Cargando…

Histopathology and surgical outcome of symptomatic treatment-related changes after gamma knife radiosurgery in patients with brain metastases

A late-onset treatment-related changes (TRCs), which represent radiographic radiation necrosis (RN), frequently occur after stereotactic radiosurgery (SRS) for brain metastases and often need surgical treatment. This study aimed to validate the true pathology and investigate clinical implication of...

Descripción completa

Detalles Bibliográficos
Autores principales: Kim, Jeong-Hwa, Choi, Jung-Won, Kong, Doo-Sik, Seol, Ho Jun, Nam, Do-Hyun, Ryu, Jae-Wook, Kim, Sung-Tae, Suh, Yeon-Lim, Lee, Jung-Il
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8863779/
https://www.ncbi.nlm.nih.gov/pubmed/35194082
http://dx.doi.org/10.1038/s41598-022-06881-6
_version_ 1784655305522544640
author Kim, Jeong-Hwa
Choi, Jung-Won
Kong, Doo-Sik
Seol, Ho Jun
Nam, Do-Hyun
Ryu, Jae-Wook
Kim, Sung-Tae
Suh, Yeon-Lim
Lee, Jung-Il
author_facet Kim, Jeong-Hwa
Choi, Jung-Won
Kong, Doo-Sik
Seol, Ho Jun
Nam, Do-Hyun
Ryu, Jae-Wook
Kim, Sung-Tae
Suh, Yeon-Lim
Lee, Jung-Il
author_sort Kim, Jeong-Hwa
collection PubMed
description A late-onset treatment-related changes (TRCs), which represent radiographic radiation necrosis (RN), frequently occur after stereotactic radiosurgery (SRS) for brain metastases and often need surgical treatment. This study aimed to validate the true pathology and investigate clinical implication of surgically resected TRCs on advanced magnetic resonance imaging (MRI). Retrospective analyses of 86 patients who underwent surgical resection after radiosurgery of brain metastases were performed. Fifty-four patients displayed TRCs on preoperative MRI, comprising pure RN in 19 patients (TRC-RN group) and mixed viable tumor cells in 35 patients (TRC-PD group). Thirty-two patients revealed the consistent diagnosis of progressive disease in both MRI and histopathology (PD–PD group). The TRC-PD group showed larger prescription isodose volume (9.4 cm(3)) than the TRC-RN (4.06 cm(3), p = 0.014) group and a shorter time interval from SRS to preoperative MRI diagnosis (median 4.07 months) than the PD–PD group (median 8.77 months, p = 0.004). Progression-free survival was significantly different among the three groups (p < 0.001), but not between TRC-RN and TRC-PD (post hoc test, p = 1.00), while no difference was observed in overall survival (p = 0.067). Brain metastases featured as TRCs after SRS frequently contained viable tumor cells. However, this histologic heterogeneity had a minor impact on benign local prognosis of TRCs after surgical resection.
format Online
Article
Text
id pubmed-8863779
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Nature Publishing Group UK
record_format MEDLINE/PubMed
spelling pubmed-88637792022-02-23 Histopathology and surgical outcome of symptomatic treatment-related changes after gamma knife radiosurgery in patients with brain metastases Kim, Jeong-Hwa Choi, Jung-Won Kong, Doo-Sik Seol, Ho Jun Nam, Do-Hyun Ryu, Jae-Wook Kim, Sung-Tae Suh, Yeon-Lim Lee, Jung-Il Sci Rep Article A late-onset treatment-related changes (TRCs), which represent radiographic radiation necrosis (RN), frequently occur after stereotactic radiosurgery (SRS) for brain metastases and often need surgical treatment. This study aimed to validate the true pathology and investigate clinical implication of surgically resected TRCs on advanced magnetic resonance imaging (MRI). Retrospective analyses of 86 patients who underwent surgical resection after radiosurgery of brain metastases were performed. Fifty-four patients displayed TRCs on preoperative MRI, comprising pure RN in 19 patients (TRC-RN group) and mixed viable tumor cells in 35 patients (TRC-PD group). Thirty-two patients revealed the consistent diagnosis of progressive disease in both MRI and histopathology (PD–PD group). The TRC-PD group showed larger prescription isodose volume (9.4 cm(3)) than the TRC-RN (4.06 cm(3), p = 0.014) group and a shorter time interval from SRS to preoperative MRI diagnosis (median 4.07 months) than the PD–PD group (median 8.77 months, p = 0.004). Progression-free survival was significantly different among the three groups (p < 0.001), but not between TRC-RN and TRC-PD (post hoc test, p = 1.00), while no difference was observed in overall survival (p = 0.067). Brain metastases featured as TRCs after SRS frequently contained viable tumor cells. However, this histologic heterogeneity had a minor impact on benign local prognosis of TRCs after surgical resection. Nature Publishing Group UK 2022-02-22 /pmc/articles/PMC8863779/ /pubmed/35194082 http://dx.doi.org/10.1038/s41598-022-06881-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Kim, Jeong-Hwa
Choi, Jung-Won
Kong, Doo-Sik
Seol, Ho Jun
Nam, Do-Hyun
Ryu, Jae-Wook
Kim, Sung-Tae
Suh, Yeon-Lim
Lee, Jung-Il
Histopathology and surgical outcome of symptomatic treatment-related changes after gamma knife radiosurgery in patients with brain metastases
title Histopathology and surgical outcome of symptomatic treatment-related changes after gamma knife radiosurgery in patients with brain metastases
title_full Histopathology and surgical outcome of symptomatic treatment-related changes after gamma knife radiosurgery in patients with brain metastases
title_fullStr Histopathology and surgical outcome of symptomatic treatment-related changes after gamma knife radiosurgery in patients with brain metastases
title_full_unstemmed Histopathology and surgical outcome of symptomatic treatment-related changes after gamma knife radiosurgery in patients with brain metastases
title_short Histopathology and surgical outcome of symptomatic treatment-related changes after gamma knife radiosurgery in patients with brain metastases
title_sort histopathology and surgical outcome of symptomatic treatment-related changes after gamma knife radiosurgery in patients with brain metastases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8863779/
https://www.ncbi.nlm.nih.gov/pubmed/35194082
http://dx.doi.org/10.1038/s41598-022-06881-6
work_keys_str_mv AT kimjeonghwa histopathologyandsurgicaloutcomeofsymptomatictreatmentrelatedchangesaftergammakniferadiosurgeryinpatientswithbrainmetastases
AT choijungwon histopathologyandsurgicaloutcomeofsymptomatictreatmentrelatedchangesaftergammakniferadiosurgeryinpatientswithbrainmetastases
AT kongdoosik histopathologyandsurgicaloutcomeofsymptomatictreatmentrelatedchangesaftergammakniferadiosurgeryinpatientswithbrainmetastases
AT seolhojun histopathologyandsurgicaloutcomeofsymptomatictreatmentrelatedchangesaftergammakniferadiosurgeryinpatientswithbrainmetastases
AT namdohyun histopathologyandsurgicaloutcomeofsymptomatictreatmentrelatedchangesaftergammakniferadiosurgeryinpatientswithbrainmetastases
AT ryujaewook histopathologyandsurgicaloutcomeofsymptomatictreatmentrelatedchangesaftergammakniferadiosurgeryinpatientswithbrainmetastases
AT kimsungtae histopathologyandsurgicaloutcomeofsymptomatictreatmentrelatedchangesaftergammakniferadiosurgeryinpatientswithbrainmetastases
AT suhyeonlim histopathologyandsurgicaloutcomeofsymptomatictreatmentrelatedchangesaftergammakniferadiosurgeryinpatientswithbrainmetastases
AT leejungil histopathologyandsurgicaloutcomeofsymptomatictreatmentrelatedchangesaftergammakniferadiosurgeryinpatientswithbrainmetastases