ReviewNeuro-oncology practice2021
Systematic review of the incidence and risk factors for cerebral vasculopathy and stroke after cranial proton and photon radiation for childhood brain tumors.
Review in Neuro-oncology practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
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Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Radiation therapy for childhood-onset craniopharyngioma: systematic review and meta-analysis.Journal of neuro-oncology · 2025Pooled it
- Proton Radiation Therapy: A Systematic Review of Treatment-Related Side Effects and Toxicities.International journal of molecular sciences · 2024Pooled it
- The incidence of radiation-induced moyamoya among pediatric brain tumor patients who received photon radiation versus those who received proton beam therapy: a systematic review.Neurosurgical review · 2023Pooled it
- Pre- and Posttherapy Risk Factors for Vasculopathy in Pediatric Patients With Craniopharyngioma Treated With Surgery and Proton Radiation Therapy.International journal of radiation oncology, biology, physics · 2022Trial
- A coexisting pseudoaneurysm hidden behind a saccular distal middle cerebral artery aneurysm in long-standing postirradiation vasculopathy: illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- Obstacles and Trials in Treating Primary Brain Tumors.International journal of molecular sciences · 2026Review
- Emerging Outcome Trends From Proton Therapy for Pediatric CNS Tumors: A Systematic Review.International journal of particle therapy · 2026Review
- Late-onset vascular and tumor complications after childhood brain radiotherapy: A rare case of dual sequelae.Radiology case reports · 2026Article
- Radiotherapy for low grade gliomas in children with neurofibromatosis type 1: when there is no other choice. Case Report.Frontiers in oncology · 2026Article
- Successful intravenous alteplase for acute ischemic stroke secondary to radiation-induced intracranial arterial stenosis in a child: An illustrative case.Surgical neurology international · 2026Article
- Feasibility of transcranial Doppler to evaluate vasculopathy among survivors of childhood brain tumors exposed to cranial radiation therapy.Pediatric blood & cancer · 2025Article
- Moyamoya syndrome after proton beam therapy in a pediatric patient with a pineal germ cell tumor and a germline polymorphism in RNF213.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Clinical significance of cerebral microbleeds in patients with germinoma who underwent long-term follow-up.Journal of neuro-oncology · 2024Article
- Delayed radiation-induced cerebral vasculopathy mimicking tumour in an adolescent 14 years after radiation therapy for posterior fossa ependymoma.BMJ case reports · 2024Article
- Stroke in Asia.Cerebrovascular diseases extra · 2024Review
- Mitigating Radiotoxicity in the Central Nervous System: Role of Proton Therapy.Current treatment options in oncology · 2023Review
- Sacral ependymoma presents 20 years after initial posterior fossa lesion.BMJ case reports · 2023Article
- Outcome after proton beam therapy versus photon-based radiation therapy in childhood-onset craniopharyngioma patients-results of KRANIOPHARYNGEOM 2007.Frontiers in oncology · 2023Article
- The tumor micro-environment in pediatric glioma: friend or foe?Frontiers in immunology · 2023Review
- Proton therapy for pediatric diencephalic tumors.Frontiers in oncology · 2023Review
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of our study is to determine the incidence, timing, and risk factors for cerebral vasculopathy after cranial proton and photon radiation for pediatric brain tumors.
methodsWe performed a single-institution retrospective review of a cohort of children treated with proton radiation for brain tumors. MRA and/or MRI were reviewed for evidence of cerebral vascular stenosis and infarcts. Twenty-one similar studies (17 photon, 4 proton) were identified by systematic literature review.
resultsFor 81 patients with median follow-up of 3 years, the rates of overall and severe vasculopathy were 9.9% and 6.2% respectively, occurring a median of 2 years post radiation. Dose to optic chiasm greater than 45 Gy and suprasellar location were significant risk factors. Results were consistent with 4 prior proton studies (752 patients) that reported incidence of 5% to 6.7%, 1.5 to 3 years post radiation. With significantly longer follow-up (3.7-19 years), 9 studies (1108 patients) with traditional photon radiation reported a higher rate (6.3%-20%) and longer time to vasculopathy (2-28 years). Significant risk factors were neurofibromatosis type 1 (NF-1; rate 7.6%-60%) and suprasellar tumors (9%-20%). In 10 studies with photon radiation (1708 patients), the stroke rate was 2% to 18.8% (2.3-24 years post radiation).
conclusionsChildhood brain tumor survivors need screening for vasculopathy after cranial radiation, especially with higher dose to optic chiasm, NF-1, and suprasellar tumors. Prospective studies are needed to identify risk groups, and ideal modality and timing, for screening of this toxicity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.