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Radionecrosis

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https://www.readbyqxmd.com/read/28408096/local-treatment-of-a-pharyngocutaneous-fistula-secondary-to-osteoradionecrosis
#1
Olga González-Antolín
Radionecrosis is a late, and difficult to treat,complication of radiotherapy performed on head and neck tumours, and it is difficult to treat. This process causes significant damage, not only in the skin, but also in muscular, nervous, vascular, and bone structures. This, in turn, leads to airway and digestive tract involvement, as well as a functional loss and a cosmetic defect that usually requires reconstructive surgery. Therefore, this process is associated with a significant loss in the quality of life of patients and involves a long hospital stay for treatment, as well as the necessary support measures...
April 10, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28382534/pseudoprogression-radionecrosis-inflammation-or-true-tumor-progression-challenges-associated-with-glioblastoma-response-assessment-in-an-evolving-therapeutic-landscape
#2
REVIEW
Benjamin M Ellingson, Caroline Chung, Whitney B Pope, Jerrold L Boxerman, Timothy J Kaufmann
The wide variety of treatment options that exist for glioblastoma, including surgery, ionizing radiation, anti-neoplastic chemotherapies, anti-angiogenic therapies, and active or passive immunotherapies, all may alter aspects of vascular permeability within the tumor and/or normal parenchyma. These alterations manifest as changes in the degree of contrast enhancement or T2-weighted signal hyperintensity on standard anatomic MRI scans, posing a potential challenge for accurate radiographic response assessment for identifying anti-tumor effects...
April 5, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28367275/radiosurgery-for-brainstem-metastases-with-and-without-whole-brain-radiotherapy-clinical-series-and-literature-review
#3
Louise Murray, Cynthia Menard, Gelareh Zadeh, Karolyn Au, Mark Bernstein, Barbara-Ann Millar, Normand Laperriere, Caroline Chung
OBJECTIVE: The objective of this study was to investigate outcomes for patients with brainstem metastases treated with stereotactic radiosurgery (SRS). METHODS: Patients with brainstem metastases treated with SRS between April 2006 and June 2012 were identified from a prospective database. Patient and treatment-related factors were recorded. Kaplan-Meier analysis was used to calculate survival and freedom from local and distant brain progression. Univariate and multivariate Cox regression was used to identify factors important for overall survival...
2017: Journal of Radiation Oncology
https://www.readbyqxmd.com/read/28334917/late-onset-cystic-brain-necrosis-after-radiotherapy-for-nasopharyngeal-carcinoma
#4
Wenli Fang, Beibei Gu, Xiuna Jing, Songhua Xiao, Shengnuo Fan, Wang Liao, Yuqiu Zheng, Jun Liu
Background: Cystic brain radionecrosis (CBRN) is a late-onset devastating complication after radiotherapy for head and neck neoplasms, especially for nasopharyngeal carcinoma (NPC). To our knowledge, it has scarcely been reported. Methods: We retrospectively reviewed all available medical records of NPC patients with CBRN who were treated with surgical intervention. Results: Sixteen patients were identified in this study and the mean latency of CBRN was 9...
February 24, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28290392/potential-for-differentiation-of-glioma-recurrence-from-radionecrosis-using-integrated-18-f-fluoroethyl-l-tyrosine-fet-positron-emission-tomography-magnetic-resonance-imaging-a-prospective-evaluation
#5
Shanti K Sogani, Amarnath Jena, Sangeeta Taneja, Aashish Gambhir, Anil K Mishra, Maria M D'Souza, Sapna M Verma, Puja P Hazari, Pradeep Negi, Ganesh K R Jadhav
PURPOSE: To assess the utility of 18F-fluoroethyl-L-tyrosine (FET) positron emission tomography/magnetic resonance imaging (PET/MRI) in distinguishing recurrence from radionecrosis. MATERIALS AND METHODS: Thirty-two patients (25 males, 7 females) of glioma who had already undergone surgery/chemoradiotherapy and had enhancing brain lesions suspicious of recurrence were evaluated using integrated 18F-FET PET/MRI, and followed up with histopathology or clinical follow-up and/or MRI/PET/MRI imaging...
March 2017: Neurology India
https://www.readbyqxmd.com/read/28270324/-imaging-methods-used-in-the-differential-diagnosis-between-brain-tumour-relapse-and-radiation-necrosis-after-stereotactic-radiosurgery-of-brain-metastases-literature-review
#6
REVIEW
I Menoux, J-P Armspach, G Noël, D Antoni
After stereotactic radiosurgery for a cerebral metastasis, one of the dreaded toxicities is radionecrosis. In the follow-up of these patients, it is impossible to distinguish radiation necrosis from tumour relapse either clinically or with MRI. In current practice, many imaging methods are designed such as special sequences of MRI (dynamic susceptibility contrast perfusion and susceptibility-weighted imaging, diffusion), proton magnetic resonance spectroscopy, positron emission tomography, or more seldom 201-thallium single-photon emission computerized tomography...
December 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28210908/updates-in-outcomes-of-stereotactic-radiation-therapy-in-acromegaly
#7
REVIEW
Monica Livia Gheorghiu
Purpose Treatment of acromegaly has undergone important progress in the last 20 years mainly due to the development of new medical options and advances in surgical techniques. Pituitary surgery is usually first-line therapy, and medical treatment is indicated for persistent disease, while radiation (RT) is often used as third-line therapy. The benefits of RT (tumor volume control and decreased hormonal secretion) are hampered by the long latency of the effect and the high risk of adverse effects. Stereotactic RT methods have been developed with the aim to provide more precise targeting of the tumor with better control of the radiation dose received by the adjacent brain structures...
February 2017: Pituitary
https://www.readbyqxmd.com/read/28149758/defining-the-endpoints-how-to-measure-the-efficacy-of-drugs-that-are-active-against-central-nervous-system-metastases
#8
REVIEW
Alessandra Fabi, Antonello Vidiri
Brain metastases (BMs) are the most common cause of malignant central nervous system (CNS) tumors in adults. In the recent past, patients with BMs were excluded from clinical trials, but now, with the advent of new biological and immunological drugs, their inclusion is more common. In the last era response and progression criteria used across clinical trials have defined the importance to consider not only measurement changes of brain lesions but also the modification of parameters related to the metastases such as metabolism of tissue and its pathological features...
December 2016: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28093345/stereotactic-radiosurgery-for-melanoma-brain-metastases-a-comprehensive-clinical-case-series
#9
Rui Feng, Eric K Oermann, Raj Shrivastava, Ariel Gold, Brian T Collins, Douglas Kondziolka, Sean P Collins
BACKGROUND: Melanoma has high propensity to metastasize to the brain. With recent gains in improving patient survival, stereotactic radiosurgery (SRS) may offer an effective and less neurotoxic alternative to whole-brain radiation. In the study, we report on the safety and efficacy of SRS in treating melanoma brain metastases in 87 patients. METHODS: This retrospective multicenter study examined 87 patients with 309 metastases who underwent single-dose or multifractionated SRS for treatment of intracranial metastases from malignant melanoma...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28046383/su-f-t-624-dose-sparing-to-normal-brain-tissue-for-stereotactic-radiosurgery-utilizing-negative-margins
#10
J Baker, J Gibb, S Ailawadi, A Hsia, J Han, J Kim, Z Xu, S Ryu
PURPOSE: The volume of normal brain tissue exposed to doses above 12 Gy (V12) strongly predicts the risk of radionecrosis. A negative margin MLC aperture results in fields smaller than the PTV. The aim of this study is to investigate the relationship between V12 and the negative margin MLC while keeping adequate PTV coverage with proper dose normalization. METHODS: Spherical PTVs were contoured with a center of mass in the frontal and left temporal lobe ranging in size from 1 cm to 4 cm in diameter...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27955888/stereotactic-radiotherapy-following-surgery-for-brain-metastasis-predictive-factors-for-local-control-and-radionecrosis
#11
M Doré, S Martin, G Delpon, K Clément, L Campion, F Thillays
PURPOSE: To evaluate local control and adverse effects after postoperative hypofractionated stereotactic radiosurgery in patients with brain metastasis. METHODS: We reviewed patients who had hypofractionated stereotactic radiosurgery (7.7Gy×3 prescribed to the 70% isodose line, with 2mm planning target volume margin) following resection from March 2008 to January 2014. The primary endpoint was local failure defined as recurrence within the surgical cavity. Secondary endpoints were distant failure rates and the occurrence of radionecrosis...
February 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/27938770/successful-healing-of-tracheal-radionecrosis-role-of-hyperbaric-oxygen-therapy
#12
Miguel Ariza-Prota, Arturo Morales, Jose Grajeda, Rosa López-Lisbona, Noelia Cubero, Jordi Dorca, Antoni Rosell
Hyperbaric oxygen therapy, the administration of 100% oxygen at pressures > 1 atm, is believed to promote wound healing by increasing angiogenesis and collagen synthesis. To our knowledge, this treatment modality has never been described in patients with tracheal radionecrosis. Here, we report the case of a 55-year-old man diagnosed with stage IIIB lung adenocarcinoma who was treated with chemotherapy and concomitant external intensity-modulated radiotherapy involving the left lung and mediastinum. Nine months later, he presented with neck pain, cough with mucopurulent sputum, and fever...
December 2016: Chest
https://www.readbyqxmd.com/read/27919464/smart-syndrome-classic-transient-symptoms-leading-to-an-unusual-unfavorable-outcome
#13
F Bompaire, L Zinchenko, M Lahutte, K Mokhtari, D Psimaras, C Gaultier, A Monjour, J-Y Delattre, D Ricard
BACKGROUND: Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare complication of cerebral radiation therapy that usually presents>10 years after treatment as reversible paroxysmal episodes of neurological dysfunction associated with headaches. CASES: We report here on two cases of SMART syndrome in long-term survivors of high-grade glioma for whom neuropathological data were available. The course of the disease was unfavorable. Although the clinico-radiological picture of SMART syndrome clearly differs from classic cerebral radionecrosis, the gross neuropathological lesions observed in our two patients appeared to be similar to those described in focal radionecrosis...
December 2, 2016: Revue Neurologique
https://www.readbyqxmd.com/read/27908375/treatment-of-radiation-induced-urethral-strictures
#14
REVIEW
Matthias D Hofer, Joceline S Liu, Allen F Morey
Radiation therapy may result in urethral strictures from vascular damage. Most radiation-induced urethral strictures occur in the bulbomembranous junction, and urinary incontinence may result as a consequence of treatment. Radiation therapy may compromise reconstruction due to poor tissue healing and radionecrosis. Excision and primary anastomosis is the preferred urethroplasty technique for radiation-induced urethral stricture. Principles of posterior urethroplasty for trauma may be applied to the treatment of radiation-induced urethral strictures...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27903180/results-of-volume-staged-fractionated-gamma-knife-radiosurgery-for-large-complex-arteriovenous-malformations-obliteration-rates-and-clinical-outcomes-of-an-evolving-treatment-paradigm
#15
Alberto Franzin, Pietro Panni, Giorgio Spatola, Antonella Del Vecchio, Alberto L Gallotti, Carmen R Gigliotti, Andrea Cavalli, Carmine A Donofrio, Pietro Mortini
OBJECTIVE There are few reported series regarding volume-staged Gamma Knife radiosurgery (GKRS) for the treatment of large, complex, cerebral arteriovenous malformations (AVMs). The object of this study was to report the results of using volume-staged Gamma Knife radiosurgery for patients affected by large and complex AVMs. METHODS Data from 20 patients with large AVMs were prospectively included in the authors' AVM database between 2004 and 2012. A staging strategy was used when treating lesion volumes larger than 10 cm(3)...
December 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27857871/sinonasal-carcinomas-with-neuroendocrine-features-histopathological-differentiation-and-treatment-outcomes
#16
Liuba Soldatova, Raewyn G Campbell, Ricardo L Carrau, Daniel M Prevedello, Paul Wakely, Bradley A Otto, Leo F Ditzel Filho
Objectives Sinonasal cancers with neuroendocrine features share similar clinical, radiological, and histopathological features; however, these tumors often exhibit varying degrees of aggressive behavior presenting significant treatment challenges. The objective of this study was to report our experience with these rare malignancies and to present a review of current literature. Methods Following institutional review board approval, the records of all patients with biopsy-proven sinonasal malignancies over a 5-year period were reviewed...
December 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27851877/understanding-the-continuum-of-radionecrosis-and-vascular-disorders-in-the-brain-following-gamma-knife-irradiation-an-mri-study
#17
Julie Constanzo, Laurence Masson-Côté, Luc Tremblay, Jérémie P Fouquet, Philippe Sarret, Sameh Geha, Kevin Whittingstall, Benoit Paquette, Martin Lepage
PURPOSE: The radiation dose delivered to brain tumors is limited by the possibility to induce vascular damage and necrosis in surrounding healthy tissue. In the present study, we assessed the ability of MRI to monitor the cascade of events occurring in the healthy rat brain after stereotactic radiosurgery, which could be used to optimize the radiation treatment planning. METHODS: The primary somatosensory forelimb area (S1FL) and the primary motor cortex in the right hemisphere of Fischer rats (n = 6) were irradiated with a single dose of Gamma Knife radiation (Leksell Perfexion, Elekta AG, Stockholm, Sweden)...
November 10, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/27823971/combined-use-of-susceptibility-weighted-magnetic-resonance-imaging-sequences-and-dynamic-susceptibility-contrast-perfusion-weighted-imaging-to-improve-the-accuracy-of-the-differential-diagnosis-of-recurrence-and-radionecrosis-in-high-grade-glioma-patients
#18
Tae-Hyung Kim, Tae Jin Yun, Chul-Kee Park, Tae Min Kim, Ji-Hoon Kim, Chul-Ho Sohn, Jae Kyung Won, Sung-Hye Park, Il Han Kim, Seung Hong Choi
Purpose was to assess predictive power for overall survival (OS) and diagnostic performance of combination of susceptibility-weighted MRI sequences (SWMRI) and dynamic susceptibility contrast (DSC) perfusion-weighted imaging (PWI) for differentiation of recurrence and radionecrosis in high-grade glioma (HGG). We enrolled 51 patients who underwent radiation therapy or gamma knife surgeryfollowed by resection for HGG and who developed new measurable enhancement more than six months after complete response. The lesions were confirmed as recurrence (n = 32) or radionecrosis (n = 19)...
March 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/27822695/the-treatment-of-melanoma-brain-metastases
#19
REVIEW
Nour Kibbi, Harriet Kluger
Melanoma is the malignancy with the highest rate of dissemination to the central nervous system once it metastasizes. Until recently, the prognosis of patients with melanoma brain metastases (MBM) was poor. In recent years, however, the prognosis has improved due to high-resolution imaging that facilitates early detection of small asymptomatic brain metastases and early intervention with local modalities such as stereotactic radiosurgery. More recently, a number of systemic therapies have been approved by the Food and Drug Administration for metastatic melanoma, resulting in improved survival for many MBM patients...
December 2016: Current Oncology Reports
https://www.readbyqxmd.com/read/27798857/re-irradiation-for-recurrent-primary-brain-tumors
#20
REVIEW
Carsten Nieder, Nicolaus H Andratschke, Anca L Grosu
BACKGROUND: Historically, radiation oncologists have been cautious about re-irradiating brain tumors because of concerns about the risks of late central nervous system (CNS) toxicity, especially radionecrosis, that may occur several months to years following treatment. Today there are still limited prospective data addressing this approach. MATERIALS AND METHODS: Systematic review of published trials reporting clinical results after re-irradiation of patients with different types of brain tumors was performed...
2016: Anticancer Research
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