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

Li Li, Shunji Mugikura, Toshihiro Kumabe, Takaki Murata, Etsuro Mori, Kei Takase, Keiichi Jingu, Shoki Takahashi

Research output: Contribution to journalArticle

7 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)302-307
Number of pages6
JournalRadiotherapy and Oncology
Volume117
Issue number2
DOIs
Publication statusPublished - 2015 Nov 1

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

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