Survivors of Childhood Cancer: Risk of New Primary Neoplasms of the CNS

Abstract

Survival following childhood cancer diagnosis has improved dramatically over the past four decades. With this improvement has come increased identification of therapy-related late effects. Among the best studied of these late effects are second neoplasms, and although these can occur at nearly any site, one of the locations often associated with high morbidity and, in some cases mortality, is the central nervous system. Second tumors of the central nervous system most commonly arise in survivors treated for primary CNS tumors or for acute leukemias; this association can be attributed to therapeutic risk factors, most notably prior treatment with radiation therapy. Additional risk factors have been identified, including age at initial cancer diagnosis, as well as underlying genetic predisposition syndromes. Data from multiple childhood cancer survivor cohorts have helped in predicting time to second tumor development and have also helped inform survivor screening and surveillance.