Targeted Radiation Therapy Can Treat Myxomatous Cerebral Aneurysms

Khatibi, Kasra; Mejia, Lucido Luciano Ponce; Kaneko, Naoki; Ooi, Yinn Cher; Kaprealian, Tania; Gonzalez, Nestor R.; Pouratian, Nader; Szeder, Viktor

doi:10.1016/j.wneu.2020.08.022

Cited by 4 publications

(7 citation statements)

References 15 publications

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“…Furthermore, given the differential response to radiation of neoplastic cells, it could interrupt the proliferation of myxomatous cells and, consequently, aneurysmal enlargement. 24…”

Section: Discussionmentioning

confidence: 99%

“…17 The other report treated with 14 Gy, obtaining the same effect (aneurysmal and parent vessel occlusion), claiming to minimize the risks of adverse effects of radiation. 24…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, radiation and chemotherapy have been used in selected cases to try to halt their growth. 24 There are limited reports of such treatments, so their efficacy remains unproven.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, given the differential response to radiation of neoplastic cells, it could interrupt the proliferation of myxomatous cells and, consequently, aneurysmal enlargement. 24 There are many reports of successful treatment of metastatic myxoma, 21 but for the treatment of myxomatous intracranial aneurysms, we have found only two literature reports of radiation therapy for multiple lesions located in eloquent areas, in which parent artery surgical or endovascular ligation would be highly deleterious.…”

Section: Radiation Therapymentioning

confidence: 92%

“…17 The other report treated with 14 Gy, obtaining the same effect (aneurysmal and parent vessel occlusion), claiming to minimize the risks of adverse effects of radiation. 24 The main issue with monotherapy with radiation is similar to its use in treating hemorrhagic brain arteriovenous malformations 26 : in hemorrhagic myxomatous aneurysms, the latency period until radiation promotes protection may put the patient at risk of new bleeding episodes.…”

Section: Radiation Therapymentioning

confidence: 99%

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Oncotic (Myxomatous) Aneurysms: A Review of Management

Peres

Brito

Peres

et al. 2022

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Atrial myxomas are the most common primary cardiac tumors and may manifest with neurological symptoms in ∼ 30% of cases. Cerebral ischemia, aneurysmal formation, and extravascular metastases are mechanisms that lead to these neurological manifestations. Perilesional changes on computed tomography (CT) and magnetic resonance imaging (MRI) may help in the diagnosis of myxomatous aneurysms, which are usually located in the distal middle cerebral artery (MCA) and in the posterior cerebral artery (PCA) circulation territories. Careful resection of the cardiac lesion is essential for preventing embolism. However, treatment of myxomatous aneurysms is controversial due to the limited understanding of the natural history of this condition. Treatment may include clinical observation in asymptomatic patients, surgical resection, endovascular approaches, adjuvant chemotherapy, and low-dose radiation therapy. We present one case of a female patient with myxomatous aneurysm secondary to an atrial myxoma who presented with neurological symptoms and another case of a female patient who developed neurological symptoms after initial surgical treatment of the primary lesion. Lesion growth rate, topography, morphology, and the patient's clinical condition must be considered when choosing a therapeutical method. Further clinical studies are needed to achieve a better understanding and treatment of this disease.

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“…Furthermore, given the differential response to radiation of neoplastic cells, it could interrupt the proliferation of myxomatous cells and, consequently, aneurysmal enlargement. 24…”

Section: Discussionmentioning

confidence: 99%

“…17 The other report treated with 14 Gy, obtaining the same effect (aneurysmal and parent vessel occlusion), claiming to minimize the risks of adverse effects of radiation. 24…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, radiation and chemotherapy have been used in selected cases to try to halt their growth. 24 There are limited reports of such treatments, so their efficacy remains unproven.…”

Section: Discussionmentioning

confidence: 99%

Section: Radiation Therapymentioning

confidence: 92%

Section: Radiation Therapymentioning

confidence: 99%

See 3 more Smart Citations

Oncotic (Myxomatous) Aneurysms: A Review of Management

Peres

Brito

Peres

et al. 2022

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Radiation therapy for cancer is potentially associated with reduced growth of concomitant abdominal aortic aneurysm

Becker von Rose,

Kobus,

Bohmann

et al. 2023

Strahlenther Onkol

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Purpose Co-prevalence of abdominal aortic aneurysm (AAA) and cancer poses a unique challenge in medical care since both diseases and their respective therapies might interact. Recently, reduced AAA growth rates were observed in cancer patients that received radiation therapy (RT). The purpose of this study was to perform a fine-grained analysis of the effects of RT on AAA growth with respect to direct (infield) and out-of-field (outfield) radiation exposure, and radiation dose-dependency. Methods A retrospective single-center analysis identified patients with AAA, cancer, and RT. Clinical data, radiation plans, and aneurysm diameters were analyzed. The total dose of radiation to each aneurysm was computed. AAA growth under infield and outfield exposure was compared to patients with AAA and cancer that did not receive RT (no-RT control) and to an external noncancer AAA reference cohort. Results Between 2003 and 2020, a total of 38 AAA patients who had received well-documented RT for their malignancy were identified. AAA growth was considerably reduced for infield patients (n = 18) compared to outfield patients (n = 20), albeit not significantly (0.8 ± 1.0 vs. 1.3 ± 1.6 mm/year, p = 0.28). Overall, annual AAA growth in RT patients was lower compared to no-RT control patients (1.1 ± 1.5 vs. 1.8 ± 2.2 mm/year, p = 0.06) and significantly reduced compared to the reference cohort (1.1 ± 1.5 vs. 2.7 ± 2.1 mm/year, p < 0.001). The pattern of AAA growth reduction due to RT was corroborated in linear regression analyses correcting for initial AAA diameter. A further investigation with respect to dose-dependency of radiation effects on AAA growth, however, revealed no apparent association. Conclusion In this study, both infield and outfield radiation exposure were associated with reduced AAA growth. This finding warrants further investigation, both in a larger scale clinical cohort and on a molecular level.

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Cerebral Myxomatous Aneurysms: Case Series and Systematic Review of Literature with Adequate Follow-Up Periods and Aneurysmal Wall Biopsy Results

Choi

Park

et al. 2023

World Neurosurgery

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Targeted Radiation Therapy Can Treat Myxomatous Cerebral Aneurysms

Cited by 4 publications

References 15 publications

Oncotic (Myxomatous) Aneurysms: A Review of Management

Oncotic (Myxomatous) Aneurysms: A Review of Management

Radiation therapy for cancer is potentially associated with reduced growth of concomitant abdominal aortic aneurysm

Cerebral Myxomatous Aneurysms: Case Series and Systematic Review of Literature with Adequate Follow-Up Periods and Aneurysmal Wall Biopsy Results

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