Radiat Oncol J.
2011 Sep;29(3):147-155. 10.3857/roj.2011.29.3.147.
Radiation-induced brain injury: retrospective analysis of twelve pathologically proven cases
- Affiliations
-
- 1Department of Radiation Oncology, The Cancer Center of Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. scyoon@catholic.ac.kr
- 2Department of Pathology, The Cancer Center of Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
- 3Department of Neurosurgery, The Cancer Center of Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
- KMID: 1995013
- DOI: http://doi.org/10.3857/roj.2011.29.3.147
Abstract
- PURPOSE
This study was designed to determine the influencing factors and clinical course of pathologically proven cases of radiation-induced brain injury (RIBI).
MATERIALS AND METHODS
The pathologic records of twelve patients were reviewed; these patients underwent surgery following radiotherapy due to disease progression found by follow-up imaging. However, they were finally diagnosed with RIBI. All patients had been treated with 3-dimensional conventional fractionated radiotherapy and/or radiosurgery for primary or metastatic brain tumors with or without chemotherapy. The histological distribution was as follows: two falx meningioma, six glioblastoma multiform (GBM), two anaplastic oligodendroglioma, one low grade oligodendroglioma, and one small cell lung cancer with brain metastasis.
RESULTS
Radiation necrosis was noted in eight patients and the remaining four were diagnosed with radiation change. Gender (p = 0.061) and biologically equivalent dose (BED)3 (p = 0.084) were the only marginally influencing factors of radiation necrosis. Median time to RIBI was 7.3 months (range, 0.5 to 61 months). Three prolonged survivors with GBM were observed. In the subgroup analysis of high grade gliomas, RIBI that developed <6 months after radiotherapy was associated with inferior overall survival rates compared to cases of RIBI that occurred > or =6 months (p = 0.085).
CONCLUSION
Our study demonstrated that RIBI could occur in early periods after conventional fractionated brain radiotherapy within normal tolerable dose ranges. Studies with a larger number of patients are required to identify the strong influencing factors for RIBI development.
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