| Clinical, dosimetric, and radiographic correlation of radiation injury involving the brainstem and the medial temporal lobes following stereotactic radiotherapy for neoplasms of central skull base. | |
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MedLine Citation:
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PMID: 20376551 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Stereotactic Radiotherapy (SRT) is more commonly used for skull base tumors in conjunction with the technical development of radiation intensity modulation. Purpose of this study is to correlate clinical and radiographic characteristics of delayed radiation injury (RI) occurring around central skull base following SRT with SRT dosimetric data. Total of six patients were identified to have developed RI in the vicinity of SRT target volume out of 141 patients who received SRT in he center or near-center of the skull base. The images and medical records were retrospectively reviewed. The analysis was performed for RI location, time of development, imaging and clinical characteristics and evolution of RI and correlated with SRT dosimetric analysis using image fusion with follow-up MRI scans. Mean follow-up time was 24 +/- 9 months. During the follow-up period, twelve sites of RI were found in 6 patients. They were clinically symptomatic in 4/6 patients (66.6%) at median 12.5 months after SRT. Mean time interval between SRT and detection of RI was 9 +/- 3, 18.5 +/- 5, and 13.5 months for brainstem, temporal lobe, and cerebellum/labyrinth lesions, respectively. All RI lesions were included in the region of high SRT doses. After steroid and symptomatic treatment, 50% of RI lesions showed complete response, and 40% showed partial response. RI can occur around the skull base because of irregular shape of target tumor, its close proximity to normal brain parenchyma, and inhomogeneity of dose distribution. Brainstem lesions occurred earlier than temporal lobe RI. The majority of the RI lesions, not mixed with the tumor in this study, showed radiographic and clinical improvement with steroid and symptomatic treatments. |
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Authors:
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Stefano Schipani; Rajan Jain; Keyur Shah; Jack P Rock; Benjamin Movsas; Mark Rosenblum; Samuel Ryu |
Publication Detail:
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Type: Journal Article Date: 2010-04-08 |
Journal Detail:
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Title: Journal of neuro-oncology Volume: 98 ISSN: 1573-7373 ISO Abbreviation: J. Neurooncol. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-14 Completed Date: 2010-09-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309335 Medline TA: J Neurooncol Country: United States |
Other Details:
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Languages: eng Pagination: 177-84 Citation Subset: IM |
Affiliation:
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Department of Radiation Oncology, Henry Ford Health System, 2799 West Grand Blvd, Detroit, MI, 48202, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Brain Stem / pathology* Female Humans Image Processing, Computer-Assisted / methods Magnetic Resonance Imaging / methods Male Middle Aged Radiation Injuries / pathology* Radiometry / methods Radiosurgery / adverse effects* Radiotherapy Dosage Skull Base Neoplasms / pathology, surgery* Temporal Lobe / pathology* Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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