We retrospectively identified adults with a supratentorial PBT diagnosed between 1975 and 2006 and with at least 10 years 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.
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%).
Stroke prevalence is increased in long-surviving PBT patients treated with cranial RT.
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.
方法:我们回顾性地确定了1975年至2006年间诊断为幕上PBT的成年人,并在治疗后至少随访10年。我们分析了人口统计,临床,和放射学特征,特别注意CV事件。我们还描述了CV事件,血管危险因素,在一项横断面研究中,对研究时存活的受照射患者进行了颅内动脉修饰。
结果:共有116名患者,接受RT(暴露组)治疗,纳入85例未经照射的患者(未照射组)。受照射的PBT患者的卒中发生率高于未暴露组(42/116(36%)vs7/85(8%);p<0.001),缺血性卒中(27/116(23%)vs6/85(7%);p=0.004)和出血性卒中(12/116(10%)vs1/85(1%);p=0.02)的患病率较高。在受照射的组中,肿瘤靠近WillisPolygon的患者更有可能发生卒中(p<0.016).横断面研究中包括了44名活着的接受过照射的患者。在这个子群中,与普通人群(9%)相比,颅内动脉狭窄更为普遍(11/45,24%).
结论:在接受头颅RT治疗的长期存活的PBT患者中,卒中患病率增加。
结论:CV事件在接受脑RT治疗的PBT长期存活者中常见。我们提出了一份清单,以指导接受RT治疗的成人PBT的晚期CV并发症的管理。