ojrdrtОнкологический журнал: лучевая диагностика, лучевая терапияJournal of oncology: diagnostic radiology and radiotherapy2587-75932713-167XНЕКОММЕРЧЕСКОЕ ПАРТНЕРСТВО «ОБЩЕСТВО ИНТЕРВЕНЦИОННЫХ ОНКОРАДИОЛОГОВ»10.37174/2587-7593-2024-7-4-48-53ojrdrt-400Research ArticleЛУЧЕВАЯ ТЕРАПИЯRADIOTHERAPYПостлучевые реакции после радиохирургии кавернозных мальформаций и факторы, влияющие на частоту их возникновенияPost-Radiation Reactions after Radiosurgery for Cavernous Malformations and Factors Influencing Their Frequencyhttps://orcid.org/0000-0001-9105-671XСеменовД. Э.SemenovD. E.

Семенов Денис Эдуардович

+7-901-902-63-11 

Россия, 125047, Москва, ул. 4-я Тверская-Ямская, 16 

 Denis E. Semenov

+7-901-902-63-11 

 16, 4th Tverskaya-Yamskaya street, Moscow, Russia, 125047 

semenovdenismed@gmail.comhttps://orcid.org/0000-0002-7806-5774КостюченкоВ. В.KostyuchenkoV. V.

Россия, 125047, Москва, ул. 4-я Тверская-Ямская, 16 

 16, 4th Tverskaya-Yamskaya street, Moscow, Russia, 125047 

https://orcid.org/0000-0002-0976-4547ГолановА. В.GolanovA. V.

Россия, 125047, Москва, ул. 4-я Тверская-Ямская, 16 

 16, 4th Tverskaya-Yamskaya street, Moscow, Russia, 125047 

https://orcid.org/0000-0003-4908-8923БелоусоваО. Б.BelousovaO. B.

Россия, 125047, Москва, ул. 4-я Тверская-Ямская, 16 

 16, 4th Tverskaya-Yamskaya street, Moscow, Russia, 125047 

https://orcid.org/0000-0003-4185-7150КоледоваЮ. В.KoledovaYu. V.

Россия, 125047, Москва, ул. 4-я Тверская-Ямская, 16 

 16, 4th Tverskaya-Yamskaya street, Moscow, Russia, 125047 

Национальный медицинский исследовательский центр нейрохирургии им. ак. Н.Н. БурденкоРоссияN.N. Burdenko National Medical Research Center for Neurosurgery of the Ministry of Health of the Russian FederationRussian Federation202426122024744853Copyright © Семенов Д.Э., Костюченко В.В., Голанов А.В., Белоусова О.Б., Коледова Ю.В., 20242024Семенов Д.Э., Костюченко В.В., Голанов А.В., Белоусова О.Б., Коледова Ю.В.Semenov D.E., Kostyuchenko V.V., Golanov A.V., Belousova O.B., Koledova Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncoradjournal.ru/jour/article/view/400

Цель: Рассмотреть структуру нежелательных постлучевых реакций, возникающих после радиохирургического (Рˈ) лечения кавернозных мальформаций (КМ) и определить факторы, влияющие на частоту их возникновения.Материал и методы: Между сентябрем 2005 и сентябрем 2020 года было облучено 123 пациента с одиночными КМ головного мозга (всего 123 КМ). В окончательный анализ было включено 67 пациентов. Данные о дозовых распределениях были подвергнуты регрессионному анализу.Результаты: Было выявлено 19 случаев постлучевого отека (28,3 %) и 2 случая постлучевого некроза (2,9 %). У 10 пациентов за время наблюдения было выявлено кровоизлияние из облученной КМ (14,9 %). Доза, полученная 50 % объема мишени (с включением ГСК), была определена как наиболее значимый предиктор развития постлучевого отека у пациентов после радиохирургии одиночных каверном.Выводы: В случаях глубинного расположения КМ микрохирургическое удаление сопряжено с высоким риском осложнений. РХ в таких случаях может предложена как безопасная альтернатива микрохирургии.

Purpose: To investigate the structure of adverse post-radiation reactions occurring after radiosurgical treatment of cavernous malformations (CMs) and to identify factors influencing their frequency.Material and methods: Between September 2005 and September 2020, 123 patients with single CMs of the brain (a total of 123 CMs) were irradiated at the center. The final analysis included 67 patients. Dose distribution data were subjected to regression analysis.Results: Nineteen cases of post-radiation edema (28.3 %) and two cases of post-radiation necrosis (2.9 %) were identified. During the observation period, ten patients experienced hemorrhage from the irradiated CM (14.9 %). The dose received by 50 % of the target volume (including the planning target volume) was determined to be the most significant predictor of post-radiation edema development in patients after radiosurgery for single cavernomas.Conclusion: In cases of deep-seated CMs, microsurgical removal is associated with a high risk of complications. In such cases, radiosurgery can be offered as a safe alternative to microsurgery.

кавернозная мальформациярадиохирургиянежелательные постлучевые реакцииcavernous malformationradiosurgeryadverse post-radiation reactionsReferencesGoldstein HE, Solomon RA. Epidemiology of cavernous malformations. Handbook of Clinical Neurology. 2017:241-7. https://doi.org/10.1016/b978-0-444-63640-9.00023-0Goldstein HE, Solomon RA. Epidemiology of cavernous malformations. Handbook of Clinical Neurology. 2017:241-7. https://doi.org/10.1016/b978-0-444-63640-9.00023-0Lunsford LD, Niranjan A, Kano H, et al. Leksell stereotactic radiosurgery for cavernous malformations. Progress in Neurological Surgery. 2019:260-6. https://doi.org/10.1159/000493072Lunsford LD, Niranjan A, Kano H, et al. Leksell stereotactic radiosurgery for cavernous malformations. Progress in Neurological Surgery. 2019:260-6. https://doi.org/10.1159/000493072Flemming KD, Lanzino G. Stereotactic radiosurgery for cavernous malformations. Neurology. 2019;93(21):921-2. https://doi.org/10.1212/wnl.0000000000008516Flemming KD, Lanzino G. Stereotactic radiosurgery for cavernous malformations. Neurology. 2019;93(21):921-2. https://doi.org/10.1212/wnl.0000000000008516Nagy G, Burkitt W, Stokes SS, et al. Contemporary radiosurgery of cerebral cavernous malformations: Part 1. Treatment outcome for critically located hemorrhagic lesions. J Neurosurg. 2018;130(6):1817-1825. https://doi.org/10.3171/2017.5.jns17776Nagy G, Burkitt W, Stokes SS, et al. Contemporary radiosurgery of cerebral cavernous malformations: Part 1. Treatment outcome for critically located hemorrhagic lesions. J Neurosurg. 2018;130(6):1817-1825. https://doi.org/10.3171/2017.5.jns17776Balentova S, Adamkov M. Molecular, Cellular and Functional Effects of Radiation-Induced Brain Injury: A review. Int J Molec Sci. 2015;16(11):27796-815. https://doi.org/10.3390/ijms161126068Balentova S, Adamkov M. Molecular, Cellular and Functional Effects of Radiation-Induced Brain Injury: A review. Int J Molec Sci. 2015;16(11):27796-815. https://doi.org/10.3390/ijms161126068Голанов АВ, Костюченко ВВ. Проблемы сбора информации. Информационная система ˉГНМ. Нейрорадиохирургия на Гамма-ноже. 2018;438-66.Golanov AV, Kostyuchenko VV. Problems of information gathering. Gamma Knife Centre Database. 2018;438-66. (In Russ.).Zabramski JM, Wascher TM, Spetzler RF, et al. The natural history of familial cavernous malformations: results of an ongoing study. J Neurosurg. 1994;80(3):422-2. https://doi.org/10.3171/jns.1994.80.3.0422Zabramski JM, Wascher TM, Spetzler RF, et al. The natural history of familial cavernous malformations: results of an ongoing study. J Neurosurg. 1994;80(3):422-2. https://doi.org/10.3171/jns.1994.80.3.0422Uysal E, Cine HS, Sahin C. Making stereotactic radiosurgery decisions by calculating the probability of perilesional edema in cavernomas. PubMed. 2023;27(22):10917-25. https://doi.org/10.26355/eurrevͺ202311ͺ34459Uysal E, Cine HS, Sahin C. Making stereotactic radiosurgery decisions by calculating the probability of perilesional edema in cavernomas. PubMed. 2023;27(22):10917-25. https://doi.org/10.26355/eurrevͺ202311ͺ34459Piedade PA. Volume-dose indexes and dose prescription descriptive review of radiosurgery planning. Brazilian J Radiat Sci. 2019;7(3B). https://doi.org/10.15392/bjrs.v7i3b.889Piedade PA. Volume-dose indexes and dose prescription descriptive review of radiosurgery planning. Brazilian J Radiat Sci. 2019;7(3B). https://doi.org/10.15392/bjrs.v7i3b.889Benedict S. MO-E-224A-02: Stereotactic Body Radiation Therapy: (1) Highlights of the AAPM Task Group Report 101 on SBRT. Med Phys. 2006;33(6Part15):2176. https://doi.org/10.1118/1.2241475Benedict S. MO-E-224A-02: Stereotactic Body Radiation Therapy: (1) Highlights of the AAPM Task Group Report 101 on SBRT. Med Phys. 2006;33(6Part15):2176. https://doi.org/10.1118/1.2241475St George EJ, Perks J, Plowman PN. Stereotactic radiosurgery yIV: the role of the haemosiderin ‘ring’ in the development of adverse reactions following radiosurgery for intracranial cavernous malformations: a sustainable hypothesis. Br J Neurosurg. 2002;16(4):385-91. https://doi.org/10.1080/026886902100007632St George EJ, Perks J, Plowman PN. Stereotactic radiosurgery yIV: the role of the haemosiderin ‘ring’ in the development of adverse reactions following radiosurgery for intracranial cavernous malformations: a sustainable hypothesis. Br J Neurosurg. 2002;16(4):385-91. https://doi.org/10.1080/026886902100007632Milano MT, Sharma M, Soltys SG, et al. Radiation-Induced Edema after Single-Fraction or Multifraction Stereotactic Radiosurgery for Meningioma: A Critical review. Int J Radiat Oncol Biol Phys. 2018;101(2):344-57. https://doi.org/10.1016/j.ijrobp.2018.03.026Milano MT, Sharma M, Soltys SG, et al. Radiation-Induced Edema after Single-Fraction or Multifraction Stereotactic Radiosurgery for Meningioma: A Critical review. Int J Radiat Oncol Biol Phys. 2018;101(2):344-57. https://doi.org/10.1016/j.ijrobp.2018.03.026Koester SW, Rhodenhiser EG, Dabrowski SJ, et al. Radiation-Induced Cerebral Cavernous Malformations: A Single-Center Experience and Systematic Literature review. World Neurosurg. 2023;179:222-32. https://doi.org/10.1016/j.wneu.2023.08.036Koester SW, Rhodenhiser EG, Dabrowski SJ, et al. Radiation-Induced Cerebral Cavernous Malformations: A Single-Center Experience and Systematic Literature review. World Neurosurg. 2023;179:222-32. https://doi.org/10.1016/j.wneu.2023.08.036Dumot C, Mantziaris G, Dayawansa S, et al. Stereotactic radiosurgery for haemorrhagic cerebral cavernous malformation: a multi-institutional, retrospective study. Stroke and Vascular Neurology. 2023;9(3):221-9. https://doi.org/10.1136/svn-2023-002380Dumot C, Mantziaris G, Dayawansa S, et al. Stereotactic radiosurgery for haemorrhagic cerebral cavernous malformation: a multi-institutional, retrospective study. Stroke and Vascular Neurology. 2023;9(3):221-9. https://doi.org/10.1136/svn-2023-002380Barillaro A, Caroprese M, Cella L, et al. Stereotactic radiation therapy for brain metastases: factors affecting outcomes and radiation necrosis. Cancers. 2023;15(7):2094. https://doi.org/10.3390/cancers15072094Barillaro A, Caroprese M, Cella L, et al. Stereotactic radiation therapy for brain metastases: factors affecting outcomes and radiation necrosis. Cancers. 2023;15(7):2094. https://doi.org/10.3390/cancers15072094Lee CC, Wang WH, Yang HC, et al. Gamma Knife radiosurgery for cerebral cavernous malformation. Sci Rep. 2019;9(1). https://doi.org/10.1038/s41598-019-56119-1Lee CC, Wang WH, Yang HC, et al. Gamma Knife radiosurgery for cerebral cavernous malformation. Sci Rep. 2019;9(1). https://doi.org/10.1038/s41598-019-56119-1Novotnlj J Jr, KollovĄ A, LiƓēĄk R. Prediction of intracranial edema after radiosurgery of meningiomas. J Neurosurg. 2006;105(Supplement):120-26. https://doi.org/10.3171/sup.2006.105.7.120Novotnlj J Jr, KollovĄ A, LiƓēĄk R. Prediction of intracranial edema after radiosurgery of meningiomas. J Neurosurg. 2006;105(Supplement):120-26. https://doi.org/10.3171/sup.2006.105.7.120

The authors declare that there are no conflicts of interest present.