PURPOSE Radiation-induced meningiomas (RIMs) are associated with previous exposure to therapeutic irradiation. RIMs are rare and have not been well characterized relative to spontaneous meningiomas (SMs). METHODS 1003 patients with proven or presumed meningiomas were identified from the VCU brain tumor database. Chart review classified RIM patients and their characteristics. RESULTS Of the 1003 total patients, 76.47% were female with a mean ± SD age of 67.55 ± 15.50 years. 15 RIM patients were identified (66.67% female), with a mean ± SD age of 52.67 ± 15.46 years, 5 were African American and 10 were Caucasian. The incidence of RIMs was 1.49% in our data set. The mean age at diagnosis was 43.27 ± 15.06 years. The mean latency was 356.27 ± 116.96 months. The mean initiating dose was 44.28 ± 14.68 Gy. There was a significant difference between mean latency period and ethnicity, 258.3 months for African American population, and 405.2 months for Caucasian population (p = 0.003). There was a significant difference between the mean number of lesions in females (2.8) versus males (1.2; p = 0.046). Of the RIMs with characterized histology, 6 (55%) were WHO grade II and 5 (45%) were WHO grade I, demonstrating a prevalence of grade II tumors approximately double that found with SMs. RIMs were treated with combinations of observation, surgery, radiation, and medical therapy. Of the 8 patients treated with radiation, 4 demonstrated response. 8 of the 15 patients (53%) demonstrated recurrence/progression despite treatment. CONCLUSION RIMs are important because of the associated higher grade histology, gender, and ethnic incidences, and increased recurrence/progression compared to SMs. Despite the presumed contributory role of prior radiation, RIMs demonstrate a significant rate of responsiveness to radiation treatment.
Purpose Radiation-induced meningiomas (RIMs) are meningiomas that associated with prior exposure to radiation. Due to the rare occurrence of RIMs, their behavior has not been well described and their incidence has not been reported. This study aims to characterize RIMs and compare the treatment and outcomes of RIMs to those of spontaneous meningiomas (SMs). Methods 1003 patients seen at a single institution with proven or presumed meningiomas were identified from brain tumor-related diagnoses between 2005 and 2015. Chart review positively-identified patients with RIMs and data was collected on initial diagnosis and treatment, meningioma recurrence/progression, histology, and treatments. Results Fifteen RIM patients were identified (66.67% were female and 66.67% were Caucasian). The average age at diagnosis was 43.27 ± 15.06 years. The overall mean latency was 356.27 ± 116.96 months. The mean latency period for the African-American population was 258.4 ± 84.86 months compared to 405.2 ± 100.5 months for the Caucasian population (p = 0.003). The mean number of lesions for males was 1.4 ± 0.89 compared to females which was 2.8 ± 1.40 (p = 0.046). The incidence of RIMs among all meningiomas in our data set was 1.5%, a statistic that has not previously been reported. The 10-year progression-free survival rate and recurrence-free survival rate was 50% and 27%, respectively. 58% of patients treated with radiotherapy were progression-free at 5 and 10 years. Conclusion Radiation remains a rare but important cause of meningioma. These meningiomas have a higher grade histology, require aggressive treatment strategies, and have higher recurrence and progression compared to spontaneous meningiomas.
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