Skip to main content

Advertisement

SpringerLink
Log in

Radiation-induced tumors in children irradiated for brain tumor: a longitudinal study

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Background

Radiation-induced tumors (RIT) are increasingly recognized as delayed complications of brain irradiation during childhood. However, the true incidence is not established, their biology is poorly understood, and few guidelines exist regarding the long-term follow-up of irradiated children.

Methods

We studied retrospectively patients irradiated for brain tumor under 18 years and followed in our institution since 1970. RIT were defined as new masses, different from the original tumor, occurring after delay in irradiated areas, and not related to phacomatosis.

Results

Among 552 irradiated patients, 42 (7.6%) developed one or more RIT, 26 months to 29 years after irradiation (mean 12.8 years). The cumulated incidence was 2.0% at 5 years and 8.9% at 10 years. Of the patients, 73.8% were adult at the time of diagnosis of RIT, and 75% were diagnosed within 18.1 years after irradiation. We identified 60 cavernomas, 26 meningiomas, 2 malignant gliomas, 1 meningosarcoma, and 6 thyroid tumors. Compared with meningiomas, cavernomas appeared earlier, in children irradiated at an older age, and with a male predominance. Although RIT were correlated with higher irradiation doses, 80.9% of these occurred at some distance from the maximum irradiation field. Twenty-five lesions were operated in 20 patients; three patients died because of progression of the RIT.

Conclusion

A significant number of patients undergoing irradiation for brain tumor during childhood develop a RIT, often during adulthood. Our data suggest that radiation-induced cavernomas result from angiogenetic processes rather than true tumorigenesis. Protracted follow-up with MRI is warranted in children irradiated for brain tumor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Arita K, Kurisu K, Sugiyama K (2006) Nervous system tumors and atomic bomb experience of Hiroshima and Nagasaki. In: McLendon RE, Rosemblum MK, Bigner DD (eds) Russell & Rubinstein's Pathology of tumors of the central nervous system, 7th edn. Hodder Arnold, London, pp 51–56

    Google Scholar 

  2. Al Mefty O, Topsakal C, Pravdenkova S, Sawyer JR, Harrisson MJ (2004) Radiation-induced meningiomas: clinical, pathological, cytokinetic, and cytogenetic characteristics. J Neurosurg 100:1002–1013

    Article  PubMed  Google Scholar 

  3. Boljesikova E, Chorvath M, Hurta P, Steno J, Bizik I (2001) Radiation-induced meningioma with a long latency period: a case report. Pediatr Radiol 31:607–609

    Article  CAS  PubMed  Google Scholar 

  4. Cahan WG, Woodard HQ, Higinbotham NL, Stewart FW, Coley BL (1948) Sarcoma arising in irradiated bone. Cancer 1:3–29

    Article  CAS  PubMed  Google Scholar 

  5. Strojan P, Popović M, Jereb B (2000) Secondary intracranial meningiomas after high-dose cranial irradiation: report of five cases and review of the literature. Int J Radiat Oncol Biol Phys 48:65–73

    Article  CAS  PubMed  Google Scholar 

  6. Amirjamshidi A, Abbassioun K (2000) Radiation-induced tumors of the central nervous system occurring in childhood and adolescence: four unusual lesions in three patients and a review of the literature. Child’s Nerv Syst 16:390–397

    Article  CAS  Google Scholar 

  7. Heckl S, Aschoff A, Kunze S (2002) Radiation-induced cavernous hemangiomas of the brain: a late effect predominantly in children. Cancer 94:3285–3291

    Article  PubMed  Google Scholar 

  8. Paulino AC, Ahmed IM, Mai WY, Teh BS (2009) The influence of pretreatment characteristics and radiotherapy parameters on time interval to development of radiation-associated meningioma. Int J Radiat Oncol Biol Phys 75:1408–1414

    Article  PubMed  Google Scholar 

  9. Salvati M, D’Elia A, Melone GA, Brogna C, Frati A, Raco A, Delfini R (2008) Radio-induced gliomas: 20-year experience and critical review of the pathology. J Neurooncol 89:169–177

    Article  PubMed  Google Scholar 

  10. Soffer D, Gomori JM, Siegal T, Shalit MN (1989) Intracranial meningiomas after high-dose irradiation. Cancer 63:1514–1519

    Article  CAS  PubMed  Google Scholar 

  11. Brada M, Ford D, Ashley S, Bliss JM, Crowley S, Mason M, Rajan B, Traish D (1992) Risk of second brain tumour after conservative surgery and radiotherapy for pituitary adenoma. Brit Med J 304:1343–1346

    Article  CAS  PubMed  Google Scholar 

  12. Lew SM, Morgan JN, Psaty EA, Lefton DR, Jeffrey AC, Abbott R (2006) Cumulative incidence of radiation-induced cavernomas in long-term survivors of medulloblastoma. J Neurosurg 104:103–107, 2 Suppl Pediatrics

    PubMed  Google Scholar 

  13. Walter AW, Hancock ML, Pui CH, Hudson MM, Ochs JS, Rivera GK, Pratt CB, Boyett JM, Kun LE (1998) Secondary brain tumors in children treated for acute lymphoblastic leukemia at St Jude Children's Research Hospital. J Clin Oncol 16:3761–3767

    CAS  PubMed  Google Scholar 

  14. Averbeck D (2009) Does scientific evidence support a change from the LNT model for low-dose radiation risk extrapolation? Health Phys 97:493–504

    Article  CAS  PubMed  Google Scholar 

  15. Lonser RR, Walbridge S, Vortmeyer AO, Pack SD, Nguyen TT, Gobate N, Olson JJ, Bobo RH, Goffman T, Shunang Z, Oldfield EH (2002) Induction of glioblastoma multiforme in nonhuman primates after therapeutic doses of fractionated whole-brain radiation therapy. J Neurosurg 87:1378–1389

    Google Scholar 

  16. Vinchon M, Dhellemmes P (2007) The transition from child to adult in neurosurgery. Adv Techn Standards Neurosurg 32:3–24

    Article  CAS  Google Scholar 

  17. Duhem R, Vinchon M, Leblond P, Soto-Ares G, Dhellemmes P (2005) Cavernous malformations after cerebral irradiation during childhood: report of nine cases. Childs Nerv Syst 10:922–925

    Article  Google Scholar 

  18. Strenger V, Sovinz P, Lackner H, Dornbusch HJ, Lingitz H, Eder HG, Moser A, Urban C (2008) Intracerebral cavernous hemangioma after cranial irradiation in childhood; incidence and risk factors. Strahlenther Onkol 184:276–280

    Article  PubMed  Google Scholar 

  19. Burn S, Roxana G, Phipps K, Gaze M, Hayward R (2007) Incidence of cavernoma development in children after radiotherapy for brain tumors. J Neurosurg (Pediatrics) 106(suppl 5):379–383

    Article  Google Scholar 

  20. Loeffler JS, Niemierko A, Chapman PH (2003) Second tumors after radiosurgery: the tip of the iceberg or a bump in the road? Neurosurgery 52:1436–1442

    Article  PubMed  Google Scholar 

  21. Sasagawa Y, Akai T, Itou S, Iizuka H (2009) Gamma knife radiosurgery-induced cavernous hemangioma: case report. Neurosurgery 64:E1006–E1007

    Article  PubMed  Google Scholar 

  22. Mack EE (1999) Radiation-induced tumors. In: Berger MS, Wilson CB (eds) The gliomas. Philadelphia, Saunders, pp 724–735

    Google Scholar 

  23. Furuta T, Sugiu K, Tamiya T, Matsumoto K, Ohmoto T (1998) Malignant cerebellar astrocytoma developing 15 years after radiation therapy for a medulloblastoma. Clin Neurol Neurosurg 100:56–59

    Article  CAS  PubMed  Google Scholar 

  24. Hope AJ, Mansur DB, Tu PH, Simpson JR (2006) Metachronous secondary atypical meningioma and anaplastic astrocytoma after postoperative craniospinal irradiation for medulloblastoma. Childs Nerv Syst 22:1201–1207

    Article  PubMed  Google Scholar 

  25. Yang SY, Wang KC, Cho BK, Kim YY, Lim SY, Park SH, Kim IH, Kim SK (2005) Radiation-induced cerebellar glioblastoma at the site of a treated medulloblastoma. J Neurosurg 102(suppl 4):417–422

    CAS  PubMed  Google Scholar 

  26. Nimjee SM, Powers CJ, Bilsara KR (2006) Review of the literature on de novo formation of cavernous malformations of the central nervous system after radiation therapy. Neurosurg Focus 21:E4

    Article  PubMed  Google Scholar 

  27. Czech T, Slavic I, Aichholzer M, Haberler C, Dietrich W, Dieckmann K, Koos W, Budka H (1999) Proliferative activity as measured by MIB-1 labeling index and long-term outcome of visual pathway astrocytomas in children. J Neurooncol 42:143–150

    Article  CAS  PubMed  Google Scholar 

  28. Simsek E, Yavuz C, Ustundag N (2003) Atypical meningioma and extensive calvarium defects in neurofibromatosis type 1. Pediatr Radiol 33:551–553

    Article  PubMed  Google Scholar 

  29. Amlashi SFA, Riffaud L, Brassier G, Morandi X (2003) Nevoid basal cell carcinoma syndrome: relation with desmoplastic medulloblastoma in infancy; population-based study and review of the literature. Cancer 98:618–624

    Article  PubMed  Google Scholar 

  30. Kantar M, Cetingu lN, Kansoy S, Anacak Y, Demirtas E, Ersahin Y, Mutluer S (2004) Radiotherapy-induced secondary cranial neoplasms in children. Childs Nerv Syst 20:46–49

    Article  PubMed  Google Scholar 

  31. Baumgartner JE, Ater JL, Ha CS, Kuttesch JF, Leeds NE, Fuller GN, Wilson RJ (2003) Pathologically proven cavernous angiomas of the brain following radiation therapy for pediatric brain tumors. Pediatr Neurosurg 39:201–207

    Article  PubMed  Google Scholar 

  32. Jain R, Robertson PL, Gandhi D, Gujar SK, Muraszko KM, Gebarski S (2005) Radiation-induced cavernomas of the brain. AJNR Am J Neuroradiol 26:1158–1162

    PubMed  Google Scholar 

  33. Koike S, Aida N, Hata M, Fujita K, Ozawa Y, Inoue T (2004) Asymptomatic radiation-induced telangiectasia in children after cranial irradiation: frequency, latency, and dose relation. Radiology 230:93–99

    Article  PubMed  Google Scholar 

  34. Pozzati E, Giangaspero F, Marliani F, Acciarri N (1996) Occult cerebrovascular malformations after irradiation. Neurosurgery 39:677–684

    Article  CAS  PubMed  Google Scholar 

  35. Lee JW, Kim DS, Shim KW, Chang JH, Huh SK, Park YG, Choi JU (2008) Management of intracranial cavernous malformation in pediatric patients. Childs Nerv Syst 24:321–327

    Article  PubMed  Google Scholar 

  36. Pettorini BL, Narducci A, de Carlo A, Abet F, Caldarelli M, Massimi L, Tamburrini G, Di Rocco C (2009) Thyroid neoplasm after central nervous system irradiation for medulloblastoma in childhood: report of two cases. Childs Nerv Syst 25:631–634

    Article  PubMed  Google Scholar 

  37. Mathews MS, Peck WW, Brant-Zawadzki M (2008) Brown–Séquard syndrome secondary to spontaneous bleed from postradiation cavernous angiomas. AJNR Am J Neuroradiol 29:1989–1990

    Article  CAS  PubMed  Google Scholar 

  38. Makidono A, Kobayashi N, Saida Y, Manabe A, Kawamori J, Suzuki K (2009) Metachronous gliomas following cranial irradiation for mixed germ cell tumors. Childs Nerv Syst 25:713–718

    Article  PubMed  Google Scholar 

  39. Pettorini BL, Park YS, Caldarelli M, Massimi L, Tamburrini G, Di Rocco C (2008) Radiation-induced brain tumours after central nervous system irradiation in childhood: a review. Childs Nerv Syst 24:793–805

    Article  PubMed  Google Scholar 

  40. Kondziolka D, Kano H, Kanaan H, Madhok R, Mathieu D, Flickinger JC, Lunsford LD (2009) Stereotactic radiosurgery for radiation-induced meningiomas. Neurosurgery 64:463–470

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Neurosurgery, University Hospital, Lille, France

    Matthieu Vinchon, Isabelle Delestret & Marc Baroncini

  2. Department of Pediatric Oncology, Centre Oscar Lambret, Lille, France

    Pierre Leblond

  3. Department of Neuroradiology, University Hospital, Lille, France

    Sabine Caron

  4. Department of Radiotherapy, Centre Oscar Lambret, Lille, France

    Bernard Coche

  5. Matthieu Vinchon, Pediatric Neurosurgery, Hôpital Roger Salengro, 59037, Lille Cedex, France

    Matthieu Vinchon

Authors
  1. Matthieu Vinchon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pierre Leblond
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sabine Caron
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Isabelle Delestret
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marc Baroncini
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bernard Coche
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Matthieu Vinchon.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vinchon, M., Leblond, P., Caron, S. et al. Radiation-induced tumors in children irradiated for brain tumor: a longitudinal study. Childs Nerv Syst 27, 445–453 (2011). https://doi.org/10.1007/s00381-011-1390-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-011-1390-4

Keywords

Search

Navigation