Neurobehavioral toxicity of total body irradiation: a follow-up in long-term survivors
Purpose: Total body irradiation (TBI) in preparation for bone marrow transplantation (BMT) is a routine treatment of hematological malignancy. A retrospective and a prospective group study of long-term cerebral side effects was performed, with a special emphasis on neurobehavioral toxicity effects....
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| Main Authors: | , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
27 January 2000
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| In: |
International journal of radiation oncology, biology, physics
Year: 2000, Volume: 46, Issue: 2, Pages: 303-311 |
| ISSN: | 1879-355X |
| DOI: | 10.1016/S0360-3016(99)00442-3 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/S0360-3016(99)00442-3
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| Author Notes: | Martin Peper, Sarah Steinvorth, Peter Schraube, Stefan Fruehauf, Rainer Haas, Bernhard N. Kimmig, Frank Lohr, Frederik Wenz, Michael Wannenmacher |
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| 520 | |a Purpose: Total body irradiation (TBI) in preparation for bone marrow transplantation (BMT) is a routine treatment of hematological malignancy. A retrospective and a prospective group study of long-term cerebral side effects was performed, with a special emphasis on neurobehavioral toxicity effects. Methods and Materials: Twenty disease-free patients treated with hyperfractionated TBI (14.4 Gy, 12 × 1.2 Gy, 4 days), 50 mg/kg cyclophosphamide, and autologous BMT (mean age 38 years, range 17-52 years; age at TBI 35 years, 16-50 years; follow-up time 32 months, 9-65 months) participated in a neuropsychological, neuroradiological, and neurological examination. Data were compared to 14 patients who were investigated prior to TBI. Eleven patients with renal insufficiencies matched for sex and age (38 years, 20-52 years) served as controls. In a longitudinal approach, neuropsychological follow-up data were assessed in 12 long-term survivors (45 years, 23-59 years; follow-up time 8.8 years, 7-10.8 years; time since diagnosis 10.1 years, 7.5-14.2 years). Results: No evidence of neurological deficits was found in post-TBI patients except one case of peripheral movement disorder of unknown origin. Some patients showed moderate brain atrophy. Neuropsychological assessment showed a subtle reduction of memory performance of about one standard deviation. Cognitive decline in individual patients appeared to be associated with pretreatment (brain irradiation, intrathecal methotrexate). Ten-years post disease onset, survivors without pretreatment showed behavioral improvement up to the premorbid level. Conclusion: The incidence of long-term neurobehavioral toxicity was very low for the present TBI/BMT regimen. | ||
| 650 | 4 | |a Behavioral toxicity | |
| 650 | 4 | |a Bone marrow transplant | |
| 650 | 4 | |a Neuropsychology | |
| 650 | 4 | |a Radiotherapy | |
| 650 | 4 | |a Total body irradiation | |
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