Treatment strategies for radiation-induced brain injury

Radiation-induced brain injury (RIBI) is a common complication in patients with head and neck tumors. RIBI usually occurs six months to three years after therapy and is often accompanied by cognitive dysfunction, epilepsy, and other neurological dysfunctions. In severe cases, RIBI can cause a wide range of cerebral edema and herniation. A systematic search was conducted through PubMed/Medline, EMBASE, and Cochrane library databases and articles with the keywords radiation-induced brain injury, pathogenesis and protective agents were collected. The commonly known pathogenesis of RIBI includes vascular injury, immune-inflammatory response, glial cell damage, and neuronal damage. Therapeutic agents, hyperbaric oxygen, surgery, and stem cells transplantation are the most common treatment for RIBI. Tamoxifen, curcumin, and quercetin can prevent glial cell activation, proliferation, and oxidative stress caused by irradiation. Over recent years, the RIBI remission rate has gradually increased; however, there are still no effective prevention and treatment methods. This review summarized recent progress in the treatment for RIBI, as well as the pathogenesis of RIBI, including vascular injury, glial cell injury, immune-inflammatory response, and neuronal damage.