Delayed leukoencephalopathy of non-small cell lung cancer patients with brain metastases underwent whole brain radiation therapy.
To explore the incidence, MR imaging findings, dynamic developing process of delayed leukoencephalopathy (DLE) in non-small cell lung cancer (NSCLC) patients with brain metastases patients who undergone whole brain radiation (WBRT) therapy, we retrospectively reviewed 48 NSCLC patients who underwent WBRT for brain metastases from January 2010 through June 2015 and had evaluable magnetic resonance imaging after treatment. The DLE were graded using a scale to evaluate T2-FLAIR (fluid attenuated image recovery) images: grade 1 = little or no white matter hyperintensity, grade 2 = limited periventricular hyperintensity and grade 3 = diffuse white matter hyperintensity. 48 NSCLC patients with brain metastases were enrolled. The median age of these patients was 55.7 years (range 33-75 years). The median follow-up was 12 months. The characteristic MR imaging of DLE in those patients was bilaterally diffuse white matter T2 hyperintensity around the periventricular areas without enhancement, sparing from U-fiber, callosum and gray matter structure. The incidence of DLE developed 6.25% (3/48), 30.00% (12/40), 48.39% (15/31), 61.90% (13/21), 85.71% (6/7), 100% (3/3) in those patients who were followed up for 3, 6, 9, 12, 24, 36 months, respectively. Through increased understanding of it, it may be possible to help clinicians develop further therapeutic strategies to maximize benefit while limiting potential long term toxicities. These data supplement existing reports regarding the late effects of WBRT in NSCLC patients with brain metastasis.
Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, 106 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China.|Southern Medical School, 1023 Shatai South Road, Baiyun District, Guangzhou, 510515, Guangdong, People's Republic of China.
Xiaoling
X
Zhong
Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, 106 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China. cjr.huangbiao@vip.163.com.
Biao
B
Huang
Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, 106 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China.
Jieying
J
Feng
Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, 106 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China.
Wanqun
W
Yang
Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, 106 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China.
Hongjun
H
Liu
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology* / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000473:pathology / Q000532:radiotherapy; D016371:Cranial Irradiation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D056784:Leukoencephalopathies / Q000209:etiology*; D008175:Lung Neoplasms / Q000150:complications / Q000473:pathology / Q000532:radiotherapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D066127:White Matter / Q000473:pathology
Brain metastases; Delayed leukoencephalopathy; MRI; Non-small cell lung cancer; Whole brain radiation therapy