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Oncologic Critical Care pp 1547–1554Cite as

Radiation Therapy Complications Leading to Critical Illness

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Abstract

Radiation therapy represents an important and effective tool in the management of oncologic emergencies, such as spinal cord compression, uncontrolled pain or bleeding, and superior vena cava syndrome. Radiation acts by inducing DNA damage within cancer cells, thereby reducing or eliminating metastatic lesions that are the source of the aforementioned emergent situations. Recent years have seen the advancement of highly conformal radiation techniques which enable better sparing of surrounding normal tissues, and there are several modalities of radiation therapy that are routinely employed in the critical care setting. This chapter will discuss the role of radiation therapy in oncologic emergencies.

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References

  1. Baskar R, Dai J, Wenlong N, et al. Biological response of cancer cells to radiation treatment. Front Mol Biosci. 2014;1:24. https://doi.org/10.3389/fmolb.2014.00024.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Bentzen SM. Preventing or reducing late side effects of radiation therapy: radiobiology meets molecular pathology. Nat Rev Cancer. 2006;6:702–13. https://doi.org/10.1038/nrc1950.

    Article  CAS  PubMed  Google Scholar 

  3. Bernier J, Hall EJ, Giaccia A. Timeline: radiation oncology: a century of achievements. Nat Rev Cancer. 2004;4:737–47. https://doi.org/10.1038/nrc1451.

    Article  CAS  PubMed  Google Scholar 

  4. Brown PD, Pugh S, Laack NN, et al. Memantine for the prevention of cognitive dysfunction in patients receiving whole-brain radiotherapy: a randomized, double-blind, placebo-controlled trial. Neuro-Oncol. 2013;15:1429–37. https://doi.org/10.1093/neuonc/not114.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Brown PD, Ballman KV, Cerhan JH, et al. Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTG N107C/CEC·3): a multicentre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18:1049–60. https://doi.org/10.1016/S1470-2045(17)30441-2.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Byrne TN. Spinal cord compression from epidural metastases. N Engl J Med. 1992;327:614–9. https://doi.org/10.1056/NEJM199208273270907.

    Article  CAS  PubMed  Google Scholar 

  7. Chow E, Harris K, Fan G, et al. Palliative radiotherapy trials for bone metastases: a systematic review. J Clin Oncol. 2007;25:1423–36. https://doi.org/10.1200/JCO.2006.09.5281.

    Article  PubMed  Google Scholar 

  8. Chow E, Meyer RM, Ding K, et al. Dexamethasone in the prophylaxis of radiation-induced pain flare after palliative radiotherapy for bone metastases: a double-blind, randomised placebo-controlled, phase 3 trial. Lancet Oncol. 2015;16:1463–72. https://doi.org/10.1016/S1470-2045(15)00199-0.

    Article  CAS  PubMed  Google Scholar 

  9. Citrin DE. Recent developments in radiotherapy. N Engl J Med. 2017;377:1065–75. https://doi.org/10.1056/NEJMra1608986.

    Article  CAS  PubMed  Google Scholar 

  10. Cole JS, Patchell RA. Metastatic epidural spinal cord compression. Lancet Neurol. 2008;7:459–66. https://doi.org/10.1016/S1474-4422(08)70089-9.

    Article  PubMed  Google Scholar 

  11. Delaney G, Jacob S, Featherstone C, Barton M. The role of radiotherapy in cancer treatment: estimating optimal utilization from a review of evidence-based clinical guidelines. Cancer. 2005;104:1129–37. https://doi.org/10.1002/cncr.21324.

    Article  PubMed  Google Scholar 

  12. Ganeshan A, Hon LQ, Warakaulle DR, et al. Superior vena caval stenting for SVC obstruction: current status. Eur J Radiol. 2009;71:343–9. https://doi.org/10.1016/j.ejrad.2008.04.014.

    Article  PubMed  Google Scholar 

  13. Gilbert RW, Kim JH, Posner JB. Epidural spinal cord compression from metastatic tumor: diagnosis and treatment. Ann Neurol. 1978;3:40–51. https://doi.org/10.1002/ana.410030107.

    Article  CAS  PubMed  Google Scholar 

  14. Gondi V, Pugh SL, Tome WA, et al. Preservation of memory with conformal avoidance of the hippocampal neural stem-cell compartment during whole-brain radiotherapy for brain metastases (RTOG 0933): a phase II multi-institutional trial. J Clin Oncol. 2014;32:3810–6. https://doi.org/10.1200/JCO.2014.57.2909.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Khan M, Ambady P, Kimbrough D, et al. Radiation-induced myelitis: initial and follow-up MRI and clinical features in patients at a single tertiary care institution during 20 years. AJNR Am J Neuroradiol. 2018; https://doi.org/10.3174/ajnr.A5671.

  16. Kwok Y, DeYoung C, Garofalo M, et al. Radiation oncology emergencies. Hematol Oncol Clin North Am. 2006;20:505–22. https://doi.org/10.1016/j.hoc.2006.01.001.

    Article  PubMed  Google Scholar 

  17. Lewis MA, Hendrickson AW, Moynihan TJ. Oncologic emergencies: pathophysiology, presentation, diagnosis, and treatment. CA Cancer J Clin. n/a–n/a. 2011; https://doi.org/10.3322/caac.20124.

  18. Lin X, DeAngelis LM. Treatment of brain metastases. J Clin Oncol. 2015;33:3475–84. https://doi.org/10.1200/JCO.2015.60.9503.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Loblaw DA, Laperriere NJ. Emergency treatment of malignant extradural spinal cord compression: an evidence-based guideline. J Clin Oncol. 1998;16:1613–24. https://doi.org/10.1200/JCO.1998.16.4.1613.

    Article  CAS  PubMed  Google Scholar 

  20. Loughrey GJ, Collins CD, Todd SM, et al. Magnetic resonance imaging in the management of suspected spinal canal disease in patients with known malignancy. Clin Radiol. 2000;55:849–55. https://doi.org/10.1053/crad.2000.0547.

    Article  CAS  PubMed  Google Scholar 

  21. Lutz S, Berk L, Chang E, et al. Palliative radiotherapy for bone metastases: an ASTRO evidence-based guideline. Int J Radiat Oncol. 2011;79:965–76. https://doi.org/10.1016/j.ijrobp.2010.11.026.

    Article  Google Scholar 

  22. Lutz S, Balboni T, Jones J, et al. Palliative radiation therapy for bone metastases: update of an ASTRO evidence-based guideline. Pract Radiat Oncol. 2017;7:4–12. https://doi.org/10.1016/j.prro.2016.08.001.

    Article  PubMed  Google Scholar 

  23. Mahajan A, Ahmed S, McAleer MF, et al. Post-operative stereotactic radiosurgery versus observation for completely resected brain metastases: a single-centre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18:1040–8. https://doi.org/10.1016/S1470-2045(17)30414-X.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Patchell RA, Tibbs PA, Walsh JW, et al. A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med. 1990;322:494–500. https://doi.org/10.1056/NEJM199002223220802.

    Article  CAS  PubMed  Google Scholar 

  25. Patchell RA, Tibbs PA, Regine WF, et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet. 2005;366:643–8. https://doi.org/10.1016/S0140-6736(05)66954-1.

    Article  PubMed  Google Scholar 

  26. Rades D, Fehlauer F, Schulte R, et al. Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression. J Clin Oncol. 2006;24:3388–93. https://doi.org/10.1200/JCO.2005.05.0542.

    Article  PubMed  Google Scholar 

  27. Rowell NP, Gleeson FV. Steroids, radiotherapy, chemotherapy and stents for superior vena caval obstruction in carcinoma of the bronchus: a systematic review. Clin Oncol R Coll Radiol G B. 2002;14:338–51.

    Article  CAS  Google Scholar 

  28. Ryken TC, McDermott M, Robinson PD, et al. The role of steroids in the management of brain metastases: a systematic review and evidence-based clinical practice guideline. J Neuro-Oncol. 2010;96:103–14. https://doi.org/10.1007/s11060-009-0057-4.

    Article  CAS  Google Scholar 

  29. Schiff D, O’Neill BP, Wang CH, O’Fallon JR. Neuroimaging and treatment implications of patients with multiple epidural spinal metastases. Cancer. 1998;83:1593–601.

    Article  CAS  PubMed  Google Scholar 

  30. Shaw E, Scott C, Souhami L, et al. Radiosurgery for the treatment of previously irradiated recurrent primary brain tumors and brain metastases: initial report of radiation therapy oncology group protocol (90-05). Int J Radiat Oncol Biol Phys. 1996;34:647–54.

    Article  CAS  PubMed  Google Scholar 

  31. Sorensen S, Helweg-Larsen S, Mouridsen H, Hansen HH. Effect of high-dose dexamethasone in carcinomatous metastatic spinal cord compression treated with radiotherapy: a randomised trial. Eur J Cancer. 1994;30A:22–7.

    Article  CAS  PubMed  Google Scholar 

  32. Tsao MN, Xu W, Wong RK, et al. Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases. Cochrane Database Syst Rev. 2018;1:CD003869. https://doi.org/10.1002/14651858.CD003869.pub4.

    Article  PubMed  Google Scholar 

  33. van der Sande JJ, Kroger R, Boogerd W. Multiple spinal epidural metastases; an unexpectedly frequent finding. J Neurol Neurosurg Psychiatry. 1990;53:1001–3.

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Radiation Oncology, UT MD Anderson Cancer Center, Houston, TX, USA

    Shalini Moningi & Geoffrey V. Martin

  2. The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Jay P. Reddy

Authors
  1. Shalini Moningi
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  2. Geoffrey V. Martin
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  3. Jay P. Reddy
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Corresponding author

Correspondence to Jay P. Reddy .

Editor information

Editors and Affiliations

  1. Department of Critical Care and Respiratory Care, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Joseph L. Nates

  2. Division of Anesthesiology, Critical Care and Pain Medicine, Department of Critical Care and Respiratory Care, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Kristen J. Price

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Moningi, S., Martin, G.V., Reddy, J.P. (2020). Radiation Therapy Complications Leading to Critical Illness. In: Nates, J., Price, K. (eds) Oncologic Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-74588-6_146

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  • DOI: https://doi.org/10.1007/978-3-319-74588-6_146

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74587-9

  • Online ISBN: 978-3-319-74588-6

  • eBook Packages: MedicineReference Module Medicine

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