Radiation-induced brain tumours: potential late complications of radiation therapy for brain tumours.
The development of neoplasms subsequent to therapeutic cranial irradiation is a rare but serious and potentially fatal complication. In this study, we retrospectively reviewed the clinical and pathological aspects of 11 patients who underwent cranial irradiation (range, 24-110 cGy) to treat their primary disease and thereafter developed secondary tumours within a span of 13 years. All tumours arose within the previous radiation fields, and satisfied the widely used criteria for the definition of radiation-induced neoplasms. There was no sex predominance (M: 5, F: 6) and the patients tended to be young at irradiation (1.3-42 years; median age: 22 years). The median latency period before the detection of the secondary tumour was 14.5 years (range: 6.5-24 years). Meningiomas developed in 5 patients, sarcomas in 4, and malignant gliomas in 2. A pre-operative diagnosis of a secondary tumour was correctly obtained in 10 patients based on the neuro-imaging as well as nuclear medicine findings. All patients underwent a surgical removal of the secondary tumour, 3 underwent additional chemotherapy, and one received stereotactic secondary irradiation therapy. During a median of 2 years of follow-up review after the diagnosis of a secondary tumour, 3 patients died related to the secondary tumours (2 sarcomas, 1 glioblastoma), one died of a recurrent primary glioma, while the remaining 7 have been alive for from 10 months to 12 years after being treated for the secondary tumours (median: 3 years). Based on these data, the clinicopathological characteristics and possible role of treatment for secondary tumours are briefly discussed.
Nishio
S
S
Department of Neurosurgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Morioka
T
T
Inamura
T
T
Takeshita
I
I
Fukui
M
M
Sasaki
M
M
Nakamura
K
K
Wakisaka
S
S
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery*; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005910:Glioma / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008579:Meningioma / Q000175:diagnosis / Q000601:surgery*; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis / Q000601:surgery*; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome