Sequelae of treatments of CNS tumors

Jai Grewal MD (Dr. Grewal of the Long Island Brain Tumor Center at Neurological Surgery, PC, received research funding from Northwest Biotherapeutics and consulting fees from Novocure.)
Harpreet K Grewal MD (Dr. Grewal of JGMDPC in Roslyn, New York, has no relevant financial relationships to disclose; Dr. Grewal's spouse received research funding from Northwest Biotherapeutics and consulting fees from Novocure.)
Roger J Packer MD, editor. (Dr. Packer of George Washington University; Senior Vice President, Center for Neuroscience and Behavioral Medicine; and Gilbert Endowed Distinguished Professor in Neurofibromatosis and Director, Gilbert Neurofibromatosis Institute and Brain Tumor Institute, Children’s National Health System, has no relevant financial relationships to disclose.)
Originally released September 11, 2006; last updated January 27, 2014; expires January 27, 2017

This article includes discussion of sequelae of treatments of CNS tumors, sequelae of treatment of CNS tumors, sequelae of treatments of central nervous system tumors, and sequelae of treatment of central nervous system tumors. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Short- and long-term complications of treatments of brain tumors are poorly understood. As we make strides in control of primary disease, the chronic toxicity of treatments will need to be addressed. In this updated article, the authors discuss the various complications of brain tumor treatments (radiation, chemotherapy, corticosteroids, antiepileptic drugs) as well as preventative and supportive treatments.

Historical note and terminology

Tumors of the CNS are dreaded not only because of the high mortality rate associated with many CNS malignancies, but also because of the devastating sequelae of the tumor and tumor treatments. Profound neurocognitive and other adverse effects result from the tumor itself, as well as from radiotherapy, chemotherapy, corticosteroid therapy, secondary epilepsy, and antiepileptic drugs. Sequelae of therapy, especially radiotherapy, is often the limiting factor in the management of CNS malignancies. Neurocognitive sequelae of CNS malignancies have long been recognized in the pediatric population. Because adults with CNS tumors are surviving longer, cognitive sequelae are an increasingly recognized problem.

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