Increased metabolic activity in the spinal cord of patients with long-standing Lhermitte's sign
To investigate the pathophysiology of the radiation-induced, chronic Lhermitte's sign (LS) on the basis of long-standing case histories with partial functional recovery. As radiotherapy in two nasopharyngeal cancer patients, a biologically effective dose (BED) of 103.8 Gy(2) (case 1) and 94.8 G...
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| Veröffentlicht in: | Strahlentherapie und Onkologie 2003-10, Vol.179 (10), p.690-693 |
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| creator | ESIK, Olga CSERE, Tibor TRON, Lajos STEFANITS, Klara SZAKALL, Szabolcs JR LENGYEL, Zsolt SAFRANY, Géza VÖNÖCZKY, Katalin LENGYEL, Erzsébet OLAJOS, Judit BAJZIK, Gabor |
| description | To investigate the pathophysiology of the radiation-induced, chronic Lhermitte's sign (LS) on the basis of long-standing case histories with partial functional recovery.
As radiotherapy in two nasopharyngeal cancer patients, a biologically effective dose (BED) of 103.8 Gy(2) (case 1) and 94.8 Gy(2) (case 2) was delivered to the cervical spinal cord. Neurologic signs relating to the irradiated spinal cord segments developed after 2 months (case 1) and 5 years (case 2), with radiation-induced damage equivalent to grade 3 (case 1) and grade 2 (case 2) toxicity (Common Toxicity Criteria, Version 2.0). The clinical status improved to grade 2 (case 1) and grade 1 (case 2). Positron emission tomography (PET) and fibroblast clonogen assay were applied 25 and 7 years postirradiation, respectively, to characterize this rare clinical picture.
PET demonstrated increased [(18)F]fluorodeoxyglucose (FDG) accumulation and [(15)O]butanol perfusion, but negligible [(11)C]methionine uptake in the irradiated spinal cord segments in both patients. In clonogenic assays, fibroblasts from case 1 displayed much higher radiation sensitivity than in healthy controls, while in case 2 the fibroblasts sensitivity was normal.
These data suggests a close direct relationship between regional perfusion and metabolism of the spinal cord, similarly as in the brain. The postirradiation recovery may be related to energy-demanding conduction, explaining the increased metabolism and perfusion. The increased radiosensitivity and higher spinal cord BED may have contributed to the more severe sequelae in case 1. |
| doi_str_mv | 10.1007/s00066-003-1115-z |
| format | Article |
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As radiotherapy in two nasopharyngeal cancer patients, a biologically effective dose (BED) of 103.8 Gy(2) (case 1) and 94.8 Gy(2) (case 2) was delivered to the cervical spinal cord. Neurologic signs relating to the irradiated spinal cord segments developed after 2 months (case 1) and 5 years (case 2), with radiation-induced damage equivalent to grade 3 (case 1) and grade 2 (case 2) toxicity (Common Toxicity Criteria, Version 2.0). The clinical status improved to grade 2 (case 1) and grade 1 (case 2). Positron emission tomography (PET) and fibroblast clonogen assay were applied 25 and 7 years postirradiation, respectively, to characterize this rare clinical picture.
PET demonstrated increased [(18)F]fluorodeoxyglucose (FDG) accumulation and [(15)O]butanol perfusion, but negligible [(11)C]methionine uptake in the irradiated spinal cord segments in both patients. In clonogenic assays, fibroblasts from case 1 displayed much higher radiation sensitivity than in healthy controls, while in case 2 the fibroblasts sensitivity was normal.
These data suggests a close direct relationship between regional perfusion and metabolism of the spinal cord, similarly as in the brain. The postirradiation recovery may be related to energy-demanding conduction, explaining the increased metabolism and perfusion. The increased radiosensitivity and higher spinal cord BED may have contributed to the more severe sequelae in case 1.</description><identifier>ISSN: 0179-7158</identifier><identifier>EISSN: 1439-099X</identifier><identifier>DOI: 10.1007/s00066-003-1115-z</identifier><identifier>PMID: 14566477</identifier><identifier>CODEN: STONE4</identifier><language>eng</language><publisher>München: Springer</publisher><subject>Adult ; Biological and medical sciences ; Diseases of the upper aerodigestive tract ; Ent and stomatology ; Female ; Fibroblasts - radiation effects ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Hodgkin Disease - radiotherapy ; Humans ; Magnetic Resonance Imaging ; Male ; Medical research ; Medical sciences ; Methionine - metabolism ; Nasopharyngeal Neoplasms - radiotherapy ; Radiation Injuries - diagnosis ; Radiation Injuries - diagnostic imaging ; Radiation Injuries - etiology ; Radiation therapy ; Radiation Tolerance ; Radiopharmaceuticals ; Radiotherapy - adverse effects ; Radiotherapy Dosage ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Spinal Cord - metabolism ; Spinal Cord - radiation effects ; Spinal Cord Diseases - diagnosis ; Spinal Cord Diseases - diagnostic imaging ; Spinal Cord Diseases - etiology ; Time Factors ; Tomography, Emission-Computed</subject><ispartof>Strahlentherapie und Onkologie, 2003-10, Vol.179 (10), p.690-693</ispartof><rights>2004 INIST-CNRS</rights><rights>Urban & Vogel München 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-96926211af864f95ba1033a9f038e36d6aea65cc90133037f7cfad4b83dba11d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15167492$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14566477$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ESIK, Olga</creatorcontrib><creatorcontrib>CSERE, Tibor</creatorcontrib><creatorcontrib>TRON, Lajos</creatorcontrib><creatorcontrib>STEFANITS, Klara</creatorcontrib><creatorcontrib>SZAKALL, Szabolcs JR</creatorcontrib><creatorcontrib>LENGYEL, Zsolt</creatorcontrib><creatorcontrib>SAFRANY, Géza</creatorcontrib><creatorcontrib>VÖNÖCZKY, Katalin</creatorcontrib><creatorcontrib>LENGYEL, Erzsébet</creatorcontrib><creatorcontrib>OLAJOS, Judit</creatorcontrib><creatorcontrib>BAJZIK, Gabor</creatorcontrib><title>Increased metabolic activity in the spinal cord of patients with long-standing Lhermitte's sign</title><title>Strahlentherapie und Onkologie</title><addtitle>Strahlenther Onkol</addtitle><description>To investigate the pathophysiology of the radiation-induced, chronic Lhermitte's sign (LS) on the basis of long-standing case histories with partial functional recovery.
As radiotherapy in two nasopharyngeal cancer patients, a biologically effective dose (BED) of 103.8 Gy(2) (case 1) and 94.8 Gy(2) (case 2) was delivered to the cervical spinal cord. Neurologic signs relating to the irradiated spinal cord segments developed after 2 months (case 1) and 5 years (case 2), with radiation-induced damage equivalent to grade 3 (case 1) and grade 2 (case 2) toxicity (Common Toxicity Criteria, Version 2.0). The clinical status improved to grade 2 (case 1) and grade 1 (case 2). Positron emission tomography (PET) and fibroblast clonogen assay were applied 25 and 7 years postirradiation, respectively, to characterize this rare clinical picture.
PET demonstrated increased [(18)F]fluorodeoxyglucose (FDG) accumulation and [(15)O]butanol perfusion, but negligible [(11)C]methionine uptake in the irradiated spinal cord segments in both patients. In clonogenic assays, fibroblasts from case 1 displayed much higher radiation sensitivity than in healthy controls, while in case 2 the fibroblasts sensitivity was normal.
These data suggests a close direct relationship between regional perfusion and metabolism of the spinal cord, similarly as in the brain. The postirradiation recovery may be related to energy-demanding conduction, explaining the increased metabolism and perfusion. The increased radiosensitivity and higher spinal cord BED may have contributed to the more severe sequelae in case 1.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Diseases of the upper aerodigestive tract</subject><subject>Ent and stomatology</subject><subject>Female</subject><subject>Fibroblasts - radiation effects</subject><subject>Fluorodeoxyglucose F18</subject><subject>Follow-Up Studies</subject><subject>Hodgkin Disease - radiotherapy</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Methionine - metabolism</subject><subject>Nasopharyngeal Neoplasms - radiotherapy</subject><subject>Radiation Injuries - diagnosis</subject><subject>Radiation Injuries - diagnostic imaging</subject><subject>Radiation Injuries - etiology</subject><subject>Radiation therapy</subject><subject>Radiation Tolerance</subject><subject>Radiopharmaceuticals</subject><subject>Radiotherapy - adverse effects</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy. 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As radiotherapy in two nasopharyngeal cancer patients, a biologically effective dose (BED) of 103.8 Gy(2) (case 1) and 94.8 Gy(2) (case 2) was delivered to the cervical spinal cord. Neurologic signs relating to the irradiated spinal cord segments developed after 2 months (case 1) and 5 years (case 2), with radiation-induced damage equivalent to grade 3 (case 1) and grade 2 (case 2) toxicity (Common Toxicity Criteria, Version 2.0). The clinical status improved to grade 2 (case 1) and grade 1 (case 2). Positron emission tomography (PET) and fibroblast clonogen assay were applied 25 and 7 years postirradiation, respectively, to characterize this rare clinical picture.
PET demonstrated increased [(18)F]fluorodeoxyglucose (FDG) accumulation and [(15)O]butanol perfusion, but negligible [(11)C]methionine uptake in the irradiated spinal cord segments in both patients. In clonogenic assays, fibroblasts from case 1 displayed much higher radiation sensitivity than in healthy controls, while in case 2 the fibroblasts sensitivity was normal.
These data suggests a close direct relationship between regional perfusion and metabolism of the spinal cord, similarly as in the brain. The postirradiation recovery may be related to energy-demanding conduction, explaining the increased metabolism and perfusion. The increased radiosensitivity and higher spinal cord BED may have contributed to the more severe sequelae in case 1.</abstract><cop>München</cop><pub>Springer</pub><pmid>14566477</pmid><doi>10.1007/s00066-003-1115-z</doi><tpages>4</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Diseases of the upper aerodigestive tract Ent and stomatology Female Fibroblasts - radiation effects Fluorodeoxyglucose F18 Follow-Up Studies Hodgkin Disease - radiotherapy Humans Magnetic Resonance Imaging Male Medical research Medical sciences Methionine - metabolism Nasopharyngeal Neoplasms - radiotherapy Radiation Injuries - diagnosis Radiation Injuries - diagnostic imaging Radiation Injuries - etiology Radiation therapy Radiation Tolerance Radiopharmaceuticals Radiotherapy - adverse effects Radiotherapy Dosage Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Spinal Cord - metabolism Spinal Cord - radiation effects Spinal Cord Diseases - diagnosis Spinal Cord Diseases - diagnostic imaging Spinal Cord Diseases - etiology Time Factors Tomography, Emission-Computed |
| title | Increased metabolic activity in the spinal cord of patients with long-standing Lhermitte's sign |
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