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Radiation-induced accelerated aging of the brain vasculature in young adult survivors of childhood brain tumors |
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| Author: | Remes, Tiina Maria1; Suo-Palosaari, Maria Helena2; Koskenkorva, Päivi K. T.3; |
| Organizations: |
1Department of Pediatrics and Adolescence, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital, and University of Oulu, Oulu, Finland 2Department of Diagnostic Radiology, Oulu University Hospital, and University of Oulu, Research Unit of Medical Imaging, Physics, and Technology, Faculty of Medicine, University of Oulu, and Medical Research Center Oulu, University of Oulu, Oulu, Finland 3Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
4Department of Pediatric Radiology, HUS Medical Imaging Center, Radiology, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
5Department of Pediatrics and Adolescence, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland 6Department of Pediatrics, Tampere University Hospital, and University of Tampere, Tampere, Finland 7Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland 8Department of Oncology and Department of Medical Physics, Tampere University Hospital, Tampere, Finland 9Department of Pediatrics and Adolescent Medicine, Turku University Hospital, and Turku University, Turku, Finland 10Department of Child Neurology, Children’s Hospital, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland 11Department of Medical Physics, Division of Medical Imaging, Turku University Hospital, Turku, Finland 12Department of Oncology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland 13Center of Oncology, Kuopio University Hospital, Kuopio, Finland 14Department of Pediatrics and Adolescence, Helsinki University, and Helsinki University Hospital, Helsinki, Finland 15Uppsala University, Department of Women’s and Children’s Health, Akademiska sjukhuset, Uppsala, Sweden |
| Format: | article |
| Version: | published version |
| Access: | open |
| Online Access: | PDF Full Text (PDF, 2.3 MB) |
| Persistent link: | http://urn.fi/urn:nbn:fi-fe2020090165973 |
| Language: | English |
| Published: |
Oxford University Press,
2020
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| Publish Date: | 2020-09-01 |
| Description: |
AbstractBackground: Cranial radiotherapy may damage the cerebral vasculature. The aim of this study was to understand the prevalence and risk factors of cerebrovascular disease (CVD) and white matter hyperintensities (WMHs) in childhood brain tumors (CBT) survivors treated with radiotherapy. Methods: Seventy CBT survivors who received radiotherapy were enrolled in a cross-sectional study at a median 20 years after radiotherapy cessation. The prevalence of and risk factors for CVD were investigated using MRI, MRA, and laboratory testing. Tumors, their treatment, and stroke-related data were retrieved from patients’ files. Results: Forty-four individuals (63%) had CVD at a median age of 27 years (range, 16–43 years). The prevalence rates at 20 years for CVD, small-vessel disease, and large-vessel disease were 52%, 38%, and 16%, respectively. Ischemic infarcts were diagnosed in 6 survivors, and cerebral hemorrhage in 2. Lacunar infarcts were present in 7, periventricular or deep WMHs in 34 (49%), and mineralizing microangiopathy in 21 (30%) survivors. Multiple pathologies were detected in 44% of the participants, and most lesions were located in a high-dose radiation area. Higher blood pressure was associated with CVD and a presence of WMHs. Higher cholesterol levels increased the risk of ischemic infarcts and WMHs, and lower levels of high-density lipoprotein and higher waist circumference increased the risk of lacunar infarcts. Conclusions: Treating CBTs with radiotherapy increases the risk of early CVD and WMHs in young adult survivors. These results suggest an urgent need for investigating CVD prevention in CBT patients. see all
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| Series: |
Neuro-oncology practice |
| ISSN: | 2054-2577 |
| ISSN-E: | 2054-2585 |
| ISSN-L: | 2054-2577 |
| Volume: | 7 |
| Issue: | 4 |
| Pages: | 415 - 427 |
| DOI: | 10.1093/nop/npaa002 |
| OADOI: | https://oadoi.org/10.1093/nop/npaa002 |
| Type of Publication: |
A1 Journal article – refereed |
| Field of Science: |
3122 Cancers 3123 Gynaecology and paediatrics |
| Subjects: | |
| Funding: |
This work was supported by Special State Grants for Health Research in the Department of Pediatrics and Adolescence, Oulu University Hospital, Finland, the Väre Foundation for Pediatric Cancer Research, Finland, the Foundation of Päivikki and Sakari Sohlberg, Finland, the Foundation of Arvo and Lea Ylppö, Finland, the Foundation for Pediatric Research, Finland, the Foundation of Emil Aaltonen, Finland, the Foundation of Thelma Mäkikyrö, Finland, the Cancer Foundation of Northern Finland, the Foundation of Alma and K. A. Snellman, Finland, and the Foundation of Märta Donner, Finland (to T.R.), and the Cancer Society of Finland (to H.R., A.H.-S., and M.O.). |
| Copyright information: |
© The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
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https://creativecommons.org/licenses/by/4.0/ |