Evaluating cerebral radiation necrosis in patients who received partial brain radiation therapy at CMJAH and WDGMC between 2014-2017
Cerebral radiation necrosis (RN) is a known late side effect of radiation to the brain. This retrospective study reviewed RN in patients who received partial brain radiation from 20142017 at CMJAH and WDGMC in Johannesburg. Results: 80 patients had follow up MRIs and were included in the sample. 5 patients developed RN in the time period, with an incidence of 6.25 % (5/80). Looking at biologically effective dose (BED) groups there was a much higher incidence of RN for BED₃ ≥ 100Gy₃ (3/13; 23%) than for BED₃ < 100Gy₃ (2/54; 3.7%). Due to the small number of RN cases no statistically significant correlations were found with patient, clinical or treatment factors. However, total dose, BED and dose per fraction consistently showed a trend that higher dose was associated with radiation necrosis. Conclusion: The incidence for RN at CMJAH and WDGMC is similar to that found in other centres internationally. The total radiation dose (adjusted for BED) is the most important factor that affects the incidence of RN.
A research report submitted in partial fulfilment of the requirements for the degree of Master of Medicine in Radiation Oncology to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2020