Treatment-related central nervous system neurotoxicity

Treatment-related white-matter damage (WMD) is an increasingly recognized sequela of central nervous system (CNS) cancer therapy. Thirteen patients with abnormal MR studies attributable to treatment-related neurotoxicities were retrospectively reviewed. All patients were treated with radiation therapy directed to the brain, and seven of 13 (54%) received chemotherapy. Seven patients were graded as having severe WMD, two had moderate WMD, and four had mild WMD . In general, the extent of CNS damage correlated with the severity of neurologic dysfunction. MR imaging was more sensitive than was CT in detecting the presence and extent of WMD. Although many of these patients were heavily treated, the most severe changes were detected in those receiving combination CNS irradiation and chemotherapy