title: Meningiomas after cranial radiotherapy for childhood cancer: a single institution experience.
abstract: OBJECTIVE
  Childhood cancer survivors (CCS) treated with cranial radiation therapy (CRT) are at risk of developing meningiomas. The aim of this study was to evaluate the cumulative incidence of meningiomas in a cohort of CCS who previously underwent CRT.
  
  
  METHODS
  We considered all CCS who received CRT and were followed up at the "Transition Unit for Childhood Cancer Survivors" in Turin. Even though asymptomatic, they had at least one brain computed tomography or magnetic resonance imaging performed at a minimum interval of 10 years after treatment for pediatric cancer.
  
  
  RESULTS
  We identified 90 patients (median follow-up 24.6 years). Fifteen patients developed meningioma (median time from pediatric cancer, 22.5 years). In four patients, it was suspected on the basis of neurological symptoms (i.e., headache or seizures), whereas all other cases, including five giant meningiomas, were discovered in otherwise asymptomatic patients. Multiple meningiomas were discovered in four CCS. Ten patients underwent surgical resection. An atypical meningioma (grade II WHO) was reported in four patients. One patient with multiple meningiomas died for a rapid growth of the intracranial lesions. A second neoplasm (SN) other than meningioma was diagnosed in five out of the 15 patients with meningioma and in ten out of the 75 CCS without meningioma. Cox multivariate analysis showed that the occurrence of meningioma was associated with the development of other SNs, whereas age, sex, or CRT dose had no influence.
  
  
  CONCLUSIONS
  CCS at risk of the development of meningioma deserve close clinical follow-up, especially those affected by other SNs.
authors.affiliation: Transition Unit for Childhood Cancer Survivors, Department of Oncology, AOU Città della Salute e della Scienza di Torino, Via Cherasco 15, 10126, Turin, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Felicetti
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Fortunati
authors.forename: Diego
authors.initials: D
authors.lastname: Garbossa
authors.forename: Eleonora
authors.initials: E
authors.lastname: Biasin
authors.forename: Roberta
authors.initials: R
authors.lastname: Rudà
authors.forename: Dino
authors.initials: D
authors.lastname: Daniele
authors.forename: Emanuela
authors.initials: E
authors.lastname: Arvat
authors.forename: Andrea
authors.initials: A
authors.lastname: Corrias
authors.forename: Franca
authors.initials: F
authors.lastname: Fagioli
authors.forename: Enrico
authors.initials: E
authors.lastname: Brignardello
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001932:Brain Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy*; D002648:Child; D016371:Cranial Irradiation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008579:Meningioma / Q000453:epidemiology* / Q000209:etiology*; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology* / Q000209:etiology*; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D017741:Survivors / Q000706:statistics & numerical data; D055815:Young Adult