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Meningioma after radiotherapy for malignancy.
Peter F Morgenstern1, Kalee Shah1, Ira J Dunkel2
1Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Neurological Surgery, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA.
Summary
Radiation exposure can lead to secondary meningiomas (RIM), a significant long-term complication. While RIM may present with more aggressive pathology, its impact on survival requires further investigation.
Area of Science:
- Neuro-oncology
- Radiation Oncology
- Cancer Survivorship
Background:
- Complications of radiation exposure are increasingly recognized, particularly secondary malignancies in cancer survivors.
- Cranial radiation therapy is associated with an increased risk of developing secondary neoplasms, including meningioma.
Purpose of the Study:
- To present the experience with intracranial radiation-induced meningioma (RIM).
- To discuss the presentation, natural history, and management implications of RIM.
Main Methods:
- Retrospective review of patients diagnosed with meningioma after radiation therapy (1960-2014).
- Analysis of radiation exposure details, previous malignancies, meningioma characteristics, treatment, and follow-up.
Main Results:
- Thirty patients were diagnosed with RIM, with initial malignancies including acute lymphocytic leukemia, medulloblastoma, and glioma.
- Mean latency to meningioma was 26 years after a mean radiation dose of 34Gy.
- Of 21 surgically treated patients, 57.1% were WHO grade I and 42.9% were WHO grade II; mortality was zero.
Conclusions:
- Meningioma is a significant long-term complication of therapeutic radiation.
- RIM may exhibit more aggressive pathology compared to sporadic meningioma, but its effect on survival is unclear.
- Further research is needed to define surveillance strategies for secondary neoplasms post-radiation therapy.
