Patients subjected to CNS-radiotherapy in childhood prone to Radiation-induced meningiomas later

Patients who underwent CNS-radiotherapy in childhood for any condition have an increased risk of developing secondary brain tumors such as radiation-induced meningiomas (RIMs), shows a recent study published in Brain and Spine journal.

Meningiomas are the most common primary brain tumors in adults and represent almost one-third of all primary tumors of the central neural system (CNS). Various risk factors have been blamed for their development, like ionizing radiation (therapeutic, diagnostic, or random exposure), hormonal factors, and genetic predilection syndromes.

Indeed, the effects of ionizing radiation on intracranial meningioma growth were first studied by Munk in 1969, and since then, many researchers have linked radiation exposure with the development of different types of cerebral tumors. One of the main causing factors of meningiomas is radiation, hence the amount of radiation and the site of it play a significant role in the side-effects of it, like the formation of meningiomas

In the international bibliography, meningiomas occurring within a previously radiated field after a defined latency period are being called “Radiation-Induced Meningiomas (RIM)”

For a tumor to be considered Radiation-Induced Meningioma, it should be formed within the irradiated field, appear with different histological characteristics from other previous tumors,

at least five years should have elapsed between irradiation and meningioma’s appearance, it should have been absent during irradiation, patient should not have a metastatic tumor, and

the incidence of neurofibromatosis type II should be excluded.

A retrospective study was undertaken by Banos et al to investigate the association of CNS irradiation during childhood with the development of meningioma in adult patients, managed at the Department of Neurosurgery of ‘Attikon’ General University Hospital, from January 2012 to September 2022.l, in which they examined the cases of thirteen patients with radiation-induced meningioma (RIM) who were diagnosed and treated in the neurosurgical department. These patients had been irradiated during their childhood for paediatric cancer.

Their study concluded that patients who underwent CNS radiation therapy in childhood for any condition had an increased risk of developing in adulthood secondary brain tumors -benign or malignant-such as radiation-induced meningiomas. The RIMs resembled sporadic meningiomas in symptomatology, location, treatment, and histological grade. They also advice that long-term follow-up and regular check-ups are recommended in irradiated patients due to the short latency period from irradiation to RIM development, as these patients are younger than those with sporadic meningiomas cases. Further research is needed to identify the regular manner in which follow-up should be suggested in such patients.

Reference

Stamatios Banos a, Mary Solou a, Ioannis Ydreos a, Evangelos K. Papadopoulos a, Georgios Savvanis a, Anastasios A. Politis a, Lampis C. Stavrinou a, Maria M. Gavra b, Efstathios J. Boviatsis a

Brain and Spine

Volume 3, 2023, 101719

https://doi.org/10.1016/j.bas.2023.101719