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  • Title: 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.
    Author: Li L, Mugikura S, Kumabe T, Murata T, Mori E, Takase K, Jingu K, Takahashi S.
    Journal: Radiother Oncol; 2015 Nov; 117(2):302-7. PubMed ID: 26386986.
    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.
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