Anticoagulation for radiation-induced neurotoxicity revisited.
No effective treatment for delayed radiation-induced neurotoxicity has been established. Its natural course is highly variable, but spontaneous recovery has been well documented. Here we report our experience with therapeutic anticoagulation in patients with cerebral lesions (n = 3), cranial nerve lesions (n = 1) or myelopathy (n = 4) attributed to irradiation. Two of three patients with cerebral lesions and the patient with cranial nerve lesions showed a minor improvement of clinical symptoms. In contrast, none of the patients with radiation myelopathy improved. No patient suffered hemorrhage or other adverse effects of anticoagulation. Overall, anticoagulation therapy demonstrates only modest activity for delayed radiation-induced neurotoxicity in this small case series.
Happold
Caroline
C
Department of General Neurology, Hertie Institute for Brain Research, Tubingen, Germany. Caroline.Happold@usz.ch
Ernemann
Ulrike
U
Roth
Patrick
P
Wick
Wolfgang
W
Weller
Michael
M
Schmidt
Friederike
F
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D001932:Brain Neoplasms / Q000145:classification / Q000532:radiotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D013116:Spinal Cord / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D013118:Spinal Cord Diseases / Q000188:drug therapy / Q000209:etiology
D000925:Anticoagulants