Incidence and long-term outcome of postradiotherapy moyamoya syndrome in pediatric patients with primary brain tumors: a single institute experience in Taiwan.
We aimed to investigate the incidence and long-term outcome of moyamoya syndrome in pediatric patients with primary brain tumors after receiving cranial radiotherapy (RT) in a single institute in Taiwan. The complete medical records, medical images, and RT notes of 391 pediatric patients with primary brain tumors treated with cranial RT between January 1975 and December 2005 in Taipei Veterans General Hospital (TVGH), Taiwan, were entered into an electronic registry and reviewed. Eight (2%) cases of post-RT moyamoya syndrome were identified in the sample of 391 patients. The median latency was 3 years post-RT. Among the eight patients, three had craniopharyngioma, two had optic glioma, two had medulloblastoma, and one had a suprasellar astrocytoma. The prescribed physical doses of RT were in the range of 40-54 Gy. The incidence was highest in those with optic glioma (0.039/person-year), followed by craniopharyngioma (0.013/person-year), astrocytoma (0.003/person-year), and medulloblastoma (0.002/person-year). No patients died of vasculopathy. No difference in crude incidence was found between our results and those of other series. The incidence of moyamoya syndrome was diagnosis dependent, with the highest incidence among patients with optic glioma. No regional difference in incidence was found. Long-term, stable neurological function may be achieved following timely surgical intervention.
Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.|Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
Yuan-Hung
YH
Wu
Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Feng-Chi
FC
Chang
Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.|Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Muh-Lii
ML
Liang
School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Hsin-Hung
HH
Chen
School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Neurosurgery, Taipei Medical University Hospital, Taipei, Taiwan.|Department of Neurosurgery, Taipei Medical University, Taipei, Taiwan.
Tai-Tong
TT
Wong
Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.|Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.
Sang-Hue
SH
Yen
Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Yi-Wei
YW
Chen
D000293:Adolescent; D000367:Age Factors; D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D009026:Mortality; D009072:Moyamoya Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D063868:Patient Outcome Assessment; D011878:Radiotherapy / Q000009:adverse effects* / Q000379:methods; D013624:Taiwan / Q000453:epidemiology
Brain irradiation; complication; radiotherapy; vasculopathy