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

作者：Li Li; Mugikura Shunji^*; Kumabe Toshihiro; Murata Takaki; Mori Etsuro; Takase Kei; Jingu Keiichi; Takahashi Shoki

来源：Radiotherapy and Oncology, 2015, 117(2): 302-307.

DOI：10.1016/j.radonc.2015.09.017

• Cranial irradiation
• Germinoma
• Radiation-induced cavernous malformation
• Long-term cancer survivors
• Pediatric cancer

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.

• 出版日期2015-11