Summary
Clinical deterioration during or after brain irradiation may be due to progression of neoplasm or radiation induced necrosis of the neoplasm and/or of normal brain tissues, or a combination of all. Eight patients with histologically documented radiation induced lesions of the brain are included in this study. The radiation therapy included the fractional schedule, group A, who received 280 to 300 rads daily, to a total dose of 4500 to 5000 rads and weekly exposure did not exceed 900 rads. Group B patients were exposed to 850 rads, daily dose on day 1, 3, 21 and 23 to a total dose of 3400 rads. The incidence of radiation induced lesions of brain was 3.4% in patients group A and 8.7% in group B patients (without) statistical significance). The median time of onset of these lesions after completion of radiation therapy was significantly shorter in group B patients (8.5 months) as opposed to group A patients (21 months).
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Deck MDF (1980) Imaging techniques in the diagnosis of radiation damage to the central nervous system. In: Gilbert HA, Kagan RA (eds) Radiation damage to the nervous system. Raven Press, New York, pp 107–127
Marks JE, Baglan RJ, Prasad SC, Blank WF (1981) Cerebral radionecrosis: Incidence and risk in relation to dose, time, fractionation and volume. Int J Radiat Oncol Biol Phys 7: 243–252
Martin AN, Johnston JS, Henry JM, Stoffel TJ, Di Chiro G (1977) Delayed radiation necrosis of the brain. J Neurosurg 47: 336–345
Nakagaki H, Brunhart G, Kemper TH, Caveness WF (1976) Monkey brain damage from radiation in the therapeutic range. J Neurosurg 44: 3–11
Prosnitz LR, Kapp DS, Weissberg JB (1983) Radiotherapy. N Engl J Med 309: 836–840
Bernstein M, Gutin PH (1981) Interstitial irradiation of brain tumors: A review. Neurosurgery 9: 741–750
Burger PC, Mahaley MS Jr, Dudka L, Vogel FS (1979) The morphologic effects of radiation administered therapeutically for intracranial gliomas. A postmortem study of 25 cases. Cancer 44: 1256–1279
Mikhael MA (1978) Radiation necrosis of the brain: Correlation between computed tomography, pathology, and dose distribution. J Comput Assist Tomogr 2: 71–80
Hoffman WF, Levin VA, Wilson CB (1979) Evaluation of malignant glioma patient during the postirradiation period. J Neurosurg 50: 624–628
Sundaresan N, Galicich JH, Deck MD, Tomita T (1981) Radiation necrosis after treatment of solitary intracranial metastases. Neurosurgery 8: 329–333
Sheline GE (1980) Irradiation injury of the human bran: A review of clinical experience. In: Gilbert HA, Kagan AR (eds) Radiation damage to the nervous system. Raven Press, New York, pp 39–58
Mikhael MA (1980) Dosimetric consideration in the diagnosis of radiation necrosis of the brain. In: Gilbert RH, Kagan RA (eds) Radiation damage to the nervous system. Raven Press, New York, pp 59–91
Mikhael MA (1979) Radiation necrosis of the brain: Correlation between pattern on computed tomography and dose of radiation. J Comput Assist Tomogr 3: 241–249
Safdari H, Boluix B, Gros C (1984) Multifocal brain radionecrosis masquerading as tumor dissemination. Surg Neurol 21: 35–41
Shewmon AD, Masdeu JC (1980) Delayed radiation necrosis of the brain contralateral to original tumor. Arch Neurol 37: 592–594
Kingsley DPE, Kendall BE (1980) CT of the adverse effect of therapeutic radiation of the central nervous system. AJNR 2: 453–460
Caveness WF (1980) Experimental observations:Delayed necrosis in normal monkey brain. In: Gilbert RH, Kagan RA (eds) Radiation damage to the nervous system. Raven Press, New York, pp 1–38
Hornsey S, Biol FI, Morris CC, Myers R (1981) The relationship between fractionation and total dose for X ray induced brain damage. Int J Radiat Oncol Biol Phys 7: 393–396
Safdari H, Richardson EP Jr (1979) Subacute necrotizing polioencephalopathy. Arch Neurol 36: 638–642
Van Dellen JR, Danziger A (1978) Failure of computerized tomography to differentiate between radiation necrosis and cerebral tumour. South Afr Med J 53: 171–172
Selker RG, Mendelow H, Walker M, Sheptak PE (1982) Pathological correlation of CT Ring in recurrent, previously treated gliomas. Surg Neurol 17: 251–254
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Safdari, H.G., Fuentes, J.M., Dubois, J.B. et al. Radiation necrosis of the brain: Time of onset and incidence related to total dose and fractionation of radiation. Neuroradiology 27, 44–47 (1985). https://doi.org/10.1007/BF00342516
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00342516