Your browser doesn't support javascript.
loading
Leukoencephalopathy in patients with brain metastases who received radiosurgery with or without whole brain radiotherapy.
Liu, Chan-Wei; Yang, Huai-Che; Chiang, Chi-Lu; Shen, Chia-I; Wu, Hsiu-Mei; Luo, Yung-Hung; Hu, Yong-Sin; Lin, Chung-Jung; Chung, Wen-Yuh; Shiau, Cheng-Ying; Guo, Wan-Yuo; Pan, David Hung-Chi; Lee, Cheng-Chia.
Afiliación
  • Liu CW; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, 17F, No. 201, Sec. 2, Shih-Pai Road, Taipei, 11217, Taiwan.
  • Yang HC; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, 17F, No. 201, Sec. 2, Shih-Pai Road, Taipei, 11217, Taiwan.
  • Chiang CL; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
  • Shen CI; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
  • Wu HM; Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Luo YH; Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
  • Hu YS; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
  • Lin CJ; Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Chung WY; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Shiau CY; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
  • Guo WY; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
  • Pan DH; Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
  • Lee CC; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
J Neurooncol ; 161(1): 85-95, 2023 Jan.
Article en En | MEDLINE | ID: mdl-36544061
ABSTRACT

BACKGROUND:

Whole brain radiation therapy (WBRT) for brain metastases (BMs) is a common cause of radiation-induced leukoencephalopathy; however the safety of alternative stereotactic radiosurgery (SRS) remains unclear. This study examined the incidence of leukoencephalopathy in patients treated with SRS alone versus WBRT plus SRS for BMs with a focus on the relationship between prognostic factors and leukoencephalopathy.

METHODS:

Analysis was performed between 2002 and 2021. The total enrollment was 993 patients with the distribution WBRT plus SRS (n = 291) and SRS only (n = 702). Leukoencephalopathy was graded from 0 to 3 for changes in white matter indicated by the MRI after WBRT or SRS. Patient characteristics and SRS dosimetric parameters were reviewed to identify factors that contributed to the incidence of leukoencephalopathy or overall survival.

RESULTS:

The incidence of leukoencephalopathy was consistently higher in WBRT plus SRS group than in SRS alone group (p < 0.001). Leukoencephalopathy was also associated with a larger total tumor volume (≧28cm3; p = 0.028) and age (> 77 years; p = 0.025). Nonetheless, the SRS integral dose to skull in the subgroup of WBRT plus SRS treatment was not demonstrated significance in development of leukoencephalopathy (p = 0.986 for integral dose 1-2 J, p = 0.776 for integral dose > 2 J).

CONCLUSIONS:

This study revealed that SRS is safe for oligo-BMs in terms of leukoencephalopathy development. Patient age and total tumor volume were identified as important factors in assessing the development of leukoencephalopathy. The additional of SRS (even at an integral dose > 2 J) did not increase the incidence of leukoencephalopathy.
Asunto(s)
Palabras clave

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Radiocirugia / Leucoencefalopatías Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Aged / Humans Idioma: En Revista: J Neurooncol Año: 2023 Tipo del documento: Article País de afiliación: Taiwán

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Radiocirugia / Leucoencefalopatías Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Aged / Humans Idioma: En Revista: J Neurooncol Año: 2023 Tipo del documento: Article País de afiliación: Taiwán