Radiation-induced cerebral lesions in childhood

Cantini, R; Giorgetti, Walfredo; Valleriani, A.M.; Burchianti, Marilena; Amodeo, Consuelo

doi:10.1007/bf00272113

Cited by 24 publications

(10 citation statements)

References 14 publications

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“…29 This finding is supported by several previous studies of CNS tumors, 2,5,19,21,[30][31][32] as well as of other secondary malignant neoplasms (SMNs). 13 It has been reported that radiation at a young age leads to the development of meningioma within a shorter time.…”

Section: Discussionsupporting

confidence: 88%

Radiation-induced meningiomas: A shadow in the success story of childhood leukemia

et al. 2009

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While the prognosis of acute childhood leukemia has improved, long-term survivors are increasingly experiencing late effects of the treatment. Cranially irradiated survivors are predisposed to the development of CNS tumors. Our aim was to describe the incidence of secondary brain tumors and to define the significance of treatment-related risk factors and host characteristics in a cohort of childhood leukemia survivors. Our cohort consisted of 60 consecutive cranially irradiated adult survivors of childhood leukemia treated in Oulu University Hospital (Oulu, Finland); MRI of the brain was performed on 49. The sites of the tumors, their histology, and details of the leukemia treatment were determined. Of the 49 patients, 11 (22%) 1-8 years of age at the time of diagnosis developed meningioma later in life, while no other brain tumors were seen. In this cohort, the development of meningioma seemed to show undisputable linkage with long latency periods (mean, 25 years; range, 14-34 years) and an increasing incidence 20 years after the treatment (47%). Three patients had multiple meningiomas, two had recurrent disease, and one had an atypical meningioma. Age at the time of irradiation, gender, or cumulative doses of chemotherapeutic agents showed no significant association with the development of meningiomas. The high incidence of meningiomas in this study was associated with long follow-up periods. Although the cohort is small, it seems probable that the increasing incidence of meningioma will shadow the future of cranially irradiated leukemia survivors. Systematic brain imaging after the treatment is therefore justifiable.

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Section: Discussionsupporting

confidence: 88%

Radiation-induced meningiomas: A shadow in the success story of childhood leukemia

et al. 2009

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“…This may be because more chromosomal injury is caused by radiation in the developing nervous tissue of young children 7 and the meninges of children are extremely sensitive and, thus, more vulnerable to radiation. 27 Thirdly, the relationship between the dose of radiation and the latency period is still uncertain: some authors have demonstrated a proportional relationship between a high dose of irradiation (> 20 Gy), particularly in children, and the risk of induced meningiomas with a shorter latency period. 2,5,8,28 however others have not shown a significant correlation between latency period and radiation dose.…”

Section: Discussionmentioning

confidence: 99%

Possible Involvement of Brain Tumour Stem Cells in the Emergence of a Fast-Growing Malignant Meningioma after Surgical Resection and Radiotherapy of High-Grade Astrocytoma: Case Report and Preliminary Laboratory Investigation

et al. 2009

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The case of a 62-year old man diagnosed with radiation-induced meningioma (RIM) after treatment for astrocytoma with an unusually short latency period of 7 months is reported. The patient first presented with a 2-month history of memory decline. Magnetic resonance imaging (MRI) showed a tumour in the left parieto-temporal lobe. Gross total resection was performed and the tumour was confirmed to be an astrocytoma. The patient received cranial radiotherapy 2 weeks later, however 7 months after radiation treatment the patient presented with headache and vomiting. MRI showed massive meningeal enhancement in the left frontal lobe, which progressively enlarged. The patient's clinical condition deteriorated and a second craniotomy was performed with complete removal of the secondary tumour, which was shown to be a malignant meningioma. Immunohistochemical staining identified CD133-positive cells in both tumours. A rare fraction of brain tumour stem cells (BTSC) was isolated from the primary astrocytoma using a serum-free culture system, suggesting that BTSC may have been involved in the rapid emergence of RIM after resection and radiation of the primary astrocytoma.

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“…How radiotherapy increases the risk of development of meningioma is not completely understood, but it is known that arachnoid cells in childhood are very sensitive to radiation,17 and given that meningiomas arise from the cap cells of the arachnoid, cellular damage at this level induced by irradiation may not be unconnected with the development of meningiomas. It has also been shown that radiation induces hydroxyl-free radicals that cause strand breaks or base damage in DNA.…”

Section: Discussionmentioning

confidence: 99%

Double trouble: a tale of two radio-treatments

et al. 2014

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In recent years, an increasing number of patients are treated with radiation. In the early era of radiotherapy, which began soon after X-rays were discovered by Roentgen in 1895, tumours were irradiated with high doses of X-rays in a single fraction. The major initial setback was the damage caused to normal tissues; however, in recent times the use of stereotactic radiosurgery, which delivers high doses of radiation precisely to abnormal tissue targets while sparing the surrounding normal brain tissue, and particularly for surgically inaccessible tumours, has taken centre stage. Prophylactic whole brain radiation (in conjunction with aggressive chemotherapy) for childhood acute lymphoblastic leukaemia has been shown to improve patient survival, however, this is associated with complications in survivors. We report an interesting case of one of the longest survivors who has had double complications from radiotherapy-based interventions.

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Radiation-induced cerebral lesions in childhood

Cited by 24 publications

References 14 publications

Radiation-induced meningiomas: A shadow in the success story of childhood leukemia

Radiation-induced meningiomas: A shadow in the success story of childhood leukemia

Possible Involvement of Brain Tumour Stem Cells in the Emergence of a Fast-Growing Malignant Meningioma after Surgical Resection and Radiotherapy of High-Grade Astrocytoma: Case Report and Preliminary Laboratory Investigation

Double trouble: a tale of two radio-treatments

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