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Cystlike Lesions as a Late Sequela of Radiotherapy in Pediatric Patients

dc.contributor.authorVeiga, MGD
dc.contributor.authorFragata, I
dc.contributor.authorPassos, J
dc.contributor.authorAlves, M
dc.contributor.authorPapoila, AL
dc.contributor.authorSalgado, D
dc.date.accessioned2023-09-11T11:49:36Z
dc.date.available2023-09-11T11:49:36Z
dc.date.issued2021
dc.description.abstractBackground and purpose: The developing nervous system is particularly vulnerable to late adverse effects of cranial radiation therapy, such as leukoencephalopathy, microbleeds, and cavernomas. Cystlike lesions have been rarely described and characterized in the literature. We aimed to characterize cystlike lesions, their risk factors, and association with other late adverse effects. Materials and methods: Children treated for brain tumors during a 30-year period (n = 139) were included. We documented imaging findings, focusing on cystlike lesion development and its relationship with clinical history and other imaging findings. Multivariable analysis was performed using logistic regression and negative binomial regression models. Results: Cystlike lesions developed in 16.5% of patients treated with radiotherapy, with a median of 2 years until the development of the first lesion. For every 4-year age increase, there were 50% decreased odds of developing lesions and a 50% decrease in the average count of lesions. Females demonstrated a 4.00 rate ratio of developing a higher number of lesions. Patients who underwent chemoradiotherapy had 3.20 increased odds of developing cystlike lesions compared with patients with radiation therapy alone. A larger proportion of patients treated with methotrexate (25%) developed cystlike lesions, but this was not statistically significant. Cystlike lesions tended to develop in cerebral locations where leukoencephalopathy was worse. A strong relationship was found between the development of cystlike lesions and leukoencephalopathy severity. Conclusions: Cystlike lesions are frequent and under-reported late adverse effects of cranial radiation therapy in children. Younger age, chemoradiotherapy, and the severity of leukoencephalopathy represent risk factors for the development of cystlike lesions.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAJNR Am J Neuroradiol . 2021 Aug;42(8):1543-1549pt_PT
dc.identifier.doi10.3174/ajnr.A7156pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4688
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherAmerican Society of Neuroradiologypt_PT
dc.subjectBrain Neoplasms*pt_PT
dc.subjectChemoradiotherapypt_PT
dc.subjectChildpt_PT
dc.subjectCranial Irradiationpt_PT
dc.subjectFemalept_PT
dc.subjectLeukoencephalopathies*pt_PT
dc.subjectMethotrexatept_PT
dc.subjectHSJ NRADpt_PT
dc.titleCystlike Lesions as a Late Sequela of Radiotherapy in Pediatric Patientspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1549pt_PT
oaire.citation.issue8pt_PT
oaire.citation.startPage1543pt_PT
oaire.citation.titleAmerican Journal of Neuroradiologypt_PT
oaire.citation.volume42pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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