Long-Term Cerebral Side-Effects of Total Body Irradiation and Quality of Life

  • M. Peper
  • P. Schraube
  • B. Kimmig
  • C. Wagensommer
  • M. Wannenmacher
  • R. Haas
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 130)

Abstract

Total body irradiation (TBI) in preparation for bone marrow transplantation (BMT) is a routine treatment for malignant hematological disorders. With increasing survival rates the evaluation of long-term side effects and the patient’s quality of life has become an important issue. However, long-term neurological and psychological side effects of BMT combined with TBI have not yet been evaluated in adults. In the following sections some introductory remarks on psychological assessment in research on radiotherapy will be made.

Keywords

Permeability Fatigue Toxicity Depression Lymphoma 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Aaronson NK, Beckman J (1987) The quality of life of cancer patients. Raven, New YorkGoogle Scholar
  2. Aaronson NK (1986) Methodological issues in psychosocial oncology with special reference to clinical trials. In: Ventafridda V, van Dam FSAM, Yancik R, Tamburini M (eds) Assessment of quality of life and cancer treatment. Excerpta Medica, Amsterdam, pp 29–41Google Scholar
  3. Bigler ED (1988) Neuropsychological and computed tomographic identification in dementia. In: Whitaker HA (ed) Neuropsychological studies of nonfocal brain damage. Springer, Berlin Heidelberg New York, pp 61–85CrossRefGoogle Scholar
  4. Bigler ED, Hubler DW, Cullum CM, Turkheimer E (1985) Intellectual and memory impairment: CT volume correlations. J Nerv Ment Dis 173: 347–352PubMedCrossRefGoogle Scholar
  5. Bleyer WA (1981) Neurologic sequelae of methotrexate and ionising radiation: a new classification. Cancer Treat Rep 65 [Suppl]: 89–98PubMedGoogle Scholar
  6. Brouwers P, Riccardi R, Fedio P, Poplack DG (1985) Long-term neuropsychologic sequelae of childhood leukaemia: correlation with CT brain scan abnormalities. J Pediatr 106: 723–728PubMedCrossRefGoogle Scholar
  7. Eiser C (1978) Intellectual abilities among survivors of childhood leukaemia as a function of CNS irradiation. Arch Dis Child 53: 391–395PubMedCrossRefGoogle Scholar
  8. Griffin TW, Rasey JS, Bleyer WA (1977) The effect of photon irradiation on blood-brain barrier permeability to methotrexate in mice. Cancer 40: 1109–1111PubMedCrossRefGoogle Scholar
  9. Hartman DE (1988) Neuropsychological toxicology. Pergamon, OxfordGoogle Scholar
  10. Holland JC, Silberfarb P, Tross S, Cella D (1986) Psychosocial research in cancer: the cancer and leukaemia group B (CALGB) experience. In: Ventafridda V, van Dam FSAM, Yancik R, Tamburini M (eds) Assessment of quality of life and cancer treatment. Excerpta Medica, Amsterdam, pp 89–101Google Scholar
  11. Janke W, Debus G (1978) Die Eigenschaftswörterliste EWL. Hogrefe, GöttingenGoogle Scholar
  12. Johnson BE, Becker J, Gott WB et al. (1985) Neurologic, neuropsychologic and computed cranial tomography scan abnormalities in 2- to 10-year survivors of small cell lung cancer. J Clin Oncol 3: 1659–1667PubMedGoogle Scholar
  13. Kerekjarto M von, Schulz KH, Kramer C, Fittschen B, Schug S (1989) Grundlegende Aspekte zum Konzept der Lebensqualität. In: Verres R, Hasenbring M (eds) Jahrbuch der psychosozialen Onkologie. Springer, Berlin Heidelberg New York, pp 18–29 (Handbuch der Medizinischen Psychologie, vol 3 )Google Scholar
  14. Kessler J, Denzler P, Markowitsch HJ (1988) Demenz-Test. Beltz, WeinheimGoogle Scholar
  15. King KB, Nail LM, Kreamer K, Strohl RA, Johnson JE (1985) Patients’ descriptions of the experience of receiving radiation therapy. Oncol Nurs Forum 12 (4): 55–61PubMedGoogle Scholar
  16. Körbling M, Hunstein W, Fliedner T, Cayeux S, Dörken B, Fehrentz D, Haas R, Ho AD, Keilholz U, Knauf W, König A, Mende U, Pezzutto A, von Reumont J, Wolf GK, Wannenmacher M, zum Winkel K, Rother K (1989) Disease-free survival after autologous bone marrow transplantation in patients with acute myelogenous leukemia. Blood 74: 1898–1904PubMedGoogle Scholar
  17. Kretzschmar K, Gutjahr P, Kutzner J (1980) CT studies before and after CNS treatment for acute lymphoblastic leukaemia and malignant non-Hodgkin’s lymphoma in childhood. Neuroradiology 20: 173–180PubMedCrossRefGoogle Scholar
  18. Laukkanen E, Klonoff H, Allan B, Graeb D, Murray N (1988) The role of prophylactic brain irradiation in limited stage small cell lung cancer: clinical, neuropsychologic, and CT sequelae. Int J Radiat Oncol Biol Phys 14: 1109–1117PubMedCrossRefGoogle Scholar
  19. Lee JS, Umsawasdi T, Lee YY et al. (1986) Neurotoxicity in longterm survivors of small cell lung cancer. Int J Radiat Oncol Biol Phys 12: 313–321PubMedCrossRefGoogle Scholar
  20. Lezak MD (1983) Neuropsychological assessment. Oxford University Press, OxfordGoogle Scholar
  21. Meadows AT, Massari JD, Fergusson J, Gordon J, Littman PH, Moss K (1981) Declines in IQ scores and cognitive dysfunctions in children with acute lymphocytic leukaemia treated with cranial irradiation. Lancet 1: 1015–1018CrossRefGoogle Scholar
  22. Neuser J (1989) Psychische Belastung unter Knochenmarkstransplantation: hat soziale Unterstützung Pufferwirkung? In: Verres R, Hasenbring M (eds) Jahrbuch der psychosozialen Onkologie. Springer, Berlin Heidelberg New York, pp 151–160 (Handbuch der Medizinischen Psychologie, vol 3 )Google Scholar
  23. Ochs J, Mulhern R, Fairclough D, Parvey L, Whitaker J, Ch’ien L, Mauer A, Simone J (1991) Comparison of neuropsychologic functioning and clinical indicators of neurotoxicity in long-term survivors of childhood leukaemia given cranial radiation or parenteral methotrexate: a prospective study. J Clin Oncol 9: 145–151PubMedGoogle Scholar
  24. Peper M, Schraube P, Kimmig B, Wannenmacher M, Haas R (1993) Neuropsychological side-effects of total body irradiation (to be published )Google Scholar
  25. Poplack DG, Brouwers P (1985) Adverse sequelae of central nervous system therapy. Clin Oncol 4: 263–285Google Scholar
  26. Rubin PH, Wasserman TH (1988) The late effects of toxicity scoring. J Radiat Oncol Biol Phys 14: 29–38CrossRefGoogle Scholar
  27. Stephani U, Rating D, Korinthenberg R, Siemes H, Riehm H, Hanefeld F (1983) Radiation-related disturbance of blood/brain barrier during therapy of acute lymphoblastic leukaemia. Lancet 4: 1036–1037CrossRefGoogle Scholar
  28. Tucker J, Prior PF, Green CR, Ede GMV, Stevenson JF, Gawler J, Jamal GA, Charlesworth M, Thakkar CM, Patel P, Lister TA (1989) Minimal neuropsychological sequelae following prophylactic treatment of the central nervous system in adult leukaemia and lymphoma. Br J Cancer 60: 775–780PubMedCrossRefGoogle Scholar
  29. Von Zerssen D (1975) Die Beschwerdenliste. Beltz, WeinheimGoogle Scholar
  30. Wilson RS, Rosenbaum G, Brown G (1979) The problem of premorbid intelligence in neuropsychological assessment. J Clin Neuropsychol 1: 49–93CrossRefGoogle Scholar
  31. Zimmermann P, Poser U (1993) Ein Fragebogen erlebter Defizite der Aufmerksamkeit. Z Neuropsychol (to be published)Google Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1993

Authors and Affiliations

  • M. Peper
    • 1
  • P. Schraube
    • 1
  • B. Kimmig
    • 1
  • C. Wagensommer
    • 2
  • M. Wannenmacher
    • 1
  • R. Haas
    • 3
  1. 1.Department of RadiologyUniversity of HeidelbergHeidelbergFed. Rep. of Germany
  2. 2.Department of PsychologyUniversity of HeidelbergHeidelbergFed. Rep. of Germany
  3. 3.Department of Internal Medicine VUniversity of HeidelbergHeidelbergFed. Rep. of Germany

Personalised recommendations