Radiation-induced brain injury: retrospective analysis of twelve pathologically proven cases

• Published in: Radiation oncology journal 2011, 29(3), , pp.147-155
• Main Authors: Lee, Dong-Soo, Yu, Mina, Jang, Hong-Seok, Kim, Yeon-Sil, Choi, Byung-Ock, Kang, Young-Nam, Lee, Youn-Soo, Kim, Dong-Chul, Hong, Yong-Kil, Jeun, Sin-Soo, Yoon, Sei-Chul
• Format: Article
• Language: English
• Subjects: Original; 방사선과학
• ISSN: 2234-1900; 2234-3164; 2234-3156
• DOI: 10.3857/roj.2011.29.3.147

Purpose: This study was designed to determine the influencing factors and clinical course of pathologically proven cases of radiation-induced brain injury (RIBI). Materials and Methods: The pathologic records of twelve patients were reviewed; these patients underwent surgery following radiotherapy due to disease progression found by follow-up imaging. However, they were fi nally diagnosed with RIBI. All patients had been treated with 3-dimensional conventional fractionated radiotherapy and/or radiosurgery for primary or metastatic brain tumors with or without chemotherapy. The histological distribution was as follows: two falx meningioma, six glioblastoma multiform (GBM), two anaplastic oligodendroglioma, one low grade oligodendroglioma, and one small cell lung cancer with brain metastasis. Results: Radiation necrosis was noted in eight patients and the remaining four were diagnosed with radiation change. Gender (p = 0.061) and biologically equivalent dose (BED)3 (p = 0.084) were the only marginally infl uencing factors of radiation necrosis. Median time to RIBI was 7.3 months (range, 0.5 to 61 months). Three prolonged survivors with GBM were observed. In the subgroup analysis of high grade gliomas, RIBI that developed