Treatment of radiation-induced nervous system injury with heparin and warfarin

Michael Glantz, P. C. Burger, A. H. Friedman, R. A. Radtke, E. W. Massey, S. C. Schold

Research output: Contribution to journalArticle

239 Citations (Scopus)

Abstract

When radiation is used to treat nervous system cancer, exposure of adjacent normal nervous system tissue is unavoidable, and radiation-induced injury may occur. Acute injury is usually mild and transient, but late forms of radiation-induced nervous system injury are usually progressive and debilitating. Treatment with corticosteroids, often ineffective. We treated 11 patients with late radiation-induced nervous system injuries (eight with cerebral radionecrosis, one with a myelopathy, and two with plexopathies, all unresponsive to dexamethasone and prednisone) with full anticoagulation. Some recovery of function occurred in five of theeight patients with cerebral radionecrosis, and all the patients with myelopathy or plexopathy. Anticoagulation was continued for 3 to 6 months. In one patient with cerebral radionecrosis, symptoms recurred after discontinuation of anticoagulation and disappeared again after reinstitution of treatment. We hypothesize that anticoagulation may arrest and reverse smallvessel endothelial injury–the fundamental lesion of radiation necrosis-and produce clinical improvement in some patients.

Original languageEnglish (US)
Pages (from-to)2020-2027
Number of pages8
JournalNeurology
Volume44
Issue number11
StatePublished - Jan 1 1994

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Nervous System Trauma
Warfarin
Heparin
Radiation
Spinal Cord Diseases
Nervous System
Therapeutics
Nerve Tissue
Radiation Injuries
Recovery of Function
Prednisone
Dexamethasone
Adrenal Cortex Hormones
Necrosis
Wounds and Injuries
Neoplasms

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Glantz, M., Burger, P. C., Friedman, A. H., Radtke, R. A., Massey, E. W., & Schold, S. C. (1994). Treatment of radiation-induced nervous system injury with heparin and warfarin. Neurology, 44(11), 2020-2027.
Glantz, Michael ; Burger, P. C. ; Friedman, A. H. ; Radtke, R. A. ; Massey, E. W. ; Schold, S. C. / Treatment of radiation-induced nervous system injury with heparin and warfarin. In: Neurology. 1994 ; Vol. 44, No. 11. pp. 2020-2027.
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Glantz, M, Burger, PC, Friedman, AH, Radtke, RA, Massey, EW & Schold, SC 1994, 'Treatment of radiation-induced nervous system injury with heparin and warfarin', Neurology, vol. 44, no. 11, pp. 2020-2027.

Treatment of radiation-induced nervous system injury with heparin and warfarin. / Glantz, Michael; Burger, P. C.; Friedman, A. H.; Radtke, R. A.; Massey, E. W.; Schold, S. C.

In: Neurology, Vol. 44, No. 11, 01.01.1994, p. 2020-2027.

Research output: Contribution to journalArticle

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Glantz M, Burger PC, Friedman AH, Radtke RA, Massey EW, Schold SC. Treatment of radiation-induced nervous system injury with heparin and warfarin. Neurology. 1994 Jan 1;44(11):2020-2027.