Radiation-induced tumors in children irradiated for brain tumor: a longitudinal study

Vinchon, Matthieu; Leblond, Pierre; Caron, S.; Delestret, Isabelle; Baroncini, Marc; Coche, B.

doi:10.1007/s00381-011-1390-4

Cited by 84 publications

(51 citation statements)

References 36 publications

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“…Galloway et al 10,15 in their analysis demonstrated that more than half of the second brain tumours were meningiomas and in the other study concluded that radiationinduced meningioma often occurred long after the primary therapy and could be successfully treated, with a 5-year OS rate of 89%. Similar conclusions were formulated by Vinchon et al 6 in a longitudinal study about the radiation-induced tumours in children. In our study, meningiomas were also the most common STs, developing after a longer period time than gliomas (13 vs 10 years) in the moderate-and high-dose regions (.25 Gy).…”

Section: Discussionsupporting

confidence: 87%

“…[1][2][3][4][5] The cranial irradiation, especially the radiation dose and the field size, is known as the significant risk factor for developing second brain neoplasms. 1,[6][7][8][9][10][11] However, details of this relationship are still not clear. The mechanisms of the tumour induction are complex.…”

mentioning

confidence: 99%

“…2 The radio-induced tumour is defined by many authors as a new mass, histologically different from the original tumour, occurring after delay in irradiated areas, and not related to phacomatosis. 6,9,10 This late complication of radiotherapy is not common but is especially important in young patients with a long life expectancy. Among factors that limit better understanding of ST's aetiology is the lack of long-term follow-up that is often interrupted when irradiated children become adults.…”

mentioning

confidence: 99%

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Second brain tumors following central nervous system radiotherapy in childhood

Chojnacka¹,

Pędziwiatr²,

Skowrońska‐Gardas³

et al. 2014

BJR

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Objective: The second tumour (ST) occurrence is a relatively uncommon late complication of radiotherapy but represents one of the most significant issues, especially in childhood oncology. We describe our experience with patients who developed second brain neoplasm following cranial irradiation in childhood. Methods: We identified nine patients who received radiotherapy owing to central nervous system tumour in childhood and subsequently developed the second brain tumour. The full clinical and radiological documentation and histopathological reports were reviewed. Risk factors such as age at irradiation, latency period to ST diagnosis, radiotherapy doses and volumes and other therapy methods were evaluated. We correlated the ST location with the three levels of irradiation dose (high, .40 Gy; medium, 25-40 Gy; and low ,25 Gy).Results: Five meningiomas and four gliomas occurred as the ST after the mean time of 11.7 years after radiotherapy. The average age of children during irradiation was 4.6 years. The shorter latency time to the ST induction was found in children treated with chemotherapy (9 years vs 17.2 years). Seven STs developed in the area of high and moderate dose (.25 Gy), only two low-grade gliomas appeared in the low-dose region. Conclusion: Our data suggest that the STs usually develop in the brain tissues that received doses .25 Gy in patients irradiated at a young age. Advances in knowledge: The low-dose volume seems not to be so significant for second brain neoplasm induction. Therefore, the modern intensity-modulated radiotherapy technique could be safely applied in paediatric patients.

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Section: Discussionsupporting

confidence: 87%

mentioning

confidence: 99%

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confidence: 99%

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Second brain tumors following central nervous system radiotherapy in childhood

Chojnacka¹,

Pędziwiatr²,

Skowrońska‐Gardas³

et al. 2014

BJR

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“…[1][2][3][4][5][6][7] Notably, unlike the incidence of high-grade glioma, the cumulative incidence of subsequent meningiomas after CRT does not seem to reach a plateau over time. 1,5,[8][9][10][11] Thus, meningiomas are the most common subsequent CNS tumors among aging adult survivors of childhood cancer. 1,5,7,10 Fortunately, given the benign nature of most meningiomas, cancer survivors with subsequent meningiomas have higher survival rates than do those with subsequent highgrade gliomas.…”

Section: Introductionmentioning

confidence: 99%

Morbidity and Mortality Associated With Meningioma After Cranial Radiotherapy: A Report From the Childhood Cancer Survivor Study

Bowers

Moskowitz

Chou

et al. 2017

JCO

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Little is known about neurologic morbidity attributable to cranial radiotherapy (CRT) -associated meningiomas. Materials and MethodsFrom 4,221 survivors exposed to CRT in the Childhood Cancer Survivor Study, a diagnosis of meningioma and onset of neurologic sequelae were ascertained. Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% CIs to evaluate the factors associated with neurologic sequelae after subsequent meningioma. ResultsOne hundred ninety-nine meningiomas were identified among 169 participants. The median interval from primary cancer to meningioma diagnosis was 22 years (5 to 37 years). The cumulative incidence of a subsequent meningioma by age 40 years was 5.6% (95% CI, 4.7% to 6.7%). CRT doses of 20 to 29.9 Gy (HR, 1.6; 95% CI,1.0 to 2.6) and doses $ 30 Gy (HR, 2.6; 95% CI, 1.6 to 4.2) were associated with an increased risk of meningioma compared with CRT doses of 1.5 to 19.9 Gy (P , .001). Within 6 months before or subsequent to a meningioma diagnosis, 20% (30 of 149) reported at least one new neurologic sequela, including seizures (8.3%), auditory-vestibular-visual deficits (6%), focal neurologic dysfunction (7.1%), and severe headaches (5.3%). Survivors reporting a meningioma had increased risks of neurologic sequelae . 5 years after primary cancer diagnosis, including seizures (HR, 10.0; 95% CI, 7.0 to 15.3); auditory-vestibular-visual sensory deficits (HR, 2.3; 95% CI, 1.3 to 4.0); focal neurologic dysfunction (HR, 4.9; 95% CI, 3.2 to 7.5); and severe headaches (HR, 3.2; 95% CI, 1.9 to 5.4). With a median follow-up of 72 months after meningioma diagnosis (range, 3.8 to 395 months), 22 participants (13%) were deceased, including six deaths attributed to a meningioma. ConclusionChildhood cancer survivors exposed to CRT and subsequently diagnosed with a meningioma experience significant neurologic morbidity.

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“…Radyasyon ilişkili kavernomların yaşla ve RT dozu ile korelasyonu bu tartışmanın konusu olup, bazı yazarlar genç yaşta terapi ve yüksek radyasyon dozunun daha çok kavernomla ilişkili olduğunu belirtmişlerdir (20,21). Bu çalışmada DAG lezyon sayısı yaşla korele bulunmadı.…”

Section: Mikroskopik Olarak Ektatik Incelmiş Duvarlıunclassified

The Role of Susceptibility Weighted Imaging to Evaluate the Radiation Injury of Primary and Metastatic Brain Tumors

Günbey¹

2017

Turk J Bioch

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ÖzetGiriş ve amaç: Radyasyon hasarı, rezeke olmuş ve radyoterapi (RT) verilmiş yüksek dereceli beyin gliomları, medulloblastomlar ve metastatik lezyonları olan olgularda sık görülmektedir. Duyarlılık ağırlıklı görüntüleme (DAG), konvansiyonel MR'da görüntülenemeyen küçük damarları ve mikrohemorajiler içindeki rezidü kanı saptamaya yarayan MRG tekniğidir. Bu çalışmanın amacı primer ve metastatik beyin tümörleri nedeniyle RT almış hastalarda DAG 'nin kanama alanlarını saptama yeteneğini araştırmaktır. Gereç ve yöntemler: Primer ve metastatik beyin tümörleri patolojik tanısıyla RT almış ve DAG yapılmış olan 13 kadın (ort.yaş 37 ± 19.3), 10 erkek (ort.yaş 37.3 ± 21) toplam 23 hasta çalışmaya dahil edildi. Supra ve infratentoriyel DAG lezyonu sayıldı ve konvansiyonel MR'ları ile karşılaştırıldı. Lokalizasyonlarına göre lezyonlar serebellar, beyin sapı, bazal ganglionlar, kortikalsubkortikal, periventriküler ve derin beyaz cevher (BC) lezyonları olarak tanımlandı. Lezyon sayıları ve en büyük lezyon çapları, RT sonrası geçen süre ile karşılaştırıldı. Bulgular: Serebellar lezyonlar sadece dört medulloblastom olgusunda görüldü. Lokalizasyonlarına göre en çok lezyon görülen lokalizasyon kortikal-subkortikal BC idi. DAG lezyonu en fazla epandimom, en az metastaz olgularında saptandı. En büyük lezyon çapları RT sonrası geçen süre ile lineere yakın ilişki gösterdi. DAG'de saptanan lezyon sayıları opere tümör tipi, RT sonrası geçen süre, yaş ve cinsiyet ile korele değildi (p>0.005). En büyük lezyon çapı RT sonrası geçen süre ve tümör tipi ile anlamlı korelasyon göstermedi (p>0.005). Tartişma ve sonuç: DAG, primer ve metastatik beyin tümörleri için RT sonrası radyasyon hasarı olan bölgelerdeki mikrokanamaları değerlendirmek ve takip etmek için yararlı bir MRG yöntemidir. AbstractIntroduction: Radiation injury is frequently seen in patients which have been resected from high-grade brain gliomas, medulloblastomas and metastatic lesions and given radiotherapy (RT). Susceptibility-weighted imaging (SWI) is a MRI technique for detecting small vessels and the residue of blood in microhaemorrhages that can not be displayed with conventional MRI. The aim of this study is to investigate the ability of SWI to detect bleeding sites in patients who received RT due to primer and metastatic brain tumors. Methods: 13 women (mean age 37 ± 19.3), 10 males (mean age 37.3 ± 21) a total of 23 patients who have been irradiated with the pathological diagnosis of primary and metastatic brain tumors were included in the study. Supra and infratentorial SWI lesions were counted and compared with conventional MRI. Localizations were classified as cerebellar, brainstem, basal ganglia and cortical-subcortical, periventricular and deep white matter (WM). Lesion counts and the largest lesion diameter were compared with the period after RT. Results: Cerebellar lesions were seen in only 4 patients with medulloblastoma. The cortical-subcortical WM was the most common localization. SWI lesions have been detected most in ependymoma and least in metastases. The l...

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Radiation-induced tumors in children irradiated for brain tumor: a longitudinal study

Cited by 84 publications

References 36 publications

Second brain tumors following central nervous system radiotherapy in childhood

Second brain tumors following central nervous system radiotherapy in childhood

Morbidity and Mortality Associated With Meningioma After Cranial Radiotherapy: A Report From the Childhood Cancer Survivor Study

The Role of Susceptibility Weighted Imaging to Evaluate the Radiation Injury of Primary and Metastatic Brain Tumors

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