Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017638 (glioma)
 30,880 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From 1965 to 1984, ten patients with suprasellar or pituitary tumors received repeat courses of radiation therapy at the Joint Radiation Oncology Center of the University of Pittsburgh. The radiation doses varied between 36.00 to 53.65 Gy for the first treatment course and from 35.00 to 49.60 Gy for retreatment. Six patients were treated for pituitary tumors, two for germinoma, one for optic glioma, and one for craniopharyngioma. One died of disease progression 19 years after a second course of radiation. Two patients were dead of intercurrent disease 0.2 and 1.5 years after repeat radiation. The remainder are free of disease progression 1.6 to 20.5 years after repeat irradiation. Optic neuropathy developed in one patient 1.3 years following a second course of treatment to 40 Gy in 20 fractions administered 7.5 years after initial treatment to 46 Gy in 23 fractions. Neither the Nominal Standard Dose nor the Neuret formula provided an adequate estimate of the repair of radiation. An estimation that 40% of the original radiation dose effect is still present appears to be a reasonable "rule of thumb" guideline to account for prior radiotherapy.
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PMID:Repeat megavoltage irradiation of pituitary and suprasellar tumors. 250 Dec 42

Here we describe the case of a 41-year-old woman with a history of Cushing disease who had previously undergone unsuccessful neurosurgery, followed by stereotactic radiosurgery. More than 4 years after this treatment, she presented severe visual impairment, which started in the left eye and was documented by neuro-ophthalmic evaluation. Radiological assessment by contrast-enhanced magnetic resonance (MR) imaging initially suggested the diagnosis of glioma of the optic nerve and the patient started corticosteroid treatment (first with prednisone, 80 mg/day, followed by dexamethasone, 8 mg/day). Despite the therapy, vision in the left eye rapidly worsened until light was no longer perceptible; similar symptoms and signs also developed in the right eye, evolving to complete temporal hemianopsia. The clinical evidence was confirmed by the rapid progression of the MR picture, which showed homogeneous enhancement of the chiasm and optic nerves. On the basis of these findings, the original diagnosis of glioma was excluded, and radiation-induced optic neuropathy was diagnosed. As corticosteroids had proved inefficacious, hyperbaric oxygen (HBO) therapy was promptly instituted and vision steadily started to improve. This improvement was documented and confirmed by the progressive recovery of the visual field in the right eye and the changes in the sequential follow-up MR scanning. Optic neuropathy is an infrequent but dramatic complication of radiation therapy. Symptoms develop, on average, 12 months after treatment, and the onset may be acute and characterized by the progressive loss of vision in one or both eyes. HBO has already been used to treat this complication, but its efficacy is still controversial. Here, in addition to describing this particular case, which presented a significantly delayed radiation injury of the optic pathways, we provide a brief literature review and discuss some important points.
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PMID:Partial visual recovery from radiation-induced optic neuropathy after hyperbaric oxygen therapy in a patient with Cushing disease. 1672 40