Second brain tumors following central nervous system radiotherapy in childhood.
PBN-AR
Instytucja
Instytut "Pomnik - Centrum Zdrowia Dziecka"
Źródłowe zdarzenia ewaluacyjne
Informacje podstawowe
Główny język publikacji
en
Czasopismo
British Journal of Radiology
ISSN
0007-1285
EISSN
1748-880X
Wydawca
BRITISH INST RADIOLOGY
DOI
URL
Rok publikacji
2014
Numer zeszytu
1041
Strony od-do
e20140211
Numer tomu
87
Identyfikator DOI
Liczba arkuszy
Streszczenia
Język
angielski
Treść
Objective: The second tumour (ST) occurrence is a relatively uncommon late complication of radiotherapy but represents one of the most significant issues, especially in childhood oncology. We describe our experience with patients who developed second brain neoplasm following cranial irradiation in childhood. Methods: We identified nine patients who received radiotherapy owing to central nervous system tumour in childhood and subsequently developed the second brain tumour. The full clinical and radiological documentation and histopathological reports were reviewed. Risk factors such as age at irradiation, latency period to ST diagnosis, radiotherapy doses and volumes and other therapy methods were evaluated. We correlated the ST location with the three levels of irradiation dose (high, >40 Gy; medium, 25–40 Gy; and low <25 Gy). Results: Five meningiomas and four gliomas occurred as the ST after the mean time of 11.7 years after radiotherapy. The average age of children during irradiation was 4.6 years. The shorter latency time to the ST induction was found in children treated with chemotherapy (9 years vs 17.2 years). Seven STs developed in the area of high and moderate dose (>25 Gy), only two low-grade gliomas appeared in the low-dose region. Conclusion: Our data suggest that the STs usually develop in the brain tissues that received doses >25 Gy in patients irradiated at a young age. Advances in knowledge: The low-dose volume seems not to be so significant for second brain neoplasm induction. Therefore, the modern intensity-modulated radiotherapy technique could be safely applied in paediatric patients. The second tumour (ST) occurrence is a multifactorial event, depending on the factors associated with therapy and with the clinical characteristics of the patient, such as age or genetic predisposition. The cranial irradiation, especially the radiation dose and the field size, is known as the significant risk factor for developing second brain neoplasms. However, details of this relationship are still not clear. The mechanisms of the tumour induction are complex. The radio-induced tumour is defined by many authors as a new mass, histologically different from the original tumour, occurring after delay in irradiated areas, and not related to phacomatosis. This late complication of radiotherapy is not common but is especially important in young patients with a long life expectancy. Among factors that limit better understanding of ST's aetiology is the lack of long-term follow-up that is often interrupted when irradiated children become adults. In this study, a single institution's experience was presented with nine second brain tumours that appeared following central nervous system (CNS) radiotherapy in childhood.
Cechy publikacji
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Inne
System-identifier
PX-58a9aa8bd5de8db965895109
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