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Second primary brain tumors following cranial irradiation for pediatric solid brain tumors

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Abstract

Purpose

We describe our institution’s experience with seven patients who developed second brain tumors following cranial irradiation.

Methods

The median age at first irradiation was 8 years (range, 3–20 years). Initial diagnoses were two cases of germinoma, one non-germinomatous germ cell tumor (NGGCT), three cases of medulloblastoma, and one pineal gland tumor (pathology undetermined). All patients received craniospinal irradiation followed by local boost and the median dose to the initial tumor area was 54.0 Gy (range, 49.8–60.6 Gy). Four patients (two medulloblastomas, one germinoma, and one NGGCT) received chemotherapy.

Results

Second brain tumors were diagnosed a median of 114 months (range, 64–203) after initial radiation. Pathologic diagnoses were one glioblastoma, two cases of anaplastic astrocytoma, one medulloblastoma, one low-grade glioma, one high-grade glial tumor, and one atypical meningioma. Five patients underwent surgical resection with subsequent radiotherapy. One anaplastic astrocytoma patient received chemotherapy only following stereotactic biopsy. The meningioma patient was alive 32 months after total resection and radiosurgery for subsequent recurrences. Six patients died within 18 months and most deaths were due to disease progression.

Conclusions

Most patients diagnosed with second brain tumors had received high-dose, large-volume radiotherapy with chemotherapy at a young age. Further studies are required to determine the relationship between radiotherapy/chemotherapy and the development of secondary brain tumors.

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Conflict of Interest

The authors declare that they have no conflict of interest.

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Author notes

  1. Sei Hwan You

    Present address: Department of Radiation Oncology, Yonsei University Wonju Christian Hospital, Wonju, South Korea

Authors and Affiliations

  1. Department of Radiation Oncology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-gu, Seoul, 120-752, South Korea

    Sei Hwan You & Chang-Ok Suh

  2. Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Chuhl Joo Lyu

  3. Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Dong-Seok Kim

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  1. Sei Hwan You
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Correspondence to Chang-Ok Suh.

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You, S.H., Lyu, C.J., Kim, DS. et al. Second primary brain tumors following cranial irradiation for pediatric solid brain tumors. Childs Nerv Syst 29, 1865–1870 (2013). https://doi.org/10.1007/s00381-013-2098-4

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  • DOI: https://doi.org/10.1007/s00381-013-2098-4

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