title: Favorable outcomes of pediatric patients treated with radiotherapy to the central nervous system who develop radiation-induced meningiomas.
abstract: OBJECTIVE
  To report the outcome of patients treated at the University of Florida who developed meningiomas after radiation to the central nervous system (CNS) for childhood cancer.
  
  
  METHODS
  We retrospectively identified 10 patients aged ≤19 years who received radiotherapy to sites in the craniospinal axis and subsequently developed a meningioma. We report the histology of the radiation-induced meningioma, treatment received, and ultimate outcome among this cohort of patients.
  
  
  RESULTS
  Meningioma was diagnosed at a median of 23.5 years after completion of the primary radiation. Fifty percent of second meningiomas were World Health Organization Grade 2 (atypical) or higher. All cases were managed with a single modality: resection alone (n = 7), fractionated radiotherapy (n = 2), and stereotactic radiosurgery (n = 1). The actuarial event-free survival and overall survival rate at 5 years after treatment for a radiation-induced meningioma was 89%. Three patients who underwent resection for retreatment experienced a Grade 3 toxicity.
  
  
  CONCLUSIONS
  Radiation-induced meningiomas after treatment of pediatric CNS tumors are effectively managed with single-modality therapy. Such late-effect data inform the overall therapeutic ratio and support the continued role of selective irradiation in managing pediatric CNS malignancies.
authors.affiliation: Department of Radiation Oncology, University of Florida, Gainesville, FL 32206, USA. dindelicato@floridaproton.org
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Galloway
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Indelicato
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Amdur
authors.forename: Erika L
authors.initials: EL
authors.lastname: Swanson
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Morris
authors.forename: Robert B
authors.initials: RB
authors.lastname: Marcus
mesh_terms: D000293:Adolescent; D016543:Central Nervous System Neoplasms / Q000532:radiotherapy*; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008579:Meningioma / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D009381:Neoplasms, Radiation-Induced / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D016634:Radiosurgery; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome