Abstract
Background. Leukoencephalopathy is a pathological status associated with multifocal demyelination of cerebral white matter. The successful advancement of anticancer therapies has resulted in survivors who suffer from leukoencephalopathy caused by anticancer drugs and cranial irradiation. Case. A 74-year-old man, who was diagnosed with limited disease small cell lung cancer of the right upper lobe, underwent cisplatin and irinotecan chemotherapy. The therapy was discontinued due to severe anemia. Complete response to chemotherapy allowed the patient to be observed with treatment only for anemia. After 15 months of observation, relapse was detected in the cranium. Whole-brain irradiation of 30 Gy in 3 Gy fractions was performed. Three months after irradiation therapy, the patient suffered from leukoencephalopathy. He has remained alive for seven months after discharge with no recurrence of lung cancer, while his activity of daily living (ADL) has deteriorated gradually. Conclusion. When patients with a previous history of chemotherapy exhibit severe adverse events or worsened performance status, the dose fractionation method should be selected in consideration of neurotoxicity, which can develop early after irradiation.
