Document Detail

Adverse radiation effects after radiosurgery may benefit from oral vitamin E and pentoxifylline therapy: a pilot study.
MedLine Citation:
PMID:  18854663     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although uncommon, adverse radiation effects (ARE) are a potentially serious side effect of brain stereotactic radiosurgery (SRS). Corticosteroids are used to treat suspected ARE but side effects may be significant after long-term usage. Oral pentoxifylline (Ptx) and vitamin E therapy (VitE) are reported to benefit ARE seen in other organ systems. We treated 11 patients with suspected ARE after SRS with Ptx and VitE. METHODS: To assess the response, edema was measured using fluid-attenuated inversion recovery magnetic resonance imaging (MRI). Edema volumes were calculated by first determining the three maximum measurements in the X, Y, and Z planes of the image with the largest signal change. Volume was plotted over time for each patient that had serial MRI scans available. Two patients had 2 separate radiosurgeries and 2 patients underwent 3. Three patients received adjuvant whole-brain radiation therapy. RESULTS: The time until clinical detection of ARE after SRS varied from 3 to 18 months (median, 8 months). The change in edema volume varied from 59.6 ml in 1 patient (worse edema) to -324.2 ml (improvement). The average change in edema from pre- to post-treatment was -72.3 ml. One patient had more edema despite treatment; this patient was found to have tumor recurrence, and not an ARE. Two patients discontinued Ptx because of persistent nausea and abdominal discomfort. CONCLUSIONS: Ptx and VitE may be of benefit in the management of adverse radiation effects and should be studied further.
Richard Williamson; Douglas Kondziolka; Hilal Kanaan; L Dade Lunsford; John C Flickinger
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-10-16
Journal Detail:
Title:  Stereotactic and functional neurosurgery     Volume:  86     ISSN:  1423-0372     ISO Abbreviation:  Stereotact Funct Neurosurg     Publication Date:  2008  
Date Detail:
Created Date:  2008-12-10     Completed Date:  2009-06-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8902881     Medline TA:  Stereotact Funct Neurosurg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  359-66     Citation Subset:  IM    
Copyright Information:
Copyright 2008 S. Karger AG, Basel.
Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pa., USA.
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MeSH Terms
Administration, Oral
Brain Edema / drug therapy,  etiology
Drug Therapy, Combination
Middle Aged
Pentoxifylline / administration & dosage*,  therapeutic use
Pilot Projects
Radiosurgery / adverse effects*
Tocopherols / administration & dosage*,  therapeutic use
Reg. No./Substance:
1406-66-2/Tocopherols; 6493-05-6/Pentoxifylline

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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