title: Late radiation injury following hyperfractionated craniospinal radiotherapy for primitive neuroectodermal tumor.
abstract: OBJECTIVE
  To document the late radiographic change following hyperfractionated craniospinal radiotherapy for primitive neuroectodermal tumor.
  
  
  METHODS
  We reviewed long-term MRI scans on 21 patients with standard risk and high risk primitive neuroectodermal tumor treated with hyperfractionated radiotherapy following surgical resection. High risk patients also received adjuvant chemotherapy. Long-term scans were defined as scan obtained at least 1 year from diagnosis. Clinical follow-up data was available on all patients.
  
  
  RESULTS
  Twelve of 21 patients had MRI evidence of necrosis, telangiectasia, white matter changes, basal ganglia change, or cerebral atrophy consistent with radiation injury. No patient required treatment for the radiographic change.
  
  
  CONCLUSIONS
  Slightly over half of the patients had evidence of long-term radiation effect following craniospinal axis radiotherapy. However, no patient had frank clinical symptoms related to the radiographic findings.
authors.affiliation: Brain Tumor Research Center of the Department of Neurological Surgery, School of Medicine, University of California, San Francisco, USA. russoc@neuro.ucsf.edu
authors.forename: C
authors.initials: C
authors.lastname: Russo
authors.forename: N
authors.initials: N
authors.lastname: Fischbein
authors.forename: E
authors.initials: E
authors.lastname: Grant
authors.forename: M D
authors.initials: MD
authors.lastname: Prados
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000528:radiation effects*; D001932:Brain Neoplasms / Q000532:radiotherapy*; D002531:Cerebellum / Q000528:radiation effects; D002648:Child; D002675:Child, Preschool; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018242:Neuroectodermal Tumors, Primitive / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000175:diagnosis*; D013116:Spinal Cord / Q000528:radiation effects*