Synonyms
Late effects
Definition
The late-delayed radiation symptoms are most commonly seen in the neurological, neurocognitive, and endocrine systems. Late-delayed radiation effects on the central nervous (CNS) system are iatrogenic injuries that are irreversible and possibly progressive. Neural substrates include vasculopathies and capillary damage, stroke, demyelination, disruption of cellular mitosis, radiation necrosis, diaschisis, destruction of the hypothalamic–pituitary axis, and gliosis. Late-delayed effects often present as leukoencephalopathy within the tumor field; this gross change is more commonly seen on MRI or CT at higher total radiation doses.
Historical Background
Changes have been retrospectively described several months to many years posttreatment (for review, see Armstrong et al. 2004; Crossen et al. 1994; DeAngelis et al. 1989). Declines have been reported using PET and [11C] methionine, an amino acid marker, in gray matter remote from the tumor during several...
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References and Readings
Archibald, Y., Lunn, D., Ruttan, L., Macdonald, D., Del Maestro, R., Barr, H., et al. (1994). Cognitive functioning in long-term survivors of high-grade glioma. Journal of Neurosurgery, 80, 247–253.
Armstrong, C., Corn, B., Ruffer, J., Pruitt, A., Mollman, J., & Phillips, P. (2000). Radiotherapeutic effects on brain function: Double dissociation of memory systems. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 13, 101–111.
Armstrong, C., Gyato, K., Awadalla, A., Lustig, R., & Tochner, Z. (2004). A critical review of the clinical effects of therapeutic irradiation damage to the brain: The roots of controversy. Neuropsychology Review, 14(1), 65–86.
Armstrong, C. L., Hunter, J. V., Hackney, D., Shabbout, M., Lustig, R., Goldstein, B., et al. (2005). MRI changes during the early-delayed phase of radiotherapy effects. International Journal of Radiation Oncology, Biology, and Physics, 63(1), 56–63.
Berg, R., Ch’ien, L., Lancaster, W., Williams, S., & Cummins, J. (1983). Neuropsychological sequelae of postradiation somnolence syndrome. Developmental Behavioral Pediatrics, 4, 103–107.
Crossen, J., Garwood, D., Glatstein, E., & Neuwelt, E. (1994). Neurobehavioral sequelae of cranial irradiation in adults: A review of radiation-induced encephalopathy. Journal of Clinical Oncology, 12, 627–642.
DeAngelis, L., Delattre, J., & Posner, J. (1989). Radiation-induced dementia in patients cured of brain metastases. Neurology, 39, 789–796.
Gondi, V., Tome, W. A., & Mehta, M. P. (2010). Why avoid the hippocampus? A comprehensive review. Radiotherapy and Oncology, 97(3), 370–376.
Klein, M., Heimans, J., Aaronson, N., van der Ploeg, H., Grit, J., Muller, M., et al. (2002). Effect of radiotherapy and other treatment-related factors on mid-term to long-term cognitive sequelae in low-grade gliomas: A comparative study. Lancet, 360, 1361–1368.
Longeway, K., Mulhern, R., Crisco, J., Kun, L., Lauer, S., Casper, J., et al. (1990). Treatment of meningeal relapse in childhood acute lymphoblastic leukemia: II. A prospective study of intellectual loss specific to CNS relapse and therapy. American Journal of Pediatric Hematology/Oncology, 12, 45–50.
Mulhern, R., Fairclough, D., & Ochs, D. (1991). A prospective comparison of neuropsychological performance of children surviving leukemia who received 18-Gy, 24-Gy, or no cranial irradiation. Journal of Clinical Oncology, 9, 1348–1356.
Mulhern, R., Hancock, J., Fairclough, D., & Kun, L. (1992). Neuropsychological status of children treated for brain tumors: A critical review and integrative analysis. Medical and Pediatric Oncology, 20, 181–191.
Ochs, J., Mulhern, R., Fairclough, D., Parvey, L., Whitaker, J., Ch’ien, L., et al. (1991). Comparison of neuropsychologic functioning and clinical indicators of neurotoxicity in long-term survivors of childhood leukemia given cranial radiation or parenteral methotrexate: A prospective study. Journal of Clinical Oncology, 9, 145–151.
Radcliffe, J., Bunin, G., Sutton, L., Goldwein, J., & Phillips, P. (1994). Cognitive deficits in long-term survivors of childhood medulloblastoma and other noncortical tumors: Age-dependent effects of whole brain radiation. International Journal of Developmental Neuroscience, 12, 327–334.
Rubenstein, C., Varni, J., & Katz, E. (1990). Cognitive functioning in long-term survivors of childhood leukemia: A prospective analysis. Journal of Developmental and Behavioral Pediatrics, 11, 301–305.
Sato, K., Kameyama, M., Kayama, T., Yoshimoto, T., Ishiwata, K., & Ito, M. (1995). Serial positron emission tomography imaging of changes in amino acid metabolism in low grade astrocytoma after radio- and chemotherapy. Neurologia Medico-Chirurfica, 35, 808–812.
Shishido, F., Uemura, K., Inugami, A., Tomura, N., Higano, S., Fujita, H., et al. (1990). Value of 11C-methionine and PET in the diagnosis of low grade gliomas. Kaku Igaku, 27, 293–302.
Vigliani, M., Sichez, N., Poisson, M., & Delattre, J. (1996). A prospective study of cognitive functions following conventional radiotherapy for supratentorial gliomas in young adults: 4-year results. International Journal of Radiation Oncology, Biology, and Physics, 35, 527–533.
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Armstrong, C.L. (2018). Late-Delayed Effects of Radiation Therapy. In: Kreutzer, J.S., DeLuca, J., Caplan, B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-57111-9_122
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