Accelerated fractionation for high-grade cerebral astrocytomas: preliminary treatment results

Article Abstract:

Astrocytomas are a type of brain tumor. In children, these tumors are low-grade. However, when adults develop astrocytomas, they are more likely to be high-grade, which means that the tumor cells appear poorly differentiated under the microscope and the tumor has high malignant potential (high likelihood of becoming cancerous). Although astrocytomas virtually never metastasize or spread outside the brain, malignant cells invade the rest of the brain with great rapidity. If surgery is the only treatment used for astrocytoma, survival time is often only a three to four months. Postoperative radiation therapy can be used to extend survival, but not for long. A study was undertaken to determine if accelerated fractionation radiotherapy might be used to improve survival for adults with high-grade astrocytomas. In general, the use of radiation to kill tumors is limited by the deleterious effect of radiation on normal tissues. Fractionation is breaking up the total dose of radiation into smaller daily doses which cause less damage to healthy tissues. Conventional radiation therapy for astrocytoma consists of 6,000 cGy divided into 30 daily fractions. (A Gy, or Gray, is a dose of radiation equivalent to one joule of energy absorbed per kilogram of tissue. It is equal to 100 rads.) In the present study, the patients were treated with 4,400 cGy given to the whole brain in 22 daily fractions. During the last eight days, the regular treatment was supplemented by 200 cGy per day directly to the tumor bed. The midpoint (median) survival time of the patients was 57 weeks, which compares favorably with the median of 37 weeks after typical radiation therapy for this brain tumor. (In this case, median means that one-half of the patients survived less than 57 weeks and the other half survived for a longer period.) Twenty-eight percent of the patients were alive two years after the start of accelerated fractionation radiation therapy. The major side effects of the treatment were loss of hair and inflammation of the scalp. In addition to shortening the time necessary for treatment, the accelerated fractionation schedule seems to be well-tolerated and encouraging in its effectiveness. (Consumer Summary produced by Reliance Medical Information, Inc.)

Fractionation, Fractional distillation, Astrocytoma, Astrocytomas

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Prophylactic glutamine protects the intestinal mucosa from radiation injury

Article Abstract:

Among cancer patients, gastrointestinal problems are among the most common side effects caused by radiation treatment. In an experimental study using rats, researchers have shown that the amino acid glutamine seems to protect the intestinal lining from the effects of radiotherapy. The rats were fed a special diet; some received a glutamine-free diet, while others received a glutamine-rich diet. The animals then received a dose of X-ray of 1,000 cGy (a Gy, or Gary, is 1 joule of energy absorbed per kilogram of tissue). This dose is somewhat less than the dose used in many radiotherapeutic treatments of cancer. Microscopic examination of the intestines revealed that the rats who were deprived of glutamine prior to irradiation sustained greater intestinal damage than those who ate the glutamine-enriched food. Examination of the lymph node of the rats found bacteria in five of seven rats who did not receive the glutamine, compared with three of eight rats who did. The presence of bacteria in the abdominal lymph nodes is a sign that the integrity of the intestinal lining was breached. This apparent protective effect of glutamine may be a result of stimulating the proliferation of the crypt cells, which may lead to improved healing from radiation-induced damage. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Prevention, Radiation, Radiation injuries, Radiation effects, Glutamine, Intestinal mucosa

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