Radiotherapy Research Today is a free monthly online journal that collates and summarizes the latest research about Radiotherapy, including details on cancer treatment, side effects.

High incidence of meningioma in cranial irradiated survivors of childhood acute lymphoblastic leukemia.

Goshen Y, Stark B, Kornreich L, Michowiz S, Feinmesser M, Yaniv I

Department of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel. ygoshen@clalit.org.il

BACKGROUND: Most survivors of childhood acute lymphoblastic leukemia (ALL) and T-cell lymphoma (T-NHL) treated before 1990 received cranial radiation. This study assessed the occurrence of second tumors in irradiated and non-irradiated survivors. METHODS: Two hundred and ten survivors of ALL and T-NHL were treated between 1974 and 1997 by several protocols. Imaging (MRI, CT) was performed every 3-6 years in 76/88 irradiated and 74/122 non-irradiated patients for the last 20 years. RESULTS: From January 1998 through 2004, meningiomas were detected in 16 survivors (8 female, 8 male) at age 20-39 years (median 28.7); 15 were asymptomatic. Cranial imaging done 2-8 years previously in 11 revealed no abnormalities. Fifteen had been diagnosed with ALL or T-NHL 10-29 years earlier (median 21) and received cranial irradiation (24 Gy in 14) at age 2-14 years (median 7.6). Fifteen tumors arose in the convexity. Three patients had multiple lesions. Complete resection was performed in 12 patients, with one complication. One patient had a recurrence, and four with small tumors are under surveillance. Only one low-grade glioma and two basal-cell carcinomas were found. Only one of the 74 non-irradiated patients (median follow-up 14 years) developed meningioma. The Kaplan-Meier estimate of incidence of meningioma was 14.8+/-7.6 at 20 years. CONCLUSIONS: Survivors of childhood ALL treated with cranial radiation require prolonged surveillance because of a high incidence of late meningiomas. Early detection, when the tumor is still small, facilitates resection and may reduce complications.

Published 19 July 2007 in Pediatr Blood Cancer, 49(3): 294-7.
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