Natural history and treatment options of radiation-induced brain cavernomas: a systematic review

Patet, Gildas; Bartoli, Andréa; Meling, Torstein R.

doi:10.1007/s10143-021-01598-y

Cited by 20 publications

(22 citation statements)

References 37 publications

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“…Ten (1 subacute and 9 late) of these appeared in patients receiving high-dose CSI. The possible development of these vascular changes after radiation for brain tumors and MB in particular is well-documented for photons [ 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. In a recent study, prevalence of cerebral microbleeds was 90% after a follow-up of 13.5 years in pediatric brain tumor survivors who received radiotherapy [ 52 ], with longer follow-up and higher CSI dose correlating with higher lesion count.…”

Section: Discussionmentioning

confidence: 99%

“…Data on their appearance after PT are limited, but they may appear with a shorter latency and are not uncommon [ 55 ]. The best management strategy for these malformations and their natural history is not yet clear: in most cases, they remain asymptomatic and experts believe that a specific treatment should be initiated only for selected symptomatic cases [ 48 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

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Toxicity and Clinical Results after Proton Therapy for Pediatric Medulloblastoma: A Multi-Centric Retrospective Study

Ruggi

Melchionda

Sardi

et al. 2022

Cancers

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Medulloblastoma is the most common malignant brain tumor in children. Even if current treatment dramatically improves the prognosis, survivors often develop long-term treatment-related sequelae. The current radiotherapy standard for medulloblastoma is craniospinal irradiation with a boost to the primary tumor site and to any metastatic sites. Proton therapy (PT) has similar efficacy compared to traditional photon-based radiotherapy but might achieve lower toxicity rates. We report on our multi-centric experience with 43 children with medulloblastoma (median age at diagnosis 8.7 years, IQR 6.6, M/F 23/20; 26 high-risk, 14 standard-risk, 3 ex-infant), who received active scanning PT between 2015 and 2021, with a focus on PT-related acute-subacute toxicity, as well as some preliminary data on late toxicity. Most acute toxicities were mild and manageable with supportive therapy. Hematological toxicity was limited, even among HR patients who underwent hematopoietic stem-cell transplantation before PT. Preliminary data on late sequelae were also encouraging, although a longer follow-up is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Toxicity and Clinical Results after Proton Therapy for Pediatric Medulloblastoma: A Multi-Centric Retrospective Study

Ruggi

Melchionda

Sardi

et al. 2022

Cancers

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“…Late complications after intracranial radiotherapy (RT) occur in 1-5% of patients [11,12]. They include delayed cysticercosis, CEH, and cavernous hemangioma; however, the mechanism is not clear [13][14][15][16]. Extracranial RT can cause radiation-induced late bleeding or pseudoaneurysm [4,17,18].…”

Section: Discussionmentioning

confidence: 99%

Chronic expanding hematoma of the left erector spinae muscle after stereotactic body radiotherapy for renal cell carcinoma: a case report

et al. 2022

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Background Hematomas that slowly increase in size for more than 1 month after the initial hemorrhage are referred to as chronic expanding hematomas. Chronic expanding hematoma can also occur after radiosurgery; however, there have been no reports about chronic expanding hematoma in the trunk after stereotactic body radiotherapy. We report a case of chronic expanding hematoma of the left erector spinae muscle after stereotactic body radiotherapy for renal cell carcinoma. Case presentation A 74-year-old Japanese male complained of back pain 7 years after stereotactic body radiotherapy for renal cell carcinoma of the left kidney. There was no history of surgery or trauma to his back. After stereotactic body radiotherapy, there was no acute or late complication of more than grade 2. The renal cell carcinoma did not show shrinkage or progression, and he was diagnosed with stable disease on computed tomography. The patient remains in a stable disease condition 7 years after treatment without surgery or chemotherapy; however, he came to the hospital with gradually worsening back pain for several months. Computed tomography revealed the left erector spinae muscle to be swollen compared with the contralateral side at the third lumbar level. Ultrasonography showed a tumor of 30 mm in size without blood flow in the left paraspinal muscle. Positron emission tomography–computed tomography revealed uptake in the left paraspinal muscle. Pathological examination showed radiation-induced chronic expanding hematoma. Conclusions We present the first case report of chronic expanding hematoma of the left erector spinae muscle after stereotactic body radiotherapy for renal cell carcinoma. Usually, stereotactic body radiotherapy for renal cell carcinoma would be considered unlikely to cause chronic expanding hematoma, but the introduction of dialysis and antiplatelet drugs may have increased the risk.

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“…The widespread use of MRI has not only increased the frequency of CM diagnosis, but has also advanced the understanding of natural history and epidemiology [7,[20][21][22][23][24][25]. Because CM is low-pressure and low-flow vascular malformations, single or multiple lumen formations in the vessels are observed on MRI [26].…”

Section: Characteristic Appearances On Magnetic Resonance Imagingmentioning

confidence: 99%

“…The general dose planning method is to exclude the hemosiderin ring and the bleeding site around the lesion because it contains adjacent brain tissue [17,19]. Patet et al [24] reported that radiation-induced cavernosum malformation (RICM) is a delayed complication induced by childhood irradiation. Its natural history is largely unknown and its incidence may be underestimated as RCIMs tend to develop several years following radiation.…”

Section: Gamma Knife Radiosurgerymentioning

confidence: 99%

Radiosurgery for cerebral cavernous malformations

Cho

2022

J Korean Ster Func Neurosurg

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Objective: A cavernous malformation (CM) is a type of an abnormally large collection of “low-flow” vascular channels without brain parenchyma intervening between the sinusoidal vessels; these occult lesions on transfemoral catheter angiograms were formerly known as “cryptic” vascular lesions. In this review, we briefly describe the overall characteristics of cerebral CMs and summarize radiosurgical methods and results of radiosurgery as treatment for CMs. Methods: The incidence, definition, and natural history of cerebral CMs are described. The principal issues of CMs are recurrent bleeding and seizures. These issues are compared to the radiosurgical interventions for CMs.Results: The rebleeding rates of CMs after radiosurgery is difficult to compare directly with untreated lesions because treated lesions are innately more vulnerable to rebleeding. Seizure outcomes after radiosurgery are also not easily estimated because of the various lesion locations; nevertheless, radiosurgery is an important treatment option for CMs in eloquent areas.Conclusion: Stereotactic radiosurgery (SRS) for CM has been effectively and widely used in recent years. Advances in magnetic resonance imaging and radiosurgery, as well as better studies of this condition’s natural history, are increasingly supporting the role of SRS as a complementary tool in CM treatment. More research is needed.

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Natural history and treatment options of radiation-induced brain cavernomas: a systematic review

Cited by 20 publications

References 37 publications

Toxicity and Clinical Results after Proton Therapy for Pediatric Medulloblastoma: A Multi-Centric Retrospective Study

Toxicity and Clinical Results after Proton Therapy for Pediatric Medulloblastoma: A Multi-Centric Retrospective Study

Chronic expanding hematoma of the left erector spinae muscle after stereotactic body radiotherapy for renal cell carcinoma: a case report

Radiosurgery for cerebral cavernous malformations

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