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Induction of Diffuse Axonal Brain Injury in Rats Based on Rotational Acceleration
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Published on: May 9, 2020

Radiation associated brainstem injury.

Charles Mayo1, Ellen Yorke, Thomas E Merchant

  • 1Department of Radiation Oncology, University of Massachusetts Medical School, Worcester, MA 01655, USA. charles.mayo@umassmemorial.org

International Journal of Radiation Oncology, Biology, Physics
|February 23, 2010
PubMed
Summary
This summary is machine-generated.

Brainstem radiation toxicity is linked to dose and volume. Limited data exists for hypofractionated treatments, but the entire brainstem can be treated to 54 Gy with low risk.

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Controlled Cortical Impact Model for Traumatic Brain Injury
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Published on: August 5, 2014

Area of Science:

  • Radiation Oncology
  • Neuro-oncology
  • Medical Physics

Background:

  • Brainstem radiation toxicity is a critical concern in cancer treatment.
  • Existing studies often have small patient cohorts, limiting definitive conclusions.
  • Quantitative dose and dose-volume measures are crucial for understanding toxicity.

Purpose of the Study:

  • To review publications correlating brainstem radiation toxicity with quantitative dose and dose-volume parameters.
  • To identify established safety limits for brainstem irradiation using conventional and hypofractionated schedules.
  • To provide guidance on safe dose prescription for brainstem tumors.

Main Methods:

  • Systematic literature review of studies reporting brainstem radiation toxicity.
  • Analysis of dose-volume histograms (DVHs) and dose-response relationships.
  • Focus on conventional fractionation and emerging hypofractionation data.

Main Results:

  • Limited evidence links toxicity to small volumes receiving >60-64 Gy with conventional fractionation.
  • No definitive criteria exist for subtle dose-volume effects or hypofractionated treatments.
  • The entire brainstem can be treated to 54 Gy with conventional fractionation, posing limited risk of severe neurological effects.
  • Irradiating 1-10 mL of the brainstem to a maximum of 59 Gy (dose fractions ≤2 Gy) is feasible, but risk increases significantly above 64 Gy.

Conclusions:

  • Establishing precise dose constraints for brainstem radiation is challenging due to limited data, especially for hypofractionation.
  • Conventional fractionation allows whole brainstem treatment up to 54 Gy with acceptable risk.
  • Higher doses to smaller brainstem volumes are possible but require careful consideration of dose escalation risks above 64 Gy.