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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Radiological and clinical assessment of long-term brain tumour survivors after radiotherapy.
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Radiological and clinical assessment of long-term brain tumour survivors after radiotherapy.

机译：放射治疗后长期脑肿瘤幸存者的放射学和临床评估。

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BACKGROUND AND PURPOSE: Late adverse effects of therapeutic brain radiotherapy (RT) may develop after long latency periods and our objective was to assess long-term brain tumour survivors following RT to large partial brain volumes. MATERIALS AND METHODS: Assessment of MRI, SOMA/LENT score, quality of life and neuroendocrine function was performed in 33 adult brain tumour patients 6-25 years following RT. Fraction dose was 1.8 Gy to a median total dose of 54 Gy (range: 45.0-59.4 Gy). Ten patients had been given two opposing portals including one whole hemisphere, while 23 patients had in addition received an ipsilateral field. In 25 patients the hypothalamic and pituitary area had been included in the RT field. Results were compared within the study group and towards the general population matched for age and gender. RESULTS: All patients had white matter changes with increased signal intensity on T2 and FLAIR images. Discrete lesions (grade 1), beginning confluence of lesions (grade 2), and large confluent areas (grade 3) were present in 8, 8 and 17 patients, respectively. Patients treated with intra-arterial chemotherapy and patients at higher age at follow-up had significantly more grade 3 changes. Atrophy, lacunar lesions and contrast enhancement was found in 17, 18 and 23 patients, respectively. Significantly worse clinical status and quality of life was found in patients with white matter changes grade 3 or atrophy. Patients given full-dose RT to less volume did not have significantly less toxicity. Two cases of meningioma were found at 16 and 22 years after RT. Nineteen neuroendocrine abnormalities were observed in 16/25 patients. CONCLUSIONS: External radiotherapy to the brain at a standard fractionation regime will cause varying degrees of late neurotoxicity and/or neuroendocrine disturbances in most patients. Life-long follow-up is recommended.
机译：背景和目的：长时间的潜伏期后，可能会出现治疗性脑放疗（RT）的后期不良反应，我们的目标是评估放疗后脑部大体积的长期脑肿瘤幸存者。材料与方法：在RT后6-25年对33名成人脑肿瘤患者进行了MRI，SOMA / LENT评分，生活质量和神经内分泌功能的评估。分数剂量为1.8 Gy，中位总剂量为54 Gy（范围：45.0-59.4 Gy）。 10名患者被给予了两个相对的门脉，包括一个整个半球，而23名患者另外接受了同侧视野。在25位患者中，下丘脑和垂体区域已包括在RT领域中。在研究组内和针对年龄和性别相匹配的普通人群比较了结果。结果：所有患者在T2和FLAIR图像上均出现白质改变，信号强度增加。在8、8和17例患者中分别存在离散病灶（1级），病灶开始融合（2级）和大融合区（3级）。接受动脉内化疗的患者和随访时年龄较大的患者的3级改变明显更多。分别在17、18和23例患者中发现萎缩，腔隙性病变和造影剂增强。白质改变为3级或萎缩的患者的临床状况和生活质量明显恶化。给予小剂量全剂量放疗的患者并没有明显减少毒性。放疗后16和22年发现2例脑膜瘤。在16/25患者中观察到19个神经内分泌异常。结论：在标准分级方案下，对脑部进行外部放射治疗将对大多数患者造成不同程度的晚期神经毒性和/或神经内分泌失调。建议终生随访。

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