Bilateral posterior RION after concomitant radiochemotherapy with temozolomide in a patient with glioblastoma multiforme: a case report

BMC Cancer

Case Report

Claudius Bartels¹  Imke Galazky¹  Ines Brueggemann¹  Stefanie Schreiber¹  Erck Elolf²  Vanessa Prox-Vagedes³  Guenther Gademann⁴ 

[1] Department of Neurology, Otto-von-Guericke University, Leipziger Straße 44, 39120, Magdeburg, Germany;Department of Neuroradiology, Otto-von-Guericke University, Leipziger Straße 44, 39120, Magdeburg, Germany;Department of Psychiatry, Social Psychiatry und Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany;Department of Radiation Therapy, Otto-von-Guericke University, Leipziger Straße 44, 39120, Magdeburg, Germany;

关键词: Single Photon Emission Compute Tomography;    Optic Nerve;    Temozolomide;    Glioblastoma Multiforme;    Optic Neuropathy;   

DOI  :  10.1186/1471-2407-10-520

 received in 2010-04-16, accepted in 2010-10-01,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundRadiation induced optic neuropathy (RION) is a rare but severe consequence of radiation therapy that is associated with adjuvant chemotherapy, specifically therapy with vincristine or nitrosoureas. However, there is very little evidence regarding the occurrence of RION after concomitant radiochemotherapy with temozolomide.Case PresentationThe case of a 63 year old woman with glioblastoma multiforme and concomitant radiochemotherapy with temozolomide is described. Due to a slight depressive episode the patient also took hypericum perforatum. Five months after cessation of fractionated radiation and adjuvant chemotherapy with temozolomide (cumulative dose of 11040 mg) the patient developed bilateral amaurosis due to RION. Tumor regrowth was excluded by magnetic resonance imaging. After the application of gadolinium a pathognomonic contrast enhancement of both prechiasmatic optic nerves could be observed.ConclusionsIn this patient, the occurrence of RION may have been the result of radiosensitization by temozolomide, which could have been strengthened by hypericin. Consequently, physicians should avoid a concomitant application of hypericum perforatum and radiochemotherapy.

【 授权许可】

CC BY   
© Schreiber et al; licensee BioMed Central Ltd. 2010