Spectrum of neuroimaging findings post-proton beam therapy in a large pediatric cohort.

Autor: Bhattacharya, Debarata, Chhabda, Sahil, Lakshmanan, Rahul, Tan, Ronald, Warne, Richard, Benenati, Massimo, Michalski, Anthony, Aquilina, Kristian, Jacques, Thomas, Hargrave, Darren, Chang, Yen-Ching, Gains, Jenny, Mankad, Kshitij
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Zdroj: Child's Nervous System; 2021, Vol. 37 Issue 2, p435-446, 12p
Abstrakt: Purpose: Proton beam therapy (PBT) is now well established for the treatment of certain pediatric brain tumors. The intrinsic properties of PBT are known to reduce long-term negative effects of photon radiotherapy (PRT). To better understand the intracranial effects of PBT, we analyzed the longitudinal imaging changes in a cohort of children with brain tumors treated by PBT with clinical and radiotherapy dose correlations. Materials and methods: Retrospective imaging review of 46 patients from our hospital with brain tumors treated by PBT. The imaging findings were correlated with clinical and dose parameters. Results: Imaging changes were assessed by reviewing serial magnetic resonance imaging (MRI) scans following PBT over a follow-up period ranging from 1 month to 7 years. Imaging changes were observed in 23 patients undergoing PBT and categorized as pseudoprogression (10 patients, 43%), white matter changes (6 patients, 23%), parenchymal atrophy (6 patients, 23%), and cerebral large vessel arteriopathy (5 patients, 25%). Three patients had more than one type of imaging change. Clinical symptoms attributable to PBT were observed in 13 (28%) patients. Conclusion: In accordance with published literature, we found evidence of varied intracranial imaging changes in pediatric brain tumor patients treated with PBT. There was a higher incidence (10%) of large vessel cerebral arteriopathy in our cohort than previously described in the literature. Twenty-eight percent of patients had clinical sequelae as a result of these changes, particularly in the large vessel arteriopathy subgroup, arguing the need for angiographic and perfusion surveillance to pre-empt any morbidities and offer potential neuro-protection. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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