000			03229nam a22003857a 4500
008			201231s20202020 xxu||||| |||| 00| 0 eng d
022			_a1531-7129
024			_a00129492-900000000-95841 [pii]
024			_a10.1097/MAO.0000000000002977 [doi]
040			_aOvid MEDLINE(R)
099			_a33351559
245			_aIncreased Radiosurgery Toxicity Associated With Treatment of Vestibular Schwannoma in Multiple Sclerosis.
251			_aOtology & Neurotology. Publish Ahead of Print, 2020 Dec 21.
252			_aOtol Neurotol. Publish Ahead of Print, 2020 Dec 21.
253			_aOtology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
260			_c2020
260			_fFY2021
265			_saheadofprint
266			_d2020-12-31
501			_aAvailable online from MWHC library: 2001 - present
520			_aCONCLUSION: Treatment options of SRS and surgery for VS should be carefully considered as patients with known MS may be at increased risk for radiation-induced damage following SRS to the CNS. Thoughtful radiosurgical planning and dosing accounting for this inherent risk is essential for managing patients with MS and VS. Copyright (c) 2020 by Otology & Neurotology, Inc. Image copyright (c) 2010 Wolters Kluwer Health/Anatomical Chart Company.
520			_aMAIN OUTCOME MEASURE: Risk of radiation-induced damage following SRS to the CNS, including radiation type and dose, toxicity, and time to symptom onset, in patients with MS.
520			_aOBJECTIVE: Explore the risk of radiation-induced neurotoxicity in patients with multiple sclerosis (MS) treated with stereotactic radiosurgery (SRS) and better understand the pathophysiology of radiation-induced injury in the central nervous system (CNS).
520			_aPATIENTS/INTERVENTION: We present the clinical course and magnetic resonance imaging (MRI) findings of a 52-year-old woman with a history of relapsing remitting MS, who developed radiation-induced neurotoxicity following CyberKnife SRS (25 Gy in five fractions) for a left-sided vestibular schwannoma (VS).
520			_aRESULTS: Our patient developed increased imbalance (grade 2 toxicity) 3 months following CyberKnife SRS. Brain MRI showed new fluid-attenuated inversion recovery (FLAIR) hyperintensity in the pons and cerebellum. Neurotoxicity from SRS is rare. However, our literature review showed that 19 patients with MS who underwent intracranial radiation therapy sustained radiation-induced toxicity. The potential mechanisms for increased toxicity in MS could be due to a combination of demyelination, inflammatory, and/or vascular changes. Efficacy of treatments including steroids, bevacizumab, and hyperbaric oxygen therapy is currently unknown.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Washington Hospital Center
656			_aRadiation Oncology
657			_aJournal Article
700			_aForsthoefel, Matthew
790			_aCollins S, Forsthoefel M, Kim HJ, Wallerius K
856			_uhttps://dx.doi.org/10.1097/MAO.0000000000002977 _zhttps://dx.doi.org/10.1097/MAO.0000000000002977
942			_cART _dArticle
999			_c5924 _d5924