a-phase-1-dose-escalation-trial
#2
Clara Y H Choi, Heather A Wakelee, Joel W Neal, Mary C Pinder-Schenck, Hsiang-Hsuan Michael Yu, Steven D Chang, John R Adler, Leslie A Modlin, Griffith R Harsh, Scott G Soltys
PURPOSE: To determine the maximum tolerated dose (MTD) of vorinostat, a histone deacetylase inhibitor, given concurrently with stereotactic radiosurgery (SRS) to treat non-small cell lung cancer (NSCLC) brain metastases. Secondary objectives were to determine toxicity, local failure, distant intracranial failure, and overall survival rates. MATERIALS AND METHODS: In this multicenter study, patients with 1 to 4 NSCLC brain metastases, each ≤2 cm, were enrolled in a phase 1, 3 + 3 dose escalation trial...
September 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28810878/classification-of-chronic-radiation-induced-ulcers-in-the-chest-wall-after-surgery-in-breast-cancers
#3
Xiao Ma, Zengqiang Jin, Guojun Li, Wenfeng Yang
BACKGROUND AND PURPOSE: To explore the methods of clinical classification in chronic radiation-induced ulcers in the chest wall (CRUCWs). MATERIALS AND METHODS: A total of 64 patients with CRUCWs were treated. We divided the cases into 3 types (mild, moderate, or severe) according to their clinical manifestations. Conservative treatments, axial-pattern myocutaneous or local flaps, or filleted flaps were applied correspondingly. RESULTS: The cases were divided as follows: mild (n = 11), moderate (n = 45), and severe (n = 8)...
August 15, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28801512/unresectable-squamous-cell-carcinoma-of-upper-trachea-with-long-term-survival-after-concurrent-chemoradiotherapy
#4
Prahlad H Yathiraj, Sandeep Ail, Anshul Singh, Vidyasagar Mamidipudi
Upper tracheal malignancies are rare, and long-term survival is even rarer, especially among the unresectable malignancies. A 66-year-old chronic smoker was diagnosed as a locally advanced, non-metastatic squamous cell carcinoma of the upper trachea. Being unresectable, he was treated with six cycles of concurrent weekly cisplatin and three-dimensional conformal radiotherapy to a dose of 60 Gy in 30 fractions over 6 weeks. Follow-up imaging at 6 and 12 months revealed no disease. Our patient is presently 36 months post-treatment and is disease free without tracheal necrosis, fistula or radiation pneumonitis but developed hypothyroidism and is presently euthyroid...
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28799876/melanoma-brain-metastasis-the-impact-of-stereotactic-radiosurgery-braf-mutational-status-and-targeted-and-or-immune-based-therapies-on-treatment-outcome
#5
Rupesh Kotecha, Jacob A Miller, Vyshak A Venur, Alireza M Mohammadi, Samuel T Chao, John H Suh, Gene H Barnett, Erin S Murphy, Pauline Funchain, Jennifer S Yu, Michael A Vogelbaum, Lilyana Angelov, Manmeet S Ahluwalia
OBJECTIVE The goal of this study was to investigate the impact of stereotactic radiosurgery (SRS), BRAF status, and targeted and immune-based therapies on the recurrence patterns and factors associated with overall survival (OS) among patients with melanoma brain metastasis (MBM). METHODS A total of 366 patients were treated for 1336 MBMs; a lesion-based analysis was performed on 793 SRS lesions. The BRAF status was available for 78 patients: 35 had BRAF (mut) and 43 had BRAF wild-type ( BRAF-WT) lesions. The Kaplan-Meier method evaluated unadjusted OS; cumulative incidence analysis determined the incidences of local failure (LF), distant failure, and radiation necrosis (RN), with death as a competing risk...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28783888/attenuation-of-collagen-induced-arthritis-by-hyperbaric-oxygen-therapy-through-altering-immune-balance-in-favor-of-regulatory-t-cells
#6
Byung-In Moon, Hyung-Ran Kim, Eun-Jeong Choi, Jeong-Hae Kie, Ju-Young Seoh
Hyperbaric oxygen (HBO₂) therapy is currently used for the treatment of chronic wounds, radiation-induced soft tissue necrosis, several oxygen-deficiency conditions and decompression sickness. In addition to the current indications, much empirical and experimental data suggest that HBO₂ therapy may benefit autoimmune diseases by suppressing immunity, but the underlying mechanism is not well understood. Therefore, in the present study, we investigated whether HBO₂ prevents the development of collagen-induced arthritis (CIA) in association with alteration of the immune balance between pro-inflammatory Th17 and anti-inflammatory regulatory T cells (Tregs)...
July 2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/28776956/first-follow-up-radiographic-response-is-one-of-the-predictors-of-local-tumor-progression-and-radiation-necrosis-after-stereotactic-radiosurgery-for-brain-metastases
#7
Mayur Sharma, Xuefei Jia, Manmeet Ahluwalia, Gene H Barnett, Michael A Vogelbaum, Samuel T Chao, John H Suh, Erin S Murphy, Jennifer S Yu, Lilyana Angelov, Alireza M Mohammadi
Local progression (LP) and radiation necrosis (RN) occur in >20% of cases following stereotactic radiosurgery (SRS) for brain metastases (BM). Expected outcomes following SRS for BM include tumor control/shrinkage, local progression and radiation necrosis. 1427 patients with 4283 BM lesions were treated using SRS at Cleveland Clinic from 2000 to 2012. Clinical, imaging and radiosurgery data were collected from the database. Local tumor progression and RN were the primary end points and correlated with patient and tumor-related variables...
August 4, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28770500/loss-of-pericytes-in-radiation-necrosis-after-glioblastoma-treatments
#8
Soon-Tae Lee, Youngbeom Seo, Ji-Yeon Bae, Kon Chu, Jin Wook Kim, Seung Hong Choi, Tae Min Kim, Il Han Kim, Sung-Hye Park, Chul-Kee Park
Radiation necrosis (RN) in brain tumor patients is often symptomatic, persistent without immediate resolution, and confused with tumor recurrence. Cerebral vascular pericytes are essential for endothelial function, vascular integrity, and angiogenesis. In this study, we showed that the loss of pericytes is involved in the pathogenesis of RN. From a brain tumor tissue repository, we identified three patients since 2011 with pathologically confirmed RN after the standard treatment for glioblastoma (GBM). The RN and their preradiation GBM tissues were serially processed for Western blotting using cell-type-specific antibodies against endothelial (CD31, active RhoA), pericyte [platelet-derived growth factor receptor-beta (PDGFR-β)], alpha-smooth muscle actin (α-SMA), astrocyte (GFAP), myelin sheath protein (MBP), and microglial markers (Iba1)...
August 2, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28767176/sequential-chimeric-medial-femoral-condyle-and-anterolateral-thigh-flow-through-flaps-for-one-stage-reconstructions-of-composite-bone-and-soft-tissue-defects-report-of-three-cases
#9
Dominic Henn, Mohamed H Abouarab, Christoph Hirche, Jochen F Hernekamp, Volker J Schmidt, Ulrich Kneser, Thomas Kremer
Small recalcitrant non-unions with poor perfusion require reconstruction with vascularized bone flaps. Cases with concomitant large soft tissue defects are especially challenging, since vascularized soft tissue transfer is often indicated and distant microvascular anastomoses may be required. We introduce a sequential chimeric free flap composed of a medial femoral condyle corticoperiosteal flap anastomosed to an anterolateral thigh flow-through flap (MFC-ALT flap) and report its use for reconstruction of small non-unions with concomitant large soft tissue defects in three exemplary patients...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28761508/sphenoid-wing-en-plaque-meningioma-development-following-craniopharyngioma-surgery-and-radiotherapy-radiation-induced-after-three-decades
#10
REVIEW
Amol Raheja, Guru Dutta Satyarthee
Radiation therapy is widely used as adjuvant or primary treatment modality of neoplastic lesions. Radiation therapy may cause an acute adverse effect such as brain edema, radiation necrosis, or delayed, for example, panhypopituitarism, vasculitis, and rare de-novo neoplasm development. However, radiation-induced meningioma (RIM) occurrence is extremely rare. A detailed PubMed and Medline search yielded only three isolated Case-reports of RIM development in craniopharyngioma cases receiving radiotherapy after surgery...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28761389/concurrent-imatinib-and-radiation-therapy-for-unresectable-and-symptomatic-desmoid-tumors
#11
Everett J Moding, Lynn Million, Raffi Avedian, Pejman Ghanouni, Christian Kunder, Kristen N Ganjoo
Desmoid tumors are locally aggressive fibroproliferative neoplasms that can lead to pain and dysfunction due to compression of nerves and surrounding structures. Desmoid tumors often progress through medical therapy, and there is frequently a delay of multiple months before radiation can provide symptomatic relief. To achieve more rapid symptomatic relief and tumor regression for unresectable desmoid tumors causing significant morbidity such as brachial plexus impingement with loss of extremity function, we have selectively utilized a combination of imatinib and radiation therapy...
2017: Sarcoma
https://www.readbyqxmd.com/read/28755324/volumetric-quantification-of-glioblastoma-experiences-with-different-measurement-techniques-and-impact-on-survival
#12
Christian Henker, Thomas Kriesen, Änne Glass, Björn Schneider, Jürgen Piek
The potential impact of different radiological features of glioblastoma multiforme (GBM) on overall survival (OS) like tumor volume, peritumoral edema (PTE), necrosis volume, necrosis-tumor ratio (NTR) and edema-tumor ratio (ETR) is still very controversial. To determine the influence of volumetric data on OS und to compare different measuring techniques described in literature. We prospectively evaluated preoperative MR images from 30 patients harboring a primary supratentorial GBM. All patients received gross-total tumor resection followed by standard radiation and chemotherapy (temozolomide)...
July 28, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28755281/radiation-induced-focal-cortical-necrosis-of-the-femur-presenting-as-a-lytic-lesion
#13
Hakan Ilaslan, Jean Schils, Michael Joyce, Chirag Shah, Yaxia Zhang
Management of soft tissue sarcomas is often complicated, requiring radiation before and in some cases after limb-sparing surgery. Radiation necrosis is a severe complication after radiation treatment and is typically dose related and involves medullary bone. We report on two cases of hitherto unreported focal circumscribed intra-cortical lytic lesions within the radiation portal, which appeared 19 months and 31 months, respectively, after the conclusion of radiation treatment. Both patients had a history of soft tissue sarcoma treated with radiation (66 Gy) and surgical resection...
July 28, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28754639/bevacizumab-for-radiation-associated-visual-decline-among-aggressive-residual-recurrent-suprasellar-tumors-more-than-a-mere-anti-neoplastic-effect
#14
Pinaki Dutta, Sivashanmugam Dhandapani, Narendra Kumar, Prakamya Gupta, Chirag Ahuja, K K Mukherjee
BACKGROUND: Angiogenesis and vascular endothelial growth factor (VEGF) are recently being implicated in animal and clinical models of radiation-induced optic nerve-retinal and brain necrosis. Though there are isolated case reports of anti-VEGF therapy (Bevacizumab) as a treatment modality in the management of radiation induced brain necrosis, there is paucity of data defining its role in radiation induced optic nerve damage. PATIENTS AND METHOD: patients with sellar suprasellar tumor who received intensity modulated or Gamma Knife radiotherapy and developed radiation induced optic neuritis refractory to three weeks of glucocorticoid therapy who were given bevacizumab 5mg/Kg intra venously as initial dose followed by 10mg/Kg subsequent doses...
July 25, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28754339/interleukin-1-receptor-knockout-mice-develop-epidermal-cysts-and-show-an-altered-innate-immune-response-following-exposure-to-ultraviolet-b-radiation
#15
Nikhil N Kulkarni, Christopher A Adase, Ling-Juan Zhang, Andrew W Borkowski, Fengwu Li, James A Sanford, Daniel J Coleman, Carlos Aguilera, Arup K Indra, Richard L Gallo
In this study, we observed that mice lacking the interleukin 1 receptor (IL1r(-/-)), or deficient in interleukin 1-beta (IL1-β), developed multiple epidermal cysts after chronic ultraviolet B (UVB) exposure. Cysts that developed in IL1r(-/-) mice were characterized by the presence of the hair follicle marker Sox 9, keratins (K10 and K14) and normal melanocyte distribution and retinoid X receptor α (RXR α) expression. The increased incidence of cysts in IL1r(-/-) mice was associated with less skin inflammation as characterized by decreased recruitment of macrophages, and their skin also maintained epidermal barrier function compared to wild-type mice...
July 25, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28749838/bevacizumab-for-the-treatment-of-gammaknife-radiosurgery-induced-brain-radiation-necrosis
#16
Yifang Ma, Chutian Zheng, Yiping Feng, Qingsheng Xu
BACKGROUND: Radiation necrosis is one of the complications of Gammaknife radiosurgery. The traditional treatment of radiation necrosis carries a high risk of failure, Bevacizumab is an antiangiogenic monoclonal antibody against vascular endothelial growth factor, a known mediator of cerebral edema. It can be used to successfully treat brain radiation necrosis. PATIENT DESCRIPTION: Two patients with a history of small cell lung cancer presented with metastatic disease to the brain...
July 26, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28740900/management-approach-for-recurrent-brain-metastases-following-upfront-radiosurgery-may-affect-risk-of-subsequent-radiation-necrosis
#17
Ali Rae, Daniel Gorovets, Paul Rava, Daniel Ebner, Deus Cielo, Timothy J Kinsella, Thomas A DiPetrillo, Jaroslaw T Hepel
PURPOSE: Many patients treated with stereotactic radiosurgery (SRS) alone as initial treatment require 1 or more subsequent salvage therapies. This study aimed to determine if commonly used salvage strategies are associated with differing risks of radiation necrosis (RN). METHODS AND MATERIALS: All patients treated with upfront SRS alone for brain metastases at our institution were retrospectively analyzed. Salvage treatment details were obtained for brain failures...
October 2016: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/28740764/multiple-free-flap-reconstructions-of-head-and-neck-defects-due-to-oral-cancer
#18
Yumi Mochizuki, Hiroyuki Harada, Hiroaki Shimamoto, Hirofumi Tomioka, Hideaki Hirai
OBJECTIVE: We studied complications following multiple free flap reconstructions in the head and neck. METHODS: In this cohort, 26 patients (14 men and 12 women) who underwent multiple microvascular free flap reconstructions were included in the study. The reasons for secondary reconstruction were recurrence of tumor (12 cases), necrosis of transferred skin and/or bone (6 cases), reconstruction plate fracture or exposure (4 cases), and others (4 cases). A third reconstruction in 4 cases and a fourth reconstruction in 1 case were performed...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28737579/prostate-specific-membrane-antigen-targeted-imaging-with-18f-dcfpyl-in-high-grade-gliomas
#19
Roberto Andres Salas Fragomeni, Joshua R Menke, Matthias Holdhoff, Clare Ferrigno, John Joseph Laterra, Lilja B Solnes, Mehrbod S Javadi, Zsolt Szabo, Martin G Pomper, Steven P Rowe
High-grade gliomas (World Health Organization grade III-IV) are highly lethal primary brain tumors. Imaging modalities, including MRI and FDG PET, provide a limited ability to differentiate treatment effects (such as radiation necrosis) from recurrent or residual tumor. As the first step in validating the applicability of prostate-specific membrane antigen (PSMA)-targeted imaging in high-grade gliomas, we evaluated the ability of the PSMA-targeted small molecule [F]DCFPyL (2-(3-(1carboxy-5-(6-[F]fluoro-pyridine-3-carbonyl)-amino]-pentyl)-ureido)-pentanedioic acid) to image high-grade gliomas in a series of 3 prospectively recruited patients...
July 22, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28735139/cumulative-intracranial-tumor-volume-and-number-of-brain-metastasis-as-predictors-of-developing-new-lesions-after-stereotactic-radiosurgery-for-brain-metastasis
#20
Mayur Sharma, Xuefei Jia, Manmeet Ahluwalia, Gene H Barnett, Michael A Vogelbaum, Samuel T Chao, John H Suh, Erin S Murphy, Jennifer S Yu, Lilyana Angelov, Alireza M Mohammadi
INTRODUCTION: The aim of our study was to identify risk factors associated with early distant radiographic progression in patients undergoing stereotactic radiosurgery (SRS) for brain metastases (BM). METHODS: Following IRB approval, data of 1427 patients (4283 BM lesions) who were treated using SRS at Cleveland Clinic from 2000-2012 were collected. Local tumor progression (LTP), distant tumor progression (DTP) and radiographic radiation necrosis (RN) were the primary end points...
July 19, 2017: World Neurosurgery
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