Neurologic Complications of Radiation Therapy

Radiation-induced nervous system toxicity remains a cause of morbidity in patients with cancer. Real advances in the design of safer radiation procedures have been counterbalanced by a wider use of combined radiotherapy-chemotherapy regimens, the development of radiosurgery, and the increasing number of long-term survivors. While classic radionecrosis have become less common, more subtle changes such as progressive cognitive dysfunction are increasingly reported after cranial radiotherapy (radiation-induced leukoencephalopathy) administered alone or in combination with chemotherapy. The most important and controversial complications of radiotherapy and combined treatments in the central nervous system and peripheral nervous system are reviewed here, including new diagnostic tools, practical management, and prevention.