title: Secondary neoplasms after stereotactic radiosurgery.
abstract: OBJECTIVE
  The use of medical radiation has increased 6-fold in the past 30 years. Within neurosurgery, the advent of stereotactic radiosurgery (SRS) has significantly altered the treatment paradigm for both benign and malignant central nervous system diseases. With this increased reliance on radiation has come a responsibility to identify the long-term risks, including the potential development of radiation-induced neoplasms. Although the data regarding traditional radiation exposure and its subsequent risks are well-defined, the data for SRS is less developed.
  
  
  METHODS
  We reviewed the published literature to more accurately define the risk of developing secondary neoplasms after stereotactic radiosurgery.
  
  
  RESULTS
  A total of 36 cases of SRS-induced neoplasms were identified. More than half of the cases had an initial diagnosis of vestibular schwannoma. Overall, the risk of developing an SRS-induced neoplasm is approximately 0.04% at 15 years.
  
  
  CONCLUSIONS
  The risk of developing an SRS-induced neoplasm is low but not zero. Thus, long-term surveillance imaging is advised for patients treated with SRS.
authors.affiliation: Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA.
authors.forename: Toral R
authors.initials: TR
authors.lastname: Patel
authors.affiliation: Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA. Electronic address: veronica.chiang@yale.edu.
authors.forename: Veronica L S
authors.initials: VL
authors.lastname: Chiang
mesh_terms: D016543:Central Nervous System Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology / Q000209:etiology; D016609:Neoplasms, Second Primary / Q000453:epidemiology* / Q000209:etiology*; D009464:Neuroma, Acoustic / Q000453:epidemiology / Q000601:surgery; D016634:Radiosurgery / Q000009:adverse effects* / Q000706:statistics & numerical data; D012307:Risk Factors
keywords: Dedifferentiation; Late complications; Malignant transformation; Secondary neoplasm; Stereotactic radiosurgery