目的:本回顾性系统文献综述旨在总结有关流行病学的现有数据,病因学,介绍,调查,差分,治疗,预防,监测,并发症,和儿童患者放射性海绵状畸形(RICMs)的预后。
方法:按照PRISMA指南进行审查。谷歌学者,PubMed,TripMedicalDatabase,Cochrane图书馆使用一个关键词进行搜索,根据纳入/排除标准过滤的文章,排除重复项。根据标准,确定了25篇文章,7进一步从系统数据中排除,但包括在讨论中(5×数据不足,2×其他系统评价)。
结果:许多研究并不包含所有探索的数据。2487例患者进行了回顾,325人后来发现有RICM(143名男性,92女)。平均照射年龄7.6岁(范围1.5-19)。平均总辐射剂量56Gy(12-112)。放射髓母细胞瘤的最常见适应症133x,星形细胞瘤23x,室管膜瘤21x,生殖细胞瘤19x.RICM诊断的平均年龄18岁(3.6-57岁)。RICM的平均潜伏期9.9年(0.25-41)。最常见的解剖位置-颞叶36,额叶36,顶叶13,基底节16,幕下20。临床表现-偶发270,癫痫发作19,头痛11,局灶性神经功能缺损7,其他13。264例患者观察,34做手术。RICM在28例患者中出血。平均随访11.7年(0.5-50.3)。预后报告变化很大。
结论:从我们的数据来看,儿科RICM似乎显示出轻微的男性优势,在青少年后期初次照射后大约10年,在大多数情况下都是偶然出现的。它们大多在出血时进行手术,随着时间的推移,主要观察到附带病变。进一步的前瞻性详细研究需要得出更强有力的结论。
OBJECTIVE: This retrospective systematic literature review aimed to summarize available data regarding epidemiology, etiology, presentation, investigations, differentials, treatment, prevention, monitoring, complications, and prognosis for radiation-induced cavernous malformations (RICMs) in pediatric patients.
METHODS: Review conducted per PRISMA guidelines. Google Scholar, PubMed, Trip Medical Database, and Cochrane Library searched utilizing a keyphrase, articles filtered per inclusion/exclusion criteria, duplicates excluded. Based on criteria, 25 articles identified, 7 further excluded from the systematic data but included in discussion (5 × insufficient data, 2 × other systematic reviews).
RESULTS: Many studies did not contain all explored data. 2487 patients reviewed, 325 later found to have RICM (143 male, 92 female). Mean age at irradiation 7.6 years (range 1.5-19). Mean total radiation dose 56 Gy (12-112). Most common indications for radiation-medulloblastoma 133x, astrocytoma 23x, ependymoma 21x, germinoma 19x. Mean age at RICM diagnosis 18 years (3.6-57). Mean latency to RICM 9.9 years (0.25-41). Most common anatomic locations-temporal 36, frontal 36, parietal 13, basal ganglia 16, infratentorial 20. Clinical presentation-incidental 270, seizures 19, headache 11, focal neurological deficit 7, other 13. 264 patients observed, 34 undergone surgery. RICM bled in 28 patients. Mean follow-up 11.7 years (0.5-50.3). Prognostic reporting highly variable.
CONCLUSIONS: From our data, pediatric RICMs appear to display slight male predominance, present about 10 years after initial irradiation in late teen years, and present incidentally in majority of cases. They are mostly operated on when they bleed, with incidental lesions mostly being observed over time. Further prospective detailed studies needed to draw stronger conclusions.