Radiation therapy is widely used for benign and malignant brain tumours as it is effective and well tolerated. However, damage to the surrounding healthy nervous system tissue leads to a variety of complications both in the short term and long term, ranging from mild and self-limiting to irreversible and fatal. Radiation neurotoxicity is due to a combination of early inflammation and oligodendroglial damage followed later by brain tissue necrosis, white matter damage, accelerated vascular disease and the development of secondary tumours. This article explains the basic principles of radiation physics, the different modalities used in clinical practice, how radiotherapy is planned and delivered and the scientific basis of radiation damage. The main body of the article focuses on the clinical features of radiation toxicity in the brain, spinal cord, cranial and peripheral nerves with an emphasis on the distinction between early and delayed complications.
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http://dx.doi.org/10.1136/pn-2022-003343 | DOI Listing |
Cancer Treat Rev
January 2025
Division of Hematology and Oncology, University of Virginia Comprehensive Cancer Center, Charlottesville, VA, United States. Electronic address:
Background: Trastuzumab deruxtecan (T-DXd) has shown promising activity in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) and central nervous system (CNS) involvement. In this updated meta-analysis, we explore the effectiveness of T-DXd in a large subset of patients with HER2-positive BC and CNS disease.
Methods: A systematic search was made on September 16th, 2024, for studies investigating T-DXd in the scenario of HER2-positive BC and brain metastases (BMs) and/or leptomeningeal disease (LMD).
J Neurosurg Case Lessons
January 2025
Department of Neurology, Mayo Clinic, Rochester, Minnesota.
Background: Adamantinomatous craniopharyngiomas (ACPs) are slow-growing, cystic, highly morbid central nervous system tumors located adjacent to vital structures including the pituitary, hypothalamus, and optic chiasm. Tumor recurrence is common. Treatment relies on resection with or without adjuvant radiation and is highly individualized.
View Article and Find Full Text PDFNeurology
February 2025
Department of Neurology, John Hunter Hospital, Newcastle, Australia.
Background And Objectives: Hyperacute cardiac CT has shown greater yield for intracardiac thrombus identification compared with transthoracic echocardiography. However, routine use comes with higher cost and additional contrast and radiation exposure. Pretest identification of patients with low probability of thrombus would enable rationalization of its use.
View Article and Find Full Text PDFAm J Physiol Endocrinol Metab
January 2025
Molecular and Cellular Exercise Physiology, Department of physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
Kynurenic acid (KYNA) and quinolinic acid (QUIN) are metabolites of the kynurenine pathway of tryptophan degradation with opposing biological activities in the central nervous system. In the periphery, KYNA is known to positively affect metabolic health, whereas the effects of QUIN remain less explored. Interestingly, metabolic stressors, including exercise and obesity, differentially change the balance between circulating KYNA and QUIN.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
January 2025
Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104.
Human brain evolution is marked by a disproportionate expansion of cortical regions associated with advanced perceptual and cognitive functions. While this expansion is often attributed to the emergence of novel specialized brain areas, modifications to evolutionarily conserved cortical regions also have been linked to species-specific behaviors. Distinguishing between these two evolutionary outcomes has been limited by the ability to make direct comparisons between species.
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