Abstract
PurposeThis pilot prospective study sought to determine whether dynamic contrast enhanced MRI (DCE-MRI) could be used as a clinical imaging biomarker of tissue toxicity from whole brain radiotherapy (WBRT).Method14 patients who received WBRT were imaged using dynamic contrast enhanced DCE-MRI prior to and at 8-weeks, 16-weeks and 24-weeks after the initiation of WBRT. Twelve of the patients were also enrolled in the RTOG 0614 trial, which randomized patients to the use of placebo or memantine. After the unblinding of the treatments received by RTOG 0614 patients, DCE-MRI measures of tumor tissue and normal appearing white matter (NAWM) vascular permeability (Initial Area Under the Curve (AUC) Blood Adjusted) was analyzed. Cognitive, quality-of-life (QOL) assessment and blood samples were collected according to the patient's ability to tolerate the exams. Circulating endothelial cells (CEC) were measured using flow cytometry.ResultsFollowing WBRT, there was an increasing trend in the vascular permeability of tumors (p=0.09) and NAWM (p=0.06) with time. Memantine significantly (p=0.01) reduced NAWM AUC changes following radiotherapy. Patients on memantine retained (COWA p= 0.03) better cognitive functions than those on placebo. No association was observed between the level of CEC and DCE-MRI changes, time from radiotherapy or memantine use.ConclusionsDCE-MRI can detect vascular damage secondary to WBRT. Our data suggests that memantine reduces WBRT-induced brain vasculature damages.
Highlights
The incidence of brain metastasis in cancer patients has been 30-40% [1,2,3]
No association was observed between the level of Circulating endothelial cells (CEC) and dynamic contrast enhanced MRI (DCE-MRI) changes, time from radiotherapy or memantine use
We found that patients receiving memantine had significantly (p = 0.01) less normal appearing white matter (NAWM) Area Under the Curve (AUC) changes following radiotherapy than those who received placebo (Figure 3)
Summary
The incidence of brain metastasis in cancer patients has been 30-40% [1,2,3]. This figure may rise as novel therapeutic agents improve the systemic control of cancers outside of the central nervous system. The brain represents a watershed area for tumor metastasis to seed and colonize as the normal blood-brain-barrier (BBB) prevents systemic agents from reaching tumor cells. Radiotherapy currently remains as the main treatment option for patients with www.impactjournals.com/oncotarget Pt # Primary disease. Volume of tumor analyzed (cc) Time between. WBRT and prior surgery or SRS brain treatment. Use of Pla, Mem or Neither Sx: 4 weeks
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
