title: Cerebral glucose metabolism in long-term survivors of childhood primary brain tumors treated with surgery and radiotherapy.
abstract: Delayed structural cerebral sequelae has been reported following cranial radiation therapy (CRT) to children with primary brain tumors, but little is known about potential functional changes. Twenty-four patients were included, diagnosed and treated at a median age of 11 years, and examined after a median recurrence free survival of 16 years by MRI and Positron Emission Tomography using the glucose analog 2-18F-fluoro-2-deoxy-D-glucose (18FDG). Three patients were not analyzed further due to diffuse cerebral atrophy, which might be related to previous hydrocephalus. Twenty-one patients were evaluable and regional cerebral metabolic rate for glucose (rCMRglc) was estimated in nontumoral brain regions in 12 patients treated with surgery alone and 9 patients treated with both surgery and CRT. Furthermore 10 normal controls matched for age at examination were included. Patients treated with both surgery and CRT had a general decreased rCMRglc compared to normal controls and patients treated with surgery alone, significantly (p < 0.05) in 5 of 11 regions of interest. No difference was found in rCMRglc between normal controls and patients treated with surgery alone. We conclude that there is a general reduction in rCMRglc in long-term recurrence free survivors of childhood primary brain tumors treated with CRT in high doses (44-56 Gy).
authors.affiliation: Department of Neurology Neurobiological Research Unit, The Neuroscience Centre, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Preben B
authors.initials: PB
authors.lastname: Andersen
authors.forename: Katja
authors.initials: K
authors.lastname: Krabbe
authors.forename: Anne M
authors.initials: AM
authors.lastname: Leffers
authors.forename: Marianne
authors.initials: M
authors.lastname: Schmiegelow
authors.forename: Søren
authors.initials: S
authors.lastname: Holm
authors.forename: Henning
authors.initials: H
authors.lastname: Laursen
authors.forename: Jørn R
authors.initials: JR
authors.lastname: Müller
authors.forename: Olaf B
authors.initials: OB
authors.lastname: Paulson
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000628:therapy*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D019275:Radiopharmaceuticals; D017741:Survivors; D014055:Tomography, Emission-Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose