1/11. collagen vascular diseases and radiation therapy: a critical review.PURPOSE: Although many oncologists have the impression that patients with collagen vascular disease tolerate radiotherapy less well than other patients, until now this was never described in a review article. methods AND RESULTS: The principal objective was to determine whether patients with collagen vascular diseases have a greater risk of severe radiation therapy complications, than those without a collagen vascular disease. However, most of the publications found on this topic are short anecdotal case reports of patients with increased toxicity after radiation. Consequently, the true incidence of these side effects is unknown. CONCLUSIONS: Unless further studies on this subject are reported, each radiation oncologist should be cautious in treating these patients.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/11. A newly recognized syndrome--radiation-related bronchiolitis obliterans and organizing pneumonia. A case report and literature review.bronchiolitis obliterans and organizing pneumonia (BOOP) is a syndrome that has been associated with a variety of underlying disorders, including infection, collagen vascular diseases and toxic fume inhalation. Rarely, however, BOOP has been associated with radiation- or chemotherapy-induced pulmonary toxicity. Over the past 3 years, several case series have reported BOOP in the unique setting of radiation in breast cancer patients. This study describes our experience with this newly recognized syndrome and a review of the English-language literature on this syndrome.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
3/11. radiation-induced enteropathy.The incidence of chronic radiation enteritis appears to have risen in recent years due to the increasing utilization of radiotherapy for abdominal and pelvic malignancies. The etiology, pathogenesis, and management of radiation enteritis are discussed. Two case reports exemplify the progressive nature of the disease. Case 1 demonstrates the classical picture of multiple exacerbations and remissions of partial small bowel obstruction and the eventual need for surgical management ten years after radiation therapy. Case 2 presents the more severe sequelae of an acute perforation with a 14-yr latency period. Predisposing factors in the progression of radiation injury include excessive radiation, underlying cardiovascular disease, fixation of the bowel, and an asthenic habitus. In both cases, radiation injury was localized to a discrete segment of bowel; therefore, resection with a primary end-to-end anastomosis was performed. In addition, diseased bowel was eliminated and, therefore, would not cause further complications such as intractable bleeding or fistula formation. The review focuses on current knowledge which may be applied to the treatment and prevention of radiation enteritis.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
4/11. Intracranial atherosclerosis following radiotherapy.We describe a case of severe intracranial atherosclerosis in a young man who had received therapeutic radiation for a presumed brain neoplasm. Since there was no evidence of vascular disease outside the radiation ports, we speculate that accelerated atherosclerosis was induced by radiation and that hyperlipidemia may have predisposed him to this effect.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
5/11. Management of radiation-induced accelerated carotid atherosclerosis.patients with long survival following cervical irradiation are at risk for accelerated carotid atherosclerosis. The neurologic presentation in these patients mimics naturally occurring atheromatous disease, but patients often present at younger ages and with less concurrent coronary or systemic vascular disease. hypercholesterolemia also contributes to this accelerated arteriosclerosis. Angiographic findings in this disorder include disproportionate involvement of the distal common carotid artery and unusually long carotid lesions. Pathologic findings include destruction of the internal elastic lamina and replacement of the normal intima and media with fibrous tissue. This article describes two surgical patients with radiation-induced accelerated carotid atherosclerosis who typify the presentation and characteristics of this disease.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
6/11. The moyamoya syndrome associated with irradiation of an optic glioma in children: report of two cases and review of the literature.We report two cases of the moyamoya syndrome which became clinically apparent after irradiation of an optic glioma during childhood. A summary of 14 cases of this syndrome following irradiation of intracranial tumors is also presented. Nine of these cases were optic gliomas; five were found in children with neurofibromatosis, another disorder that has a strong association with the moyamoya syndrome. The effectiveness of irradiation of optic gliomas in childhood is not definitely established. The possibility of inducing serious vascular disease is a further reason for caution when considering irradiating these tumors.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
7/11. Cerebral embolism in cancer patients.Sudden neurological deterioration suggesting embolism in a patient with a history of cancer should alert the physician to the possibility of a non-metastatic, and therefore potentially reversible, cause of cerebral embolism before cerebral metastasis is implicated. During a four year period, we have observed eight cases of acute cerebral embolism among 3000 cancer patients seen in a department of medical oncology. Five patients had features post mortem of non-bacterial thrombotic endocarditis, and in one, the diagnosis had been made antemortem, but treatment with heparin did not prevent further emboli. Two patients had radiation related carotid vascular disease, and one patient post lymphangiographic embolism. The literature reporting these uncommon causes of cerebral embolism is reviewed. Post-lymphangiographic embolism carries a uniformly good prognosis. In selected cases of post-irradiation cerebral embolism, surgical intervention may prevent a neurological catastrophe. Non-bacterial thrombotic endocarditis and mucin embolism are of uncertain aetiology and natural history; long-term survival is uncommon, and treatment does not appear to influence the clinical course or outcome.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
8/11. Extensive corporeal fibrosis after penile irradiation.A potent man with early signs and symptoms of Peyronie's disease 3 months in duration received 1,200 rad of external beam radiation to the penis and presented 5 months later with impotence. physical examination revealed diffusely woody indurated corporeal tissue. Nocturnal penile tumescence testing was abnormal and pharmaco-cavernosometry demonstrated diffuse corporeal veno-occlusive dysfunction. Treatment by penile injections was unsuccessful. During penile prosthesis implantation bilateral rubbery erectile tissue was encountered, requiring extensive bilateral corporotomy and sharp corporeal tissue excision for prosthesis insertion. Histological analysis of excised corporeal tissue demonstrated extensive corporeal fibrosis and arterial vasculopathy. Computer assisted color histomorphometry revealed that the mean percentage of trabecular smooth muscle area to total erectile tissue area was 26.5 /- 15.8 (normal 40 to 52%). Immunohistochemical staining with desmin confirmed extensive fibrosis. The most likely explanation for severe corporeal fibrosis is penile irradiation. The hypothesized mechanism of radiation associated fibrosis is ionizing injury to the endothelial cells of the lacunar spaces and cavernous/helicine arteries, which induced irreversible corporeal extracellular matrix structural changes. Penile irradiation, like vascular disease and priapism, is a potential cause of diffuse corporeal fibrosis.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
9/11. Acute and late reactions to radiation therapy in patients with collagen vascular diseases.BACKGROUND. A commonly held belief is that patients with collagen vascular diseases (CVD) have a greater risk of radiation therapy complications than patients without CVD. This impression is based on anecdotal reports, however. methods. A group of 61 patients with CVD were compared with a matched control group of 61 patients without CVD. The CVD group included 39 patients with rheumatoid arthritis (RA), 13 with systemic lupus erythematosus (SLE), 4 with systemic sclerosis (scleroderma) (SSc), 4 with dermatomyositis, and 1 with polymyositis. The control group was matched with respect to age, sex, tumor site and histologic characteristics, treatment aim, general treatment method, radiation therapy technique, site irradiated, radiation dose, date of treatment, and follow-up. RESULTS. overall, there was no significant difference between the CVD and control groups in terms of acute (11% versus 7%, respectively) or late complications (10% versus 7%, respectively). This was also true when only patients who were treated definitively were considered. Furthermore, none of the patients treated palliatively had complications. Three patients in the CVD group had fatal complications, compared with none in the control group. RA was associated with a slight increase in late complications in the definitively treated patients, whereas SLE was associated with a slight increase in acute reactions. No significant acute or late reactions were observed in the patients with SSc, dermatomyositis, or polymyositis. CONCLUSIONS. In general, these differences are less than expected and not statistically significant. Consequently, from these data, the authors could not show a significant increase in radiation therapy complications for patients with CVD.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
10/11. Progressive cerebral occlusive disease after hypothalamic astrocytoma radiation therapy.An 18 year-old woman received radiation therapy for hypothalamic astrocytoma at the age of 11 years. She developed progressive cerebral occlusive vascular disease with moyamoya vessels formation in both carotid systems. Apart from diabetes mellitus, she had no other risk factors for occlusive cerebrovascular disease. The site of occlusion was confined to the field of radiation and the development of moyamoya vessels strongly suggestive of a radiation-induced cause. radiation therapy around the sella and parasellar region appears to be the most common risk factor for this vasculopathy. Progressive irradiation-induced cerebral vasculopathy is due to accelerated atherosclerosis.- - - - - - - - - - ranking = 0.28571428571429keywords = vascular disease (Clic here for more details about this article) |
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