Radiation-Induced Gliomas

Aherne, Noel J; Murphy, Brona M.

doi:10.1615/critrevoncog.2018025740

Cited by 13 publications

(7 citation statements)

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“…The average dose of radiation-induced grades II and IV glioma is estimated to be 29.7 ± 18.4 Gy and 37.3 ± 17.5 Gy, respectively. 14 Of note, the total dose for craniopharyngiomas ranges between 50 and 54 Gy. 1 …”

Section: Discussionmentioning

confidence: 99%

Development of multifocal glioblastoma after radiotherapy for craniopharyngioma: illustrative case

Yuan

Lin

Min

et al. 2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND Radiation-induced glioblastoma (GBM) in patients previously treated for craniopharyngioma is a rare phenomenon. To the authors’ knowledge, only seven cases have previously been documented in the literature. OBSERVATIONS Herein, the authors report a case of a patient presenting with a new diagnosis of multifocal GBM 15 years after having received adjuvant radiotherapy for a craniopharyngioma. Magnetic resonance imaging revealed an extensive enhancing infiltrative lesion in the right frontal lobe as well as two satellite lesions in the contralateral frontal lobe. Histopathology on biopsy was consistent with GBM. LESSONS Even though this case is rare, it is nevertheless important to recognize GBM as a potential side effect of radiation. Long-term follow-up in postradiation craniopharyngioma patients is crucial for early detection.

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Section: Discussionmentioning

confidence: 99%

Development of multifocal glioblastoma after radiotherapy for craniopharyngioma: illustrative case

Yuan

Lin

Min

et al. 2023

Journal of Neurosurgery: Case Lessons

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“…These secondary malignancies include astrocytoma, meningioma, sarcoma, and schwannoma. Treatment of radiation-induced malignancies remains challenging given the increased likelihood of radioresistance of these tumors ( case 9-1 ) 20 …”

Section: Radiationmentioning

confidence: 99%

“…Treatment of radiation-induced malignancies remains challenging given the increased likelihood of radioresistance of these tumors (CASE 9-1). 20…”

Section: Radiation-induced Secondary Malignanciesmentioning

confidence: 99%

Neurologic Complications of Cancer Treatment

Porter¹

2023

CONTINUUM: Lifelong Learning in Neurology

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Objective Advances in cancer treatment have led to extended survival and increased risk of neurologic complications in an aging population. This review summarizes potential neurologic complications in patients who have undergone treatment for neurologic and systemic malignancies. Latest Developments Radiation and cytotoxic chemotherapy along with other targeted therapies continue to be the mainstay of cancer treatment. These advances in cancer care have led to improved outcomes and increased the need to understand the spectrum of neurologic complications that may arise from treatment. While radiation and older therapies including cytotoxic chemotherapies have side effect profiles that are widely known and well understood, this article serves as a review of the more commonly associated neurologic complications of both traditional and newer treatments being offered to this patient population. Essential Points Neurotoxicity is a common complication of cancer-directed treatment. In general, neurologic complications of radiation therapy are more common in central nervous system malignancies, and neurologic complications of chemotherapy are more common in non-neurologic malignancies. Attempts at prevention, early detection, and intervention remain paramount in the reduction of neurologic morbidity.

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“…Our work is largely concordant with the small but existing body of RIG literature. Incidence of RIG development after cranial RT has been estimated to occur in ~0.5-3% of patients 13,26 after a median latency period of 9-15 years, 27,28 with a median OS of 9-11 months and 2-year survival rate of approximately 20%. 22,27 While these retrospective cohort and comprehensive review-style studies provide an important foundation for RIG epidemiology, we expand upon these here by providing annual incidence rates over four decades both by year of original diagnosis and as a proportion of all CNS tumors diagnosed in a given year.…”

Section: Overall Survivalmentioning

confidence: 99%

Population-based analysis of radiation-induced gliomas after cranial radiotherapy for childhood cancers

Leary

Anderson-Mellies

Green

2022

Preprint

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Background: Cranial radiotherapy (RT) is used to treat pediatric central nervous system (CNS) cancers and leukemias. RT carries a risk of secondary CNS malignancies, including radiation-induced gliomas, the epidemiology of which is poorly understood. Methods: This retrospective study using SEER registry data (1975-2016) included two cohorts. Cohort 1 included patients diagnosed with Grade III/IV or ungraded glioma as a second malignancy at least 2 years after receiving beam radiation and/or chemotherapy for a first malignancy diagnosed at ages 0-19 years, either a primary CNS tumor treated with RT (1a, n=57) or leukemia with unknown RT treatment (1b, n=20). Cohort 2 included patients with possible missed RIG who received RT for a primary CNS tumor diagnosed at 0-19 and then died of presumed progressive disease more than 5 years after diagnosis, since previous studies have documented many missed RIGs in this group (n=296). Controls (n=10,687) included all other patients ages 0-19 who received RT for a first CNS tumor or leukemia who did not fit inclusion criteria above. Results: For Cohort 1 (likely/definite RIGs), 0.97% of patients receiving cranial RT went on to develop RIG. 3.39% of patients receiving cranial RT for primary CNS tumors fell in Cohort 2 (potential RIGs). Median latency to RIG diagnosis was 11.1 years; latency was significantly shorter for Cohort 1b (median 10.0, range 5.0-16.1) vs. 1a (12.0, 3.6-34.4, p=0.018). Median OS for Cohort 1 was 9.0 months. Receiving surgery, radiation, or chemotherapy were all associated with a non-statistically significant improvement in OS (p 0.1-0.2). 1.8% of brain tumor deaths in the cohort fell in Cohort 1, with an additional 7.9% in Cohort 2. Conclusion: Within the limitations of a population-based study, 1-4% of patients undergoing cranial RT for pediatric cancers later develop RIG, which is incurable and can occur anywhere from 3-35 years later. 2-10% of pediatric brain tumor deaths are attributable to RIG. Effective treatment of RIG remains unclear and is thus deserving of increased attention in preclinical and clinical studies.

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Radiation-Induced Gliomas

Cited by 13 publications

References 0 publications

Development of multifocal glioblastoma after radiotherapy for craniopharyngioma: illustrative case

Development of multifocal glioblastoma after radiotherapy for craniopharyngioma: illustrative case

Neurologic Complications of Cancer Treatment

Population-based analysis of radiation-induced gliomas after cranial radiotherapy for childhood cancers

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