Subacute neurotoxicity after cranial profilactic radiotherapy in small cell lung cancer – clinical ase with literature review
- Marinova, I. Mihaylova
The profilactic cranial radiotherapy is a standart treatment approach in patients with small cell lung cancer (SCLC), with local and extensive diasease treated with chemotherapy and radiotherapy of the primary tumor. Two schemes of dose fractioning are applied: daily dose 2,5 Gy to a total dose of 25 Gy in 10 fractions five time weekly, and daily dose 3 Gy to a total dose of 30 Gy in 10 fractions five time weekly. We present a 73 y.o. patient with SCLC treated with 6 courses first line chemotherapy with Cisplatin and Etoposid. Three months following performed profilactic cranial radiotherapy with a daily dose of 3 Gy to a total dose of 30 Gy – 5 times weekly, brain oedema was visualised on a CT and MRI, along with signes of chronic ischemic disease of the small brain vessels. In the literature review, the problem of radiation induced acute, subacute and late neurotoxicity after applied profilactic cranial radiotherapy has been thorougly examined. We emphasize on the possibilities for minimalization of these radiation side effects in profilactic cranial radiotherapy.
Key words: PROFILACTIC CRANIAL RADIOTHERAPY. RADIATION INDUCED NEUROTOXICITY. RADIOTHERAPY. CHEMOTHERAPY