White matter changes in breast cancer brain metastases patients who undergo radiosurgery alone compared to whole brain radiation therapy plus radiosurgery.
Identifieur interne : 000223 ( Main/Exploration ); précédent : 000222; suivant : 000224White matter changes in breast cancer brain metastases patients who undergo radiosurgery alone compared to whole brain radiation therapy plus radiosurgery.
Auteurs : Timothy B. Stokes [États-Unis] ; Ajay Niranjan ; Hideyuki Kano ; Phillip A. Choi ; Douglas Kondziolka ; L. Dade Lunsford ; Edward A. MonacoSource :
- Journal of neuro-oncology [ 1573-7373 ] ; 2015.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Estimation de Kaplan-Meier, Femelle, Humains, Irradiation crânienne (effets indésirables), Lésions radio-induites (anatomopathologie), Lésions radio-induites (mortalité), Radiochirurgie (effets indésirables), Substance blanche (anatomopathologie), Substance blanche (effets des radiations), Tumeurs du cerveau (), Tumeurs du cerveau (mortalité), Tumeurs du cerveau (secondaire), Tumeurs du sein (), Tumeurs du sein (anatomopathologie), Tumeurs du sein (mortalité).
- MESH :
- anatomopathologie : Lésions radio-induites, Substance blanche, Tumeurs du sein.
- effets des radiations : Substance blanche.
- effets indésirables : Irradiation crânienne, Radiochirurgie.
- mortalité : Lésions radio-induites, Tumeurs du cerveau, Tumeurs du sein.
- secondaire : Tumeurs du cerveau.
- Adulte d'âge moyen, Estimation de Kaplan-Meier, Femelle, Humains, Tumeurs du cerveau, Tumeurs du sein.
English descriptors
- KwdEn :
- Brain Neoplasms (mortality), Brain Neoplasms (secondary), Brain Neoplasms (therapy), Breast Neoplasms (mortality), Breast Neoplasms (pathology), Breast Neoplasms (therapy), Cranial Irradiation (adverse effects), Female, Humans, Kaplan-Meier Estimate, Middle Aged, Radiation Injuries (mortality), Radiation Injuries (pathology), Radiosurgery (adverse effects), White Matter (pathology), White Matter (radiation effects).
- MESH :
- adverse effects : Cranial Irradiation, Radiosurgery.
- mortality : Brain Neoplasms, Breast Neoplasms, Radiation Injuries.
- pathology : Breast Neoplasms, Radiation Injuries, White Matter.
- radiation effects : White Matter.
- secondary : Brain Neoplasms.
- therapy : Brain Neoplasms, Breast Neoplasms.
- Female, Humans, Kaplan-Meier Estimate, Middle Aged.
Abstract
Delayed toxicity after whole brain radiation therapy (WBRT) is of increasing concern in patients who survive more than one year with brain metastases from breast cancer. Radiation-related white matter toxicity is detected by magnetic resonance imaging (MRI) and has been correlated with neurocognitive dysfunction. This study assessed the risk of developing white matter changes (WMC) in breast cancer patients who underwent either WBRT plus stereotactic radiosurgery (SRS) or SRS alone. We retrospectively compared 35 patients with breast cancer brain metastases who received WBRT and SRS to 30 patients who only received SRS. All patients had evaluable imaging at a median of one year after their initial management. The development of white matter T2 prolongation as detected by T2 or FLAIR imaging was graded: grade 1 = little or no white matter T2 hyperintensity; grade 2 = limited periventricular hyperintensity; and grade 3 = diffuse white matter hyperintensity. After WBRT plus SRS, patients demonstrated a significantly higher incidence of WMC (p < 0.0001). After one year, 71.5 % of patients whose treatment included WBRT demonstrated WMC (42.9 % grade 2; 28.6 % grade 3). Only one patient receiving only SRS developed WMC. In long-term survivors of breast cancer, the risk of WMC was significantly reduced when SRS alone was used for management. Further prospective studies are necessary to determine how these findings correlate with neurocognitive toxicity. WBRT usage as initial management of limited brain disease should be replaced by SRS alone to reduce the risk of delayed white matter toxicity.
DOI: 10.1007/s11060-014-1670-4
PubMed: 25445836
Affiliations:
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Le document en format XML
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Stokes</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213</wicri:regionArea><wicri:noRegion>15213</wicri:noRegion></affiliation></author><author><name sortKey="Niranjan, Ajay" sort="Niranjan, Ajay" uniqKey="Niranjan A" first="Ajay" last="Niranjan">Ajay Niranjan</name></author><author><name sortKey="Kano, Hideyuki" sort="Kano, Hideyuki" uniqKey="Kano H" first="Hideyuki" last="Kano">Hideyuki Kano</name></author><author><name sortKey="Choi, Phillip A" sort="Choi, Phillip A" uniqKey="Choi P" first="Phillip A" last="Choi">Phillip A. Choi</name></author><author><name sortKey="Kondziolka, Douglas" sort="Kondziolka, Douglas" uniqKey="Kondziolka D" first="Douglas" last="Kondziolka">Douglas Kondziolka</name></author><author><name sortKey="Dade Lunsford, L" sort="Dade Lunsford, L" uniqKey="Dade Lunsford L" first="L" last="Dade Lunsford">L. Dade Lunsford</name></author><author><name sortKey="Monaco, Edward A" sort="Monaco, Edward A" uniqKey="Monaco E" first="Edward A" last="Monaco">Edward A. 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Choi</name></author><author><name sortKey="Kondziolka, Douglas" sort="Kondziolka, Douglas" uniqKey="Kondziolka D" first="Douglas" last="Kondziolka">Douglas Kondziolka</name></author><author><name sortKey="Dade Lunsford, L" sort="Dade Lunsford, L" uniqKey="Dade Lunsford L" first="L" last="Dade Lunsford">L. Dade Lunsford</name></author><author><name sortKey="Monaco, Edward A" sort="Monaco, Edward A" uniqKey="Monaco E" first="Edward A" last="Monaco">Edward A. 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Radiation-related white matter toxicity is detected by magnetic resonance imaging (MRI) and has been correlated with neurocognitive dysfunction. This study assessed the risk of developing white matter changes (WMC) in breast cancer patients who underwent either WBRT plus stereotactic radiosurgery (SRS) or SRS alone. We retrospectively compared 35 patients with breast cancer brain metastases who received WBRT and SRS to 30 patients who only received SRS. All patients had evaluable imaging at a median of one year after their initial management. The development of white matter T2 prolongation as detected by T2 or FLAIR imaging was graded: grade 1 = little or no white matter T2 hyperintensity; grade 2 = limited periventricular hyperintensity; and grade 3 = diffuse white matter hyperintensity. After WBRT plus SRS, patients demonstrated a significantly higher incidence of WMC (p < 0.0001). After one year, 71.5 % of patients whose treatment included WBRT demonstrated WMC (42.9 % grade 2; 28.6 % grade 3). Only one patient receiving only SRS developed WMC. In long-term survivors of breast cancer, the risk of WMC was significantly reduced when SRS alone was used for management. Further prospective studies are necessary to determine how these findings correlate with neurocognitive toxicity. WBRT usage as initial management of limited brain disease should be replaced by SRS alone to reduce the risk of delayed white matter toxicity.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country></list><tree><noCountry><name sortKey="Choi, Phillip A" sort="Choi, Phillip A" uniqKey="Choi P" first="Phillip A" last="Choi">Phillip A. Choi</name><name sortKey="Dade Lunsford, L" sort="Dade Lunsford, L" uniqKey="Dade Lunsford L" first="L" last="Dade Lunsford">L. Dade Lunsford</name><name sortKey="Kano, Hideyuki" sort="Kano, Hideyuki" uniqKey="Kano H" first="Hideyuki" last="Kano">Hideyuki Kano</name><name sortKey="Kondziolka, Douglas" sort="Kondziolka, Douglas" uniqKey="Kondziolka D" first="Douglas" last="Kondziolka">Douglas Kondziolka</name><name sortKey="Monaco, Edward A" sort="Monaco, Edward A" uniqKey="Monaco E" first="Edward A" last="Monaco">Edward A. Monaco</name><name sortKey="Niranjan, Ajay" sort="Niranjan, Ajay" uniqKey="Niranjan A" first="Ajay" last="Niranjan">Ajay Niranjan</name></noCountry><country name="États-Unis"><noRegion><name sortKey="Stokes, Timothy B" sort="Stokes, Timothy B" uniqKey="Stokes T" first="Timothy B" last="Stokes">Timothy B. Stokes</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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