Introduction: GK is an effective treatment modality for intracranial pathologies. Radiation Necrosis is the late effect of radiotherapy/radiosurgery . Pentoxyphylline and Vitamin E has been proved to be effective in preventing the effects of radiation for other systems but effectiveness for cerebral radiation necrosis has not been proved yet. Our aim to design this reseach is to reveal the utility of these drugs.
Methods: Fifty Sprague-Dawley rats irrespective of their sex used for this research by the permission of Marmara University Animal Research Local Ethic Committe. Seven subgroups were determined as control, prophylacticvitE, therapeuticvitE, prophylacticpentoxyphylline, therapeuticpentoxyphylline, prophylacticpentoxyphyllineandvitE and therapeuticpentoxyphyllineandvitE. All subjects have been performed GK with special design frame for rats after MRI. Medications (VitE30mg/kg/day, Pentoxyphylline50 mg/kg/dayIP) for prophylactic groups started on the day that the GK performed and 12 weeks later from the GK for the therapeutic groups and continued for 4 weeks. All subjectsweredecapitatedafter16weeksafterMRIandimmunohistochemicalevaluationsperformed.
Results: There are statistically significant difference in H&E examination for cystic formation in prophylacticpentoxyphylline and therapeuticpentoxyphylline groups; in HIF-1a and VEGF examination for immunreactivity pattern at the necrotic zone in prophylacticpentoxyphylline, therapeuticpentoxyphylline and therapeuticvit E and pentoxyphylline groups; in TGF-ß examination for immunreactivity pattern at the necrotic zone in therapeutic vit E, therapeuticpentoxyphylline and therapeutic vitamin E and pentoxyphylline groups; in BRDU examination for immunreactivity at the necrotic zone in therapeutic vitamin E and therapeutic pentoxyphylline groups; in apoptosis examination for the number of positive cell count at the perinecrotic area in prophylactic pentoxyphylline and therapeutic pentoxyphylline groups. For the radiological considerations statistical significance was prominent in contrast enhancement pattern in prophylactic vitamin E, prophylactic pentoxyphylline and therapeutic pentoxyphylline groups.
Conclusions: As a result we concluded that vitamin E and pentoxyphylline irrespective of prophylaxis or combination therapy is effective to restrict the progression of radiation necrosis which is proved by statistically significant difference for immunhistochemical and radiological aspect.
Patient Care: a treatment modality for radiation necrosis based on evidence.
Learning Objectives: a treatment modality for radiation necrosis based on evidence.