The limiting factor in the clinical application of radiation for the treatment of brain tumours is its effect on the normal structures that must be included in the irradiated volume. A risk of radiation-induced complications is a necessary price of tumour control. The size of the risk of complications that the radiation oncologist is prepared to accept on behalf of the patient depends on the clinical situation, and in particular on the morphology of the tumour. The radiation oncologist must know as accurately as possible how the total dose should be varied with overall time, fractionation and volume in order to achieve an adequate result. Several authors have attempted to establish the radiation tolerance of the brain by constructing log dose — log time plots using documented cases of cerebral radionecrosis. Moreover a substantial amount of work has been carried out with experimental models of radiation-induced injury to the central nervous system. As a result, several tolerance formulas have been drawn up. Tolerance formulas are important because there are many experiments going on with dose and fractionation. The purpose of this chapter is to review clinical and experimental literature on the hazards associated with irradiation of the brain.
KeywordsWhite Matter Malignant Glioma Radiation Damage Cerebral Metastasis Brain Necrosis
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