ABSTRACT
Las complicaciones de la radioterapia se pueden presentar de manera aguda, subaguda o retardada y son diferentes en sus manifestaciones, según afecten al cerebro, la médula espinal o los nervios periféricos. Se presentaron 2 pacientes que recibieron tratamiento con radioterapia y después de un año del proceder terapéutico desarrollaron manifestaciones clínicas e imaginológicas compatibles con una mielopatía posradiación. Ninguno ha tenido progresión de la enfermedad con el uso de los esteroides aplicados...
Complications of radiation therapy can occur in acute, subacute or delayed manner and they are different in manifestations, as they affect the brain, spinal cord or peripheral nerves. Two patients who were treated with radiotherapy were presented and after a year of therapeutic procedure, they developed clinical manifestations and imaging features consistent with a post-radiation myelopathy. None had disease progression with the use of steroids...
Subject(s)
Humans , Spinal Cord Diseases/complications , Spinal Cord Diseases/radiotherapy , Myelitis/diagnosis , Myelitis/prevention & control , Radiotherapy/adverse effects , Radiation RisksABSTRACT
Radiation myelopathy [RM] is known as a serious complication of head and neck radiation therapy. Furthermore, the radioprotective roles of melatonin have been investigated on different tissues. The aim of this study was to assess the radio protective effects of melatonin on biochemical, histopathological and clinical manifestations of RM in the rat cervical spinal cord. Four groups of rats were investigated as follows: The control group was treated with vehicle. The second group [melatonin only] was intraperitoneally injected with 100 mg/kg melatonin. The third group's [radiation] cervical spinal cord area was irradiated with 22 Gy cobalt-60 gamma-rays. The fourth group [melatonin plus irradiation] received 100 mg/kg melatonin intraperitoneally, and after 30 minutes their spinal cord area was irradiated with 22 Gy gamma radiation. Five animals from each group were randomly selected. 72 hours, 8 and 22 weeks after irradiation for analysis of malondialdehyde [MDA] and glutathione [GSH] levels, and underwent histopathological studies. The MDA levels in the irradiation group were significantly higher than in the control group [p < 0.001]. Furthermore, the GSH levels in this group were significantly lower than that of those in the control group [p < 0.001]. Administration of melatonin markedly reduced MDA [p < 0.001] and increased GSH [p < 0.05] levels in this group. Demyelination and clinical signs of myelopathy were decreased in the melatonin plus irradiation group in comparison to the irradiated group. Our study confirms the radioprotective effects of melatonin at early stages of biochemical, as well as late histological and clinical changes in the spinal cord
Subject(s)
Animals, Laboratory , Spinal Cord Diseases/radiotherapy , Radiotherapy/adverse effects , Malondialdehyde/analysis , Glutathione/analysis , Rats , Cervical Vertebrae , Spinal Cord , Radiation-Protective AgentsABSTRACT
A incidência de ossificação heterotópica (OH) nos pacientes adultos com lesão raquimedular é de aproximadamente 20 por cento. A OH costumater evolução benigna, mas pode causar redução da amplitude do movimento articular e dificultar o processo de reabilitação. Existem poucos estudos que mostram o uso da radioterapia no tratamento da OH em pacientes com lesão medular. O objetivo deste estudo éavaliar se há progressão da ossificação imatura em pacientes com lesão medular submetidos à radioterapia como tratamento primário. Foram selecionados os prontuários de pacientes da clínica de lesão medular da Associação de Assistência à Criança Deficiente (AACD)que apresentaram OH imatura e que receberam tratamento com radioterapia, sendo este o único tratamento em todos os casos. É um estudo tipo corte histórico. Para análise da evolução da ossificação foram utilizados como parâmetros a comparação da amplitude demovimento da articulação afetada, medida com goniômetro, e a imagem radiográfica, graduando a ossificação de acordo com a classificação proposta por Brooker et al. O tempo de seguimento do estudo foi de 23,3 meses. Quatorze das 15 articulações estudadas não apresentaram piora clínica ou progressão da ossificação heterotópica. Não foram observados efeitos colaterais à radioterapia. Concluímos que os pacientes tratados precocemente com radioterapia não apresentaram progressão significativa da OH e que a radioterapia é um método seguro e de fácil aplicação.