Cerebral infarction after fractionated stereotactic radiation therapy of benign anterior skull base tumors.
Journal
Clinical and translational radiation oncology
ISSN: 2405-6308
Titre abrégé: Clin Transl Radiat Oncol
Pays: Ireland
ID NLM: 101713416
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
29
01
2019
revised:
04
02
2019
accepted:
04
02
2019
entrez:
1
3
2019
pubmed:
1
3
2019
medline:
1
3
2019
Statut:
epublish
Résumé
The purpose of this study was to examine the occurrence of cerebral infarction (ischemic stroke), in a large combined cohort of patients with anterior skull base meningiomas, pituitary adenomas and craniopharyngiomas, after fractionated stereotactic radiation therapy (FSRT). All patients, 18 years and older, with anterior skull base meningiomas, pituitary adenomas and craniopharyngiomas, treated with fractionated stereotactic radiation, in our center, from January 1999 to December 2015 were identified. In total 169 patients were included. The prescription dose to the tumor was 54 Gy for 164 patients (97%) and 46.0-52.2 Gy for 5 patients (3%). Cases of cerebral infarctions subsequent to FSRT were identified from the Danish National Patient Registry and verified with review of case notes. The rate of cerebral infarction after FSRT was compared to the rate in the general population with a one sample At a median follow-up of 9.3 years (range 0.1-16.5), 7 of the 169 patients (4.1%) developed a cerebral infarction, at a median 5.7 years (range 1.2-11.5) after FSRT. The mean cerebral infarction rate for the general population was 0.0035 and 0.0048 for the FSRT cohort (p = 0.423). Univariate cox models analysis showed that increasing age correlated significantly with the cerebral infarction risk, with a hazard ratio of 1.090 (p = 0.013). Increased risk of cerebral infarction after FSRT of anterior skull base tumors was associated with age, similar to the general population. Our study revealed that FSRT did not introduce an excess risk of cerebral infarction.
Sections du résumé
BACKGROUND
BACKGROUND
The purpose of this study was to examine the occurrence of cerebral infarction (ischemic stroke), in a large combined cohort of patients with anterior skull base meningiomas, pituitary adenomas and craniopharyngiomas, after fractionated stereotactic radiation therapy (FSRT).
MATERIAL AND METHODS
METHODS
All patients, 18 years and older, with anterior skull base meningiomas, pituitary adenomas and craniopharyngiomas, treated with fractionated stereotactic radiation, in our center, from January 1999 to December 2015 were identified. In total 169 patients were included. The prescription dose to the tumor was 54 Gy for 164 patients (97%) and 46.0-52.2 Gy for 5 patients (3%). Cases of cerebral infarctions subsequent to FSRT were identified from the Danish National Patient Registry and verified with review of case notes. The rate of cerebral infarction after FSRT was compared to the rate in the general population with a one sample
RESULTS
RESULTS
At a median follow-up of 9.3 years (range 0.1-16.5), 7 of the 169 patients (4.1%) developed a cerebral infarction, at a median 5.7 years (range 1.2-11.5) after FSRT. The mean cerebral infarction rate for the general population was 0.0035 and 0.0048 for the FSRT cohort (p = 0.423). Univariate cox models analysis showed that increasing age correlated significantly with the cerebral infarction risk, with a hazard ratio of 1.090 (p = 0.013).
CONCLUSION
CONCLUSIONS
Increased risk of cerebral infarction after FSRT of anterior skull base tumors was associated with age, similar to the general population. Our study revealed that FSRT did not introduce an excess risk of cerebral infarction.
Identifiants
pubmed: 30815592
doi: 10.1016/j.ctro.2019.02.001
pii: S2405-6308(19)30001-1
pmc: PMC6378839
doi:
Types de publication
Journal Article
Langues
eng
Pagination
93-98Références
J Neurosurg. 1999 May;90(5):823-7
pubmed: 10223446
Stereotact Funct Neurosurg. 1999;72 Suppl 1:132-9
pubmed: 10681701
J Neurosurg. 2000 Dec;93 Suppl 3:68-73
pubmed: 11143266
Int J Radiat Oncol Biol Phys. 2001 Aug 1;50(5):1279-86
pubmed: 11483339
Neurosurgery. 2001 Nov;49(5):1029-37; discussion 1037-8
pubmed: 11846894
Clin Oncol (R Coll Radiol). 2002 Apr;14(2):103-9
pubmed: 12069116
J Neurosurg. 2002 Sep;97(3):525-30
pubmed: 12296634
Int J Radiat Oncol Biol Phys. 2002 Nov 15;54(4):1114-20
pubmed: 12419438
Neurosurgery. 2002 Dec;51(6):1373-79; discussion 1379-80
pubmed: 12445342
Int J Radiat Oncol Biol Phys. 2005 Mar 1;61(3):795-808
pubmed: 15708259
Stroke. 1992 Jun;23(6):908-11
pubmed: 1595114
Int J Radiat Oncol Biol Phys. 2005 Aug 1;62(5):1427-31
pubmed: 16029803
Int J Radiat Oncol Biol Phys. 2005 Sep 1;63(1):37-46
pubmed: 16111570
Clin Endocrinol (Oxf). 2006 May;64(5):542-8
pubmed: 16649974
Neurology. 2007 Feb 20;68(8):590
pubmed: 17310028
Cancer. 2007 Jun 1;109(11):2308-14
pubmed: 17469176
Zentralbl Neurochir. 2008 Feb;69(1):14-21
pubmed: 18393160
Int J Radiat Oncol Biol Phys. 2010 Nov 1;78(3):836-43
pubmed: 20133076
Eur J Endocrinol. 2010 Apr;162(4):685-94
pubmed: 20133445
J Neurooncol. 2010 Jun;98(2):195-202
pubmed: 20405308
Radiat Oncol. 2011 Apr 12;6:36
pubmed: 21486436
Neurol Med Chir (Tokyo). 2012;52(12):933-6
pubmed: 23269054
J Neurosurg. 2013 Sep;119(3):675-82
pubmed: 23808540
Int J Radiat Oncol Biol Phys. 2013 Sep 1;87(1):53-9
pubmed: 23920387
Radiat Oncol. 2014 Jan 17;9:27
pubmed: 24438670
J Neurooncol. 2014 May;118(1):101-8
pubmed: 24532196
Radiat Oncol. 2014 Sep 16;9:203
pubmed: 25227427
J Neurooncol. 2015 May;122(3):421-9
pubmed: 25670390
Q J Med. 1989 Feb;70(262):145-60
pubmed: 2594955
Arch Neurol. 1989 Apr;46(4):449-55
pubmed: 2650664
Cancer. 1989 Jun 15;63(12):2404-8
pubmed: 2720586
Acta Oncol. 2017 Mar;56(3):415-421
pubmed: 28084862
Int J Radiat Oncol Biol Phys. 2017 Nov 15;99(4):787-796
pubmed: 28865924
Surg Neurol. 1986 Jan;25(1):49-54
pubmed: 3941968
J Neurosurg. 1998 Jan;88(1):43-50
pubmed: 9420071