Late-onset vascular complications of radiotherapy for primary brain tumors: a case-control and cross-sectional analysis.

Fecha de publicación: 05/05/2023 Fecha Ahead of Print: 01/05/2023

Autores de IIS La Fe

• Luís Bataller Alberola

  Autor

Participantes ajenos a IIS La Fe

• Ibanez-Julia, Maria-Jose
• Picca, Alberto
• Leclercq, Delphine
• Berzero, Giulia
• Jacob, Julian
• Feuvret, Loic
• Rosso, Charlotte
• Birzu, Cristina
• Alentorn, Agusti
• Sanson, Marc
• Tafani, Camille
• Bompaire, Flavie
• Hoang-Xuan, Khe
• Delattre, Jean-Yves
• Psimaras, Dimitri
• Ricard, Damien

Grupos

• Patología Neuromuscular y Ataxias

  

  Investigador Principal

  Teresa Sevilla Mantecón

• Unidad mixta de investigación en enfermedades raras (CIPF)

  

  Leader

  José María Millán Salvador

Abstract

PURPOSE: Radiotherapy (RT) is a recognized risk factor for cerebrovascular (CV) disease in children and in adults with head and neck cancer. We aimed to investigate whether cerebral RT increases the risk of CV disease in adults with primary brain tumors (PBT). METHODS: We retrospectively identified adults with a supratentorial PBT diagnosed between 1975 and 2006 and with at least 10years follow-up after treatment. We analyzed demographic, clinical, and radiological features with special attention to CV events. We also described CV events, vascular risk factors, and intracranial artery modifications in a cross-sectional study of irradiated patients alive at the time of the study. RESULTS: A total of 116 patients, treated with RT (exposed group), and 85 non-irradiated patients (unexposed group) were enrolled. Stroke was more frequent in irradiated PBT patients than in the unexposed group (42/116 (36%) vs 7/85 (8%); p<0.001), with higher prevalence of both ischemic (27/116 (23%) vs 6/85 (7%); p=0.004) and hemorrhagic (12/116 (10%) vs 1/85 (1%); p=0.02) stroke. In the irradiated group, patients with tumors near the Willis Polygon were more likely to experience stroke (p<0.016). Fourty-four alive irradiated patients were included in the cross-sectional study. In this subgroup, intracranial arterial stenosis was more prevalent (11/45, 24%) compared to general population (9%). CONCLUSIONS: Stroke prevalence is increased in long-survivingPBTpatients treated with cranial RT. IMPLICATIONS FOR CANCER SURVIVORS: CV events are frequent in long survivors of PBT treated with cerebral RT. We propose a check list to guide management of late CV complications in adults treated with RT for PBT.

© 2023. The Author(s).

Keywords

• Cerebrovascular events; Primary brain tumor; Radiotherapy; Stroke