Lee Y Y, Nauert C, Glass J P
Cancer. 1986 Apr 15;57(8):1473-82. doi: 10.1002/1097-0142(19860415)57:8<1473::aid-cncr2820570807>3.0.co;2-b.
Forty cancer patients with bilateral diffuse cerebral white matter hypodensities on computerized tomography (CT) scan were reviewed. Brain irradiation and/or chemotherapy were considered responsible for the CT abnormalities in all patients but one, whose changes were presumably due to demyelination related to the aging process. Among these 39 patients, 7 had clinical symptoms of leukoencephalopathy. Two patients had acute transient leukoencephalopathy, and one of them experienced permanent neurologic changes after continuing treatment. Six additional patients had delayed leukoencephalopathy. The interval between whole-brain irradiation (WBXRT) alone and the CT detection of white matter hypodensities was almost always longer than 1 year. This interval was shortened to less than 1 year in a significant number of patients when WBXRT was followed by various chemotherapeutic protocols. More importantly, there was an increased incidence of clinical leukoencephalopathy. A higher incidence of clinical leukoencephalopathy in patients receiving intracarotid chemotherapy in the treatment of brain tumors and in patients receiving combination chemotherapy for central nervous system relapse of adult leukemia suggests a need for further investigation.
对40例计算机断层扫描（CT）显示双侧弥漫性脑白质密度减低的癌症患者进行了回顾性研究。除1例患者外，所有患者的CT异常均被认为与脑照射和/或化疗有关，该例患者的改变可能是由于与衰老过程相关的脱髓鞘所致。在这39例患者中，7例有白质脑病的临床症状。2例患者患有急性短暂性白质脑病，其中1例在继续治疗后出现永久性神经功能改变。另外6例患者患有迟发性白质脑病。单纯全脑照射（WBXRT）与CT检测到白质密度减低之间的间隔几乎总是超过1年。当WBXRT后采用各种化疗方案时，相当数量患者的这一间隔缩短至不到1年。更重要的是，临床白质脑病的发生率增加。在脑肿瘤治疗中接受颈内动脉化疗的患者以及在成人白血病中枢神经系统复发接受联合化疗的患者中，临床白质脑病的发生率较高，提示有必要进一步研究。
