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. 2020 Mar-Apr;25(2):245-249.
doi: 10.1016/j.rpor.2020.01.009. Epub 2020 Jan 30.

Secondary brain tumors after cranial radiation therapy: A single-institution study

Masazumi Fujii  1 , Masahiro Ichikawa  1 , Kensho Iwatate  1 , Mudathir Bakhit  1 , Masayuki Yamada  1 , Yosuke Kuromi  1 , Taku Sato  1 , Jun Sakuma  1 , Hisashi Sato  2 , Atsushi Kikuta  3 , Yoshiyuki Suzuki  2 , Kiyoshi Saito  1
Affiliations

Secondary brain tumors after cranial radiation therapy: A single-institution study

Masazumi Fujii et al. Rep Pract Oncol Radiother. 2020 Mar-Apr.

Abstract

Aim: To study the probability of developing secondary brain tumors after cranial radiotherapy.Background Patients treated with cranial radiotherapy are at risk for developing secondary brain tumors.

Patients and methods: We planned an institutional survey for secondary brain tumors in survivors after cranial irradiation and reviewed the 30-year duration data. Event analysis and cumulative proportion curves were performed to generally estimate the cumulative proportion of developing secondary brain tumors, cavernoma and meningioma at different periods of time.

Results: Secondary brain tumors occurred in 21% of cases: 10% were cavernomas, 6% were meningiomas, 3% were skull osteomas, and 1% were anaplastic astrocytoma. The cumulative proportion of developing secondary brain tumor was 6% at 10 years and 20% at 20 years, while the cumulative proportion for developing cavernomas and meningiomas was 16% and 7% at 20 years, respectively.

Conclusion: Our study shows that patients who received cranial irradiation were at risk of secondary brain tumors such as cavernomas and meningiomas. Thus, a meticulous follow-up of cancer survivors with history of cranial irradiation by an annual MRI scan is justifiable. This will help clinicians to detect secondary brain tumors early and make its management much easier.

Keywords: Cavernoma; Cranial radiation; Glioma; Meningioma.

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Figures

Fig. 1
Fig. 1
Cumulative proportion curve for cranial-irradiated patients who developed secondary brain tumors.
Fig. 2
Fig. 2
Cumulative proportion curve for cranial-irradiated patients who developed secondary cavernomas.
Fig. 3
Fig. 3
Cumulative proportion curve for cranial-irradiated patients who developed secondary meningiomas.
Fig. 4
Fig. 4
Case 1. Axial plain CT scan (A) and coronal MRI FLAIR (B) images show a cavernoma in the right temporal stem. Postoperative follow up MRI FLAIR images show removal of the right temporal cavernoma (C) and the remaining small right frontal cavernoma (D, arrow).
Fig. 5
Fig. 5
Case 2. T2-weighted MRI images. Images taken 18 months before surgery (A) and before surgery (B) show an increase in the size of a left temporal cavernoma. Postoperative follow-up image shows removal of the cavernoma (C).
See this image and copyright information in PMC

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