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Large Vessel Arteriopathy After Cranial Radiation Therapy in Pediatric Brain Tumor Survivors.

Abstract
Among childhood cancer survivors, increased stroke risk after cranial radiation therapy may be caused by radiation-induced arteriopathy, but limited data exist to support this hypothesis. Herein, we assess the timing and presence of cerebral arteriopathy identified by magnetic resonance angiography (MRA) after cranial radiation therapy in childhood brain tumor survivors. In a cohort of 115 pediatric brain tumor survivors, we performed chart abstraction and prospective annual follow-up to assess the presence of large vessel cerebral arteriopathy by MRA. We identified 10 patients with cerebral arteriopathy. The cumulative incidence of arteriopathy 5 years post-cranial radiation therapy was 5.4% (CI 0.6%-10%) and 10 years was 16% (CI 4.6%-26%). One patient had an arterial ischemic stroke 2.4 years post-cranial radiation therapy in the distribution of a radiation-induced stenotic artery. We conclude that large vessel arteriopathies can occur within a few years of cranial radiation therapy and can become apparent on MRA in under a year.
AuthorsMatthew Nordstrom, Erin Felton, Katherine Sear, Benita Tamrazi, Joseph Torkildson, Karen Gauvain, Daphne A Haas-Kogan, Josephine Chen, Benedict Del Buono, Anuradha Banerjee, David Samuel, David Saloner, Bing Tian, Erika Roddy, Christopher Hess, Heather Fullerton, Sabine Mueller
JournalJournal of child neurology (J Child Neurol) Vol. 33 Issue 5 Pg. 359-366 (04 2018) ISSN: 1708-8283 [Electronic] United States
PMID29575995 (Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Topics
  • Brain Neoplasms (epidemiology, radiotherapy)
  • Cancer Survivors
  • Cerebral Angiography
  • Cerebral Arterial Diseases (diagnostic imaging, epidemiology, etiology)
  • Child
  • Child, Preschool
  • Cranial Irradiation (adverse effects)
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Magnetic Resonance Angiography
  • Male
  • Prospective Studies
  • Radiation Injuries (diagnostic imaging, epidemiology, etiology)
  • Time Factors

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