Experimental concepts for toxicity prevention and tissue restoration after central nervous system irradiation

This review discusses strategies to prevent and treat radiation-induced damage to the central nervous system (CNS), focusing on neurocognitive decline and radiation necrosis. It explores the potential of drugs, cell transplantation, and creating a supportive environment for tissue repair. The authors suggest that treatment approaches should be tailored to individual patients, considering factors like age, comorbidities, and the type of toxicity. Some patients might benefit from early prevention strategies, while others could be treated with delayed interventions that promote tissue regeneration. The review emphasizes the complexity of radiation-induced changes and suggests that single-target interventions may not be sufficient. Future treatments might involve combining drugs, cell transplantation, and methods to improve blood flow and create a supportive microenvironment for cell homing and repair.

• 1
  Early intervention with agents like amifostine and growth factors (IGF-1, FGF-2) shows preliminary evidence of modulating the radiation response in the CNS and increasing long-term radiation tolerance.
• 2
  Anti-inflammatory drugs like dexamethasone and pioglitazone may protect against neurocognitive damage or necrosis by reducing the expression of inflammatory cytokines and mediators.
• 3
  Stem cell transplantation, using both neural and hematopoietic stem cells, holds promise for CNS regeneration by promoting cell proliferation, differentiation, and tissue repair, though the success depends on creating a permissive microenvironment.