Meningioma after radiotherapy for malignancy |
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| Affiliation: | 1. Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA;2. Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA;3. Department of Neurological Surgery, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA;4. Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA;5. Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, USA;6. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA;7. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA;1. University of Illinois, Department of Neurological Surgery, Chicago, IL 60612, USA;2. Emory University School of Medicine, Department of Neurological Surgery, Atlanta, GA 30307, USA;3. University of Miami Miller School of Medicine, Department of Neurological Surgery, Lois Pope Life Center, 1095 NW 14th Terrace (D4-6), Miami, FL 33136, USA;1. Department of Neurological Surgery, University of Arkansas for Medical Sciences, 4301 W. Markham Street, #507, Little Rock, AR 72205, USA;2. New York University School of Medicine, New York, NY, USA;3. Department of Pediatric Neuro-oncology, New York University School of Medicine, New York, NY, USA;4. Department of Neuroradiology, New York University School of Medicine, New York, NY, USA;5. Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA;6. Department of Neuropathology, New York University School of Medicine, New York, NY, USA;1. Stroke Unit, Level 4, Central Block, Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia;2. Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia;3. Department of Radiology, Alfred Hospital, Melbourne, VIC, Australia;1. Department of Neurosurgery, Kurtköy Ersoy Hospital, Istanbul, Turkey;2. Department of Neurosurgery, Batman State Hospital, Batman, Turkey;3. Department of Orthopedic Surgery, Spine Center, University of California San Francisco, 500 Parnassus Avenue, MU320 West San Francisco, CA 94143-0728, USA |
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| Abstract: | Complications of radiation exposure have gained importance with increasing cancer survivorship. Secondary malignancies have been associated with cranial radiation exposure. We present our experience with intracranial radiation-induced meningioma (RIM) and discuss the implications of its presentation and natural history for patient management. Patients diagnosed with meningioma who had received radiation therapy between 1960 and 2014 were identified. Records were retrospectively reviewed for details of radiation exposure, previous malignancies, meningioma subtypes, multiplicity and pathologic descriptions, treatment and follow-up. Thirty patients were diagnosed with RIM. Initial malignancies included acute lymphocytic leukemia (33.3%), medulloblastoma (26.7%) and glioma (16.7%) at a mean age of 8.1 years (range 0.04–33 years). The mean radiation dose was 34 Gy (range 16–60 Gy) and latency time to meningioma was 26 years (range 8–51 years). Twenty-one patients (70%) underwent surgery. Of these, 57.1% of tumors were World Health Organization (WHO) grade I while 42.9% were WHO II (atypical). The mean MIB-1 labeling index for patients with WHO I tumors was 5.44%, with 33.3% exhibiting at least 5% staining. Mean follow-up after meningioma diagnosis was 5.8 years. Mortality was zero during the follow-up period. Meningioma is an important long-term complication of therapeutic radiation. While more aggressive pathology occurs more frequently in RIM than in sporadic meningioma, it remains unclear whether this translates into an effect on survival. Further study should be aimed at delineating the risks and benefits of routine surveillance for the development of secondary neoplasms after radiation therapy. |
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| Keywords: | Meningioma Radiation induced meningioma Radiation therapy |
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