Review of cranial radiotherapy-induced vasculopathy
- 12 February 2015
- journal article
- review article
- Published by Springer Science and Business Media LLC in Journal of Neuro-Oncology
- Vol. 122 (3), 421-429
- https://doi.org/10.1007/s11060-015-1732-2
Abstract
Cranial radiation can impact the cerebral vasculature in many ways, with a wide range of clinical manifestations. The incidence of these late effects including cerebrovascular accidents (CVAs), lacunar lesions, vascular occlusive disease including moyamoya syndrome, vascular malformations, and hemorrhage is not well known. This article reviews the preclinical findings regarding the pathophysiology of late radiation-induced vascular damage, and discusses the clinical incidence and risk factors for each type of vasculopathy. The pathophysiology is complex and dependent on the targeted blood vessels, and upregulation of pro-inflammatory and hypoxia-related genes. The risk factors for adult CVAs are similar to those for patients not exposed to cranial radiotherapy. For children, risks for late vascular complications include young age at radiotherapy, radiotherapy dose, NF1, tumor location, chemotherapy, and endocrine abnormalities. The incidence of late vascular complications of radiotherapy may be impacted by improved technology, therapeutic interventions, and appropriate follow up.Keywords
This publication has 57 references indexed in Scilit:
- Cranial Irradiation Increases Risk of Stroke in Pediatric Brain Tumor SurvivorsStroke, 2012
- Cerebrovascular disease in childhood cancer survivorsNeurology, 2009
- Intracranial aneurysm following radiation therapy during childhood for a brain tumorJournal of Neurosurgery: Pediatrics, 2006
- Ionizing Radiation Accelerates the Development of Atherosclerotic Lesions in ApoE−/− Mice and Predisposes to an Inflammatory Plaque Phenotype Prone to HemorrhageThe American Journal of Pathology, 2006
- Cumulative incidence of radiation-induced cavernomas in long-term survivors of medulloblastomaJournal of Neurosurgery: Pediatrics, 2006
- Cumulative incidence of radiation-induced cavernomas in long-term survivors of medulloblastomaJournal of Neurosurgery: Pediatrics, 2006
- Results of stereotactic radiosurgery in patients with hormone-producing pituitary adenomas: factors associated with endocrine normalizationJournal of Neurosurgery, 2002
- Chemo‐irradiation induced aortoesophageal fistulaJournal of Surgical Oncology, 1991
- Development of blood vessel-related radiation damage in the fimbria of the central nervous systemInternational Journal of Radiation Oncology*Biology*Physics, 1990
- Incidence of cerebral infarction after radiotherapy for pituitary adenomaCancer, 1989