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Radiation-induced moyamoya syndrome
Snehal S Desai1, Arnold C Paulino, Wei Y Mai
1Department of Radiology, Division of Radiation Oncology, Baylor College of Medicine, Methodist Hospital, Houston, TX 77030, USA.
Summary
Moyamoya syndrome is a rare complication after radiotherapy (RT), especially in young children treated for brain tumors. The risk increases over time, with most cases appearing within 12 years post-RT.
Area of Science:
- Neurology
- Oncology
- Radiotherapy
Background:
- Moyamoya syndrome is an uncommon but serious late complication following radiotherapy.
- Understanding the risk factors and temporal progression is crucial for patient management.
Purpose of the Study:
- To investigate the incidence and characteristics of moyamoya syndrome as a late complication of radiotherapy.
- To identify patient groups and treatment parameters associated with increased risk.
Main Methods:
- A comprehensive literature search was conducted on PubMed using keywords: radiation, radiotherapy, and moyamoya syndrome.
- Data from 33 English-language articles published between 1967 and 2002, involving 54 patients, were analyzed.
Main Results:
- The majority of patients (56.3%) received radiotherapy at less than 5 years of age.
- Low-grade gliomas, particularly optic-pathway gliomas, were the most common tumors treated.
- The median latent period for moyamoya syndrome development was 40 months, with incidence increasing up to 12 years post-RT.
Conclusions:
- Young age at radiotherapy (especially <5 years) and parasellar region treatment are significant risk factors for moyamoya syndrome.
- Neurofibromatosis type 1 (NF-1) patients exhibit a lower radiation dose threshold for developing the condition.
- The incidence of moyamoya syndrome continues to rise years after radiotherapy, necessitating long-term surveillance.