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Radiation myelitis

MedGen UID:
1638362
•Concept ID:
C4706614
•
Disease or Syndrome
Synonyms: delayed radiation myelopathy; Myelitis caused by ionizing radiation following radiotherapy; radiation myelitis; radiation myelopathy
SNOMED CT: Radiation myelitis (763869003); Myelitis caused by ionizing radiation following radiotherapy (763869003)
 
Monarch Initiative: MONDO:0019529
Orphanet: ORPHA90021

Definition

A rare neurological disease characterized by the development of paresthesia as well as in severe cases progressive paresis and paralysis following irradiation of tumors in which the spinal cord is included within the radiation field. Symptoms may develop months or years after radiation therapy was administered. [from SNOMEDCT_US]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVRadiation myelitis

Professional guidelines

PubMed

Radiosurgery for Treatment of Renal Cell Metastases to Spine: A Systematic Review of the Literature.
Smith BW, Joseph JR, Saadeh YS, La Marca F, Szerlip NJ, Schermerhorn TC, Spratt DE, Younge KC, Park P
World Neurosurg 2018 Jan;109:e502-e509. Epub 2017 Oct 13 doi: 10.1016/j.wneu.2017.10.011. PMID: 29038086
Differential diagnosis of T2 hyperintense spinal cord lesions: part B.
Bou-Haidar P, Peduto AJ, Karunaratne N
J Med Imaging Radiat Oncol 2009 Apr;53(2):152-9. doi: 10.1111/j.1754-9485.2009.02067.x. PMID: 19527360
Image-guided helical Tomotherapy for treatment of spine tumors.
Kim B, Soisson ET, Duma C, Chen P, Hafer R, Cox C, Cubellis J, Minion A, Plunkett M, Mackintosh R
Clin Neurol Neurosurg 2008 Apr;110(4):357-62. Epub 2008 Mar 4 doi: 10.1016/j.clineuro.2007.12.024. PMID: 18295971

Recent clinical studies

Etiology

Radiation-Induced Myelitis: Initial and Follow-Up MRI and Clinical Features in Patients at a Single Tertiary Care Institution during 20 Years.
Khan M, Ambady P, Kimbrough D, Shoemaker T, Terezakis S, Blakeley J, Newsome SD, Izbudak I
AJNR Am J Neuroradiol 2018 Aug;39(8):1576-1581. Epub 2018 May 17 doi: 10.3174/ajnr.A5671. PMID: 29773568Free PMC Article
Experience with CHART.
Saunders MI, Dische S, Grosch EJ, Fermont DC, Ashford RF, Maher EJ, Makepeace AR
Int J Radiat Oncol Biol Phys 1991 Aug;21(3):871-8. doi: 10.1016/0360-3016(91)90722-g. PMID: 1651312
Radiation myelitis and survival in the radiotherapy of lung cancer.
Dische S, Warburton MF, Saunders MI
Int J Radiat Oncol Biol Phys 1988 Jul;15(1):75-81. doi: 10.1016/0360-3016(88)90349-5. PMID: 3391828
Radiation myelopathy: a review.
Goldwein JW
Med Pediatr Oncol 1987;15(2):89-95. doi: 10.1002/mpo.2950150208. PMID: 3295502
Chronic radiation myelitis.
Fitzgerald RH Jr, Marks RD Jr, Wallace KM
Radiology 1982 Aug;144(3):609-12. doi: 10.1148/radiology.144.3.6808557. PMID: 6808557

Diagnosis

Neuroimaging of Spinal Cord and Cauda Equina Disorders.
Diehn FE, Krecke KN
Continuum (Minneap Minn) 2021 Feb 1;27(1):225-263. doi: 10.1212/CON.0000000000000926. PMID: 33522744
Neoplastic myelopathies.
Chamberlain MC
Continuum (Minneap Minn) 2015 Feb;21(1 Spinal Cord Disorders):132-45. doi: 10.1212/01.CON.0000461089.02113.1b. PMID: 25651222
Differential diagnosis of T2 hyperintense spinal cord lesions: part B.
Bou-Haidar P, Peduto AJ, Karunaratne N
J Med Imaging Radiat Oncol 2009 Apr;53(2):152-9. doi: 10.1111/j.1754-9485.2009.02067.x. PMID: 19527360
Radiation myelopathy.
Rampling R, Symonds P
Curr Opin Neurol 1998 Dec;11(6):627-32. doi: 10.1097/00019052-199812000-00003. PMID: 9870128
Radiation myelopathy: a review.
Goldwein JW
Med Pediatr Oncol 1987;15(2):89-95. doi: 10.1002/mpo.2950150208. PMID: 3295502

Therapy

Radiation myelitis after pembrolizumab administration, with favorable clinical evolution and safe rechallenge: a case report and review of the literature.
Carausu M, Beddok A, Langer A, Girard N, Bidard FC, Massiani MA, Ricard D, Cabel L
J Immunother Cancer 2019 Nov 21;7(1):317. doi: 10.1186/s40425-019-0803-x. PMID: 31753021Free PMC Article
Neoplastic myelopathies.
Chamberlain MC
Continuum (Minneap Minn) 2015 Feb;21(1 Spinal Cord Disorders):132-45. doi: 10.1212/01.CON.0000461089.02113.1b. PMID: 25651222
Accelerated treatment and radiation myelitis.
Dische S
Radiother Oncol 1991 Jan;20(1):1-2. doi: 10.1016/0167-8140(91)90104-o. PMID: 1902318
Radiation myelopathy: a review.
Goldwein JW
Med Pediatr Oncol 1987;15(2):89-95. doi: 10.1002/mpo.2950150208. PMID: 3295502
Chronic radiation myelitis.
Fitzgerald RH Jr, Marks RD Jr, Wallace KM
Radiology 1982 Aug;144(3):609-12. doi: 10.1148/radiology.144.3.6808557. PMID: 6808557

Prognosis

Radiation-Induced Myelitis: Initial and Follow-Up MRI and Clinical Features in Patients at a Single Tertiary Care Institution during 20 Years.
Khan M, Ambady P, Kimbrough D, Shoemaker T, Terezakis S, Blakeley J, Newsome SD, Izbudak I
AJNR Am J Neuroradiol 2018 Aug;39(8):1576-1581. Epub 2018 May 17 doi: 10.3174/ajnr.A5671. PMID: 29773568Free PMC Article
A Detailed Dosimetric Analysis of Spinal Cord Tolerance in High-Dose Spine Radiosurgery.
Katsoulakis E, Jackson A, Cox B, Lovelock M, Yamada Y
Int J Radiat Oncol Biol Phys 2017 Nov 1;99(3):598-607. doi: 10.1016/j.ijrobp.2017.05.053. PMID: 29280455
Intramedullary spinal cord astrocytomas in children.
Townsend N, Handler M, Fleitz J, Foreman N
Pediatr Blood Cancer 2004 Nov;43(6):629-32. doi: 10.1002/pbc.20082. PMID: 15390309
Radiation myelitis and survival in the radiotherapy of lung cancer.
Dische S, Warburton MF, Saunders MI
Int J Radiat Oncol Biol Phys 1988 Jul;15(1):75-81. doi: 10.1016/0360-3016(88)90349-5. PMID: 3391828
Chronic radiation myelitis.
Fitzgerald RH Jr, Marks RD Jr, Wallace KM
Radiology 1982 Aug;144(3):609-12. doi: 10.1148/radiology.144.3.6808557. PMID: 6808557

Clinical prediction guides

A Detailed Dosimetric Analysis of Spinal Cord Tolerance in High-Dose Spine Radiosurgery.
Katsoulakis E, Jackson A, Cox B, Lovelock M, Yamada Y
Int J Radiat Oncol Biol Phys 2017 Nov 1;99(3):598-607. doi: 10.1016/j.ijrobp.2017.05.053. PMID: 29280455
Clinical outcome and morbidity in pediatric patients with nasopharyngeal cancer treated with chemoradiotherapy.
Sahai P, Mohanti BK, Sharma A, Thakar A, Bhasker S, Kakkar A, Sharma MC, Upadhyay AD
Pediatr Blood Cancer 2017 Feb;64(2):259-266. Epub 2016 Sep 29 doi: 10.1002/pbc.26240. PMID: 27681956
Variation in radiation sensitivity and repair kinetics in different parts of the spinal cord.
Adamus-Górka M, Brahme A, Mavroidis P, Lind BK
Acta Oncol 2008;47(5):928-36. doi: 10.1080/02841860701864668. PMID: 18568487
Non-compressive myelopathy: clinical and radiological study.
Prabhakar S, Syal P, Singh P, Lal V, Khandelwal N, Das CP
Neurol India 1999 Dec;47(4):294-9. PMID: 10625902
Twice-a-day radiation therapy for cancer of the head and neck.
Wang CC, Blitzer PH, Suit HD
Cancer 1985 May 1;55(9 Suppl):2100-4. doi: 10.1002/1097-0142(19850501)55:9+<2100::aid-cncr2820551411>3.0.co;2-a. PMID: 3919925

Recent systematic reviews

Radiosurgery for Treatment of Renal Cell Metastases to Spine: A Systematic Review of the Literature.
Smith BW, Joseph JR, Saadeh YS, La Marca F, Szerlip NJ, Schermerhorn TC, Spratt DE, Younge KC, Park P
World Neurosurg 2018 Jan;109:e502-e509. Epub 2017 Oct 13 doi: 10.1016/j.wneu.2017.10.011. PMID: 29038086
Palliative radiotherapy regimens for patients with thoracic symptoms from non-small cell lung cancer.
Stevens R, Macbeth F, Toy E, Coles B, Lester JF
Cochrane Database Syst Rev 2015 Jan 14;1(1):CD002143. doi: 10.1002/14651858.CD002143.pub4. PMID: 25586198Free PMC Article
Palliative radiotherapy regimens for non-small cell lung cancer.
Lester JF, Macbeth FR, Toy E, Coles B
Cochrane Database Syst Rev 2006 Oct 18;(4):CD002143. doi: 10.1002/14651858.CD002143.pub2. PMID: 17054152

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