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Rad Oncology Homepage

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New trial seeks to reverse effects of dead brain tissue caused by radiation

Press releases may be edited for formatting or style
LOUISVILLE, Ky., May 14, 2019 /PRNewswire/ -- A new procedure pioneered by Norton Healthcare physician-scientists directly targets brain tissue affected by radiation necrosis.

"I started losing my sight and then passed out," Alyssa Coffey recalled about experiencing her first seizure.

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Coffey was in the midst of training for an upcoming bodybuilding competition. A scan revealed the then 23-year-old New Jersey resident had an arteriovenous malformation (AVM), a tangle of abnormal blood vessels connecting arteries and veins in the brain.

To treat the AVM, doctors in her home state used radiation therapy. The radiation therapy treated the AVM, but Coffey experienced the severe side effect of radiation necrosis.

Radiation therapy is an effective way to treat certain brain AVMs. In up to 5 percent of cases, however, it can cause damage to the surrounding brain. This can result in radiation necrosis, when the nearby brain tissue becomes injured and dies.

The condition can be disabling, causing severe headaches, nausea and vomiting, seizures, cognitive issues and even death.

Doctors use a variety of medications, such as steroids, to manage the symptoms. None of the medications works very well, and all have serious side effects. There is no approved cure.

"It was miserable," Coffey said. "The necrosis impacted my ability to work. Going to the gym was out of the question."

Doctors in New Jersey suggested exploratory brain surgery, but Coffey felt it was too risky.


Last year, while on an AVM support group website, Coffey learned about a study at Norton Neuroscience Institute in Louisville, Kentucky, and the University of Kentucky that sought to reverse radiation necrosis.

The trial, led by Shervin Dashti, M.D., Ph.D., endovascular neurosurgeon with Norton Neuroscience Institute, is the first in the world to deliver a single small dose of the cancer drug Avastin directly to the area of the brain affected by the necrosis. Tom Yao, M.D., endovascular neurosurgeon with Norton Neuroscience Institute, and Justin Fraser, M.D., neurosurgeon with UK HealthCare, also are treating patients in the study.

Avastin previously has been used effectively to treat radiation necrosis. The medication is given through an IV, meaning the drug has to circulate through the body before only a small percentage reaches the brain. When the drug does reach the brain, it has a hard time penetrating because of a natural defense mechanism called the blood-brain barrier. Making matters worse, exposing the body to Avastin can result in brain bleeds, clots and uncontrolled high blood pressure.
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