Favorable outcomes of pediatric patients treated with radiotherapy to the central nervous system who develop radiation-induced meningiomas

Int J Radiat Oncol Biol Phys. 2011 Jan 1;79(1):117-20. doi: 10.1016/j.ijrobp.2009.10.045. Epub 2010 Apr 24.

Abstract

Purpose: 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 and materials: 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.

MeSH terms

  • Adolescent
  • Central Nervous System Neoplasms / radiotherapy*
  • Child
  • Child, Preschool
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Meningioma / etiology
  • Meningioma / mortality
  • Meningioma / pathology
  • Meningioma / radiotherapy
  • Meningioma / surgery
  • Neoplasms, Radiation-Induced / etiology
  • Neoplasms, Radiation-Induced / mortality
  • Neoplasms, Radiation-Induced / pathology
  • Neoplasms, Radiation-Induced / radiotherapy
  • Neoplasms, Radiation-Induced / surgery
  • Radiosurgery
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome

Supplementary concepts

  • Radiation induced meningioma