Neuroinflammation as a consequence of GBM treatment
Inflammation and necrosis of healthy brain tissue is one of the main unwanted effects of radiotherapy used to treat GBM. Studies have found incidences of radiation-induced necrosis ranging from 2.5% to about 30% of GBM patient cohorts [31-33]. Necrosis can include underlying inflammation together with occlusive vasculopathy and perivascular parenchymal changes. Alterations in the integrity of the blood-brain barrier in inflamed sites leads to immune cell infiltration, fluid transudation into the interstitial space and brain edema. Infiltrated immune cells as well as reactive glial cells increase expression of mediators, amplifying the response [31, 34-36].