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Radiation dose-volume effects in the brain.

Publication ,  Journal Article
Lawrence, YR; Li, XA; el Naqa, I; Hahn, CA; Marks, LB; Merchant, TE; Dicker, AP
Published in: Int J Radiat Oncol Biol Phys
March 1, 2010

We have reviewed the published data regarding radiotherapy (RT)-induced brain injury. Radiation necrosis appears a median of 1-2 years after RT; however, cognitive decline develops over many years. The incidence and severity is dose and volume dependent and can also be increased by chemotherapy, age, diabetes, and spatial factors. For fractionated RT with a fraction size of <2.5 Gy, an incidence of radiation necrosis of 5% and 10% is predicted to occur at a biologically effective dose of 120 Gy (range, 100-140) and 150 Gy (range, 140-170), respectively. For twice-daily fractionation, a steep increase in toxicity appears to occur when the biologically effective dose is >80 Gy. For large fraction sizes (>or=2.5 Gy), the incidence and severity of toxicity is unpredictable. For single fraction radiosurgery, a clear correlation has been demonstrated between the target size and the risk of adverse events. Substantial variation among different centers' reported outcomes have prevented us from making toxicity-risk predictions. Cognitive dysfunction in children is largely seen for whole brain doses of >or=18 Gy. No substantial evidence has shown that RT induces irreversible cognitive decline in adults within 4 years of RT.

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Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

March 1, 2010

Volume

76

Issue

3 Suppl

Start / End Page

S20 / S27

Location

United States

Related Subject Headings

  • Radiosurgery
  • Radiation Tolerance
  • Oncology & Carcinogenesis
  • Necrosis
  • Models, Theoretical
  • Models, Biological
  • Humans
  • Dose-Response Relationship, Radiation
  • Cranial Irradiation
  • Cognition Disorders
 

Citation

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Lawrence, Y. R., Li, X. A., el Naqa, I., Hahn, C. A., Marks, L. B., Merchant, T. E., & Dicker, A. P. (2010). Radiation dose-volume effects in the brain. Int J Radiat Oncol Biol Phys, 76(3 Suppl), S20–S27. https://doi.org/10.1016/j.ijrobp.2009.02.091
Lawrence, Yaacov Richard, X Allen Li, Issam el Naqa, Carol A. Hahn, Lawrence B. Marks, Thomas E. Merchant, and Adam P. Dicker. “Radiation dose-volume effects in the brain.Int J Radiat Oncol Biol Phys 76, no. 3 Suppl (March 1, 2010): S20–27. https://doi.org/10.1016/j.ijrobp.2009.02.091.
Lawrence YR, Li XA, el Naqa I, Hahn CA, Marks LB, Merchant TE, et al. Radiation dose-volume effects in the brain. Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S20–7.
Lawrence, Yaacov Richard, et al. “Radiation dose-volume effects in the brain.Int J Radiat Oncol Biol Phys, vol. 76, no. 3 Suppl, Mar. 2010, pp. S20–27. Pubmed, doi:10.1016/j.ijrobp.2009.02.091.
Lawrence YR, Li XA, el Naqa I, Hahn CA, Marks LB, Merchant TE, Dicker AP. Radiation dose-volume effects in the brain. Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S20–S27.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

March 1, 2010

Volume

76

Issue

3 Suppl

Start / End Page

S20 / S27

Location

United States

Related Subject Headings

  • Radiosurgery
  • Radiation Tolerance
  • Oncology & Carcinogenesis
  • Necrosis
  • Models, Theoretical
  • Models, Biological
  • Humans
  • Dose-Response Relationship, Radiation
  • Cranial Irradiation
  • Cognition Disorders