[White matter alterations after chemotherapy and radiation]

Area of Science:

• Neuro-oncology
• Radiation oncology
• Medical oncology

Background:

• Chemotherapy and radiotherapy are standard treatments for central nervous system (CNS) tumors.
• These therapies can induce neurological symptoms and white matter alterations.
• These changes are categorized into acute, subacute, and chronic phases.

Purpose of the Study:

• To review the clinical implications of chemotherapy- and radiotherapy-induced white matter alterations in CNS tumors.
• To differentiate between reversible and potentially permanent neurological sequelae.

Main Methods:

• Literature review of studies on CNS tumor treatments and their neurological side effects.
• Analysis of the temporal progression and reversibility of white matter changes.

Main Results:

• Acute and subacute neurological symptoms and white matter alterations are generally reversible.
• Chronic white matter alterations can result in persistent neurological impairments.
• These long-term effects significantly impact patients' quality of life.

Conclusions:

• While acute/subacute treatment effects are often temporary, chronic changes pose a significant challenge in CNS oncology.
• Managing and mitigating chronic neurotoxicity is crucial for improving long-term outcomes and quality of life in brain tumor survivors.