A comparative study of the extent of cerebral microvascular injury following whole-brain irradiation versus reduced-field irradiation in long-term survivors of intracranial germ cell tumors. Issue 2 (November 2015)

• Record Type: Journal Article
• Authors: Li, Li; Mugikura, Shunji; Kumabe, Toshihiro; Murata, Takaki; Mori, Etsuro; Takase, Kei; Jingu, Keiichi; Takahashi, Shoki
• Is Part Of: Radiotherapy and oncology. Volume 117:Issue 2(2015:Nov.)
• Page Start: 302
• Page End: 307
• Publication Date: 2015-11
• Subjects: Cranial irradiation -- Germinoma -- Radiation-induced cavernous malformation -- Long-term cancer survivors -- Pediatric cancer; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2015.09.017
• Languages: English
• ISSNs: 0167-8140

Abstract

Abstract: Background and purpose: Radiation-induced cerebral cavernous malformation reflects post-irradiation impairment of cerebral microcirculation. Our purpose was to determine effects of radiation field size and dose on the extent of developing cavernous malformations in long-term survivors of intracranial germ cell tumors (GCTs). Methods: The study involved 34 patients with a history of intracranial GCTs treated with either whole-brain or reduced-field irradiation and undergoing magnetic resonance (MR) imaging with a mean follow-up of 18.5 years. The number of cavernous malformations on T2*-weighted MR images between whole-brain and reduced-field irradiation groups as well as between high- (50.2 Gy) and low-dose (24.4 Gy) fields were compared. Results: A total of 235 cavernous malformation lesions were observed in 32 of 34 patients (94.1%). The mean number of lesions was 2.3 times as high in the whole-brain group as in the reduced-field group ( P = 0.00296). The number of lesions in high-dose fields was significantly larger than in low-dose ( P < 0.000001) or untreated fields ( P < 0.001). Conclusion: Radiation field size and dose were positively associated with the number of cavernous malformations developed. Cavernous malformations detected on MR imaging can be used as a surrogate marker for microvascular injury following intracranial irradiation in long-term cancer survivors.