scholarly journals RONC-18. ANALYSIS OF BRAIN TUMOR INDUCED BY IRRADIATION IN CHILDHOOD - A SINGLE INSTITUTIONAL ANALYSIS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii458-iii459
Author(s):  
Takashi Sano ◽  
Kaoru Tamura ◽  
Masae Kuroha ◽  
Kazutaka Sumita ◽  
Yukika Arai ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Irradiation Dose ◽  
Clinical Characteristics ◽  
Cranial Irradiation ◽  
Surgical Removal ◽  
Long Term Follow Up ◽  
Long Time ◽  
Radiation Induced

Abstract BACKGROUND Radiation-induced brain tumors are rare tumors that appear during long-term follow-up after radiation therapy. Children are at greater risk for radiation -induced brain tumors than adults. The clinical characteristics of radiation-induced brain tumor treated at our hospital were retrospectively examined. PATIENTS AND METHODS Clinical characteristics of seven radiation-induced brain tumors that developed in 6 patients irradiated in their childhood at our hospital were analyzed. The background disease, age at irradiation, irradiation dose, period from irradiation to onset, pathological diagnosis, and treatment for radiation-induced brain tumor were examined. RESULTS Background diseases for irradiation were leukemia in 3 patients, germinoma in 2, medulloblastoma in 1, and the average cranial irradiation dose was 23.2 Gy. The patients tended to be young at irradiation (2–17 yeays; median:4 years old). The time between irradiation and the onset of radiation-induced brain tumors ranged from 9.5 to 39.1 years (median:28 years). Radiation-induced brain tumors comprised 6 meningioma（grade I:5, grade II:1）and 1 high-grade gliomas. All patients underwent surgical removal of the radiation-induced brain tumors and 2 received additional irradiation. During a median of 5.3 years of follow-up after the diagnosis of radiation-induced brain tumors, 2 underwent second surgery, while the remaining 4 have no recurrence. DISCUSSION: In most cases, radiation-induced brain tumors occur for a long time after irradiation in childhood. Monitoring of radiation-induced brain tumors as well as primary tumor recurrence was considered important.

scholarly journals HGG-39. CLINICAL CHARACTERISTICS AND OUTCOME OF PATIENTS WITH RADIATION-INDUCED GLIOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii350-iii351
Author(s):  
Makoto Ohno ◽  
Yasuji Miyakita ◽  
Masamichi Takahashi ◽  
Takaki Ohmura ◽  
Natsuko Satomi ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Progression Free Survival ◽  
Metastatic Tumor ◽  
Cranial Irradiation ◽  
Surgical Removal ◽  
Diffuse Astrocytoma ◽  
Median Latency ◽  
Free Survival ◽  
Primary Disease ◽  
Radiation Induced

Abstract The development of gliomas subsequent to therapeutic cranial irradiation is a rare but serious complication. The purpose of this study is to understand the clinical characteristics and outcome of patients with radiation-induced glioma (RIG). Between 2001 and 2018, we identified 10 patients with RIG, which satisfied the Cahan’s criteria in our data base. There was no sex predominance (M: 5, F: 5), and the median age of the primary diseased was 13.5 years (range: 1–39). The primary diseases included 2 germinoma, 2 acute lymphoblastic lymphoma, 2 medulloblastoma, 1 diffuse astrocytoma, 1 pilocytic astrocytoma, 1 pituitary adenoma and 1 metastatic tumor from lung cancer. All the patients received cranial radiation (range: 12–60 Gy). The median latency time between primary disease and RIG was 16 years (range: 9–30 years), which was not correlated with age at the time of primary disease (r2= 0.014, p=0.74). Radiation-induced gliomas included 8 glioblastoma and 2 grade III glioma based on histological diagnosis. After surgical removal or biopsy of the RIG, 4 patients underwent chemotherapy alone (nimustine, temozolomide (TMZ), carboplatin and etoposide), and 6 received chemotherapy (nimustine, TMZ, bevacizumab) combined with radiotherapy (range: 40-66Gy). The median progression free survival and survival time from RIG were 10.1 and 27.5 months, respectively. In summary, RIG may occur many years after successful initial treatment using radiotherapy, and the outcome of our patients with RIG supports the use of radiotherapy and/or chemotherapy after surgical resection.

scholarly journals NCMP-06. THE INCIDENCE OF POST-IRRADIATION CAVERNOUS ANGIOMA AND CYSTIC MALACIA AFTER HIGH DOSE CRANIAL IRRADIATION IN PEDIATRIC AND ADULT MALIGNANT BRAIN TUMORS

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi180-vi180
Author(s):  
Hiroki Taniguchi ◽  
Fumiyuki Yamasaki ◽  
Motoki Takano ◽  
Ushio Yonezawa ◽  
Kazuhiko Sugiyama ◽  
...  
Keyword(s):  
Irradiation Dose ◽  
Pediatric Patients ◽  
Cavernous Angioma ◽  
Cranial Irradiation ◽  
Adult Patients ◽  
High Dose ◽  
Local Irradiation ◽  
Long Term Follow Up

Abstract PURPOSE The purpose of this study is to investigate the incidence of cavernous angioma (CVA) and cystic malacia in long-term survivors of pediatric and adult malignant brain tumors treated by cranial irradiation. MATERIALS AND METHODS 36 pediatric (age < 18, M:F=24:12, mainly consisted of embryonal tumors) and 43 adults (age ≥18,M:F=27:16, mainly consisted of gliomas) patients with malignant tumors receiving high dose cranial irradiation and at least three years disease free period were included in this study. Follow-up of adult patients ranged from 3.2–19.4 years (median 7.6 years), the local irradiation dose from 50 to 60Gy. Follow-up of pediatric patients ranged from 3.8–18.4 years (median 9.0 years), the local irradiation dose from 49.6 to 60.4Gy. All patients underwent follow-up magnetic resonance imaging studies at least once a year, and the diagnosis of post-treatment CVA and cystic malacia was based solely on MRI findings. RESULTS At the timing of preparing this abstract, 16 adult patients developed CVAs during the median course of 13 years, while 24 pediatric patients developed CVAs during the median course of 5.8 years, and the difference was significant (P=0.0298, log-rank test). While, there was no statistical difference between adult and pediatric patients for the development of Zabramski type 1 & 2 CVAs, or of cystic malacia (P=0.6254 and P=0.4652, respectively). CONCLUSION We attribute the high rate of post-RT CVAs in our long-term follow-up study of adult patients to the delivery of cranial irradiation for glioma patients. Our data imply the importance of long term follow-up not only for pediatric patients but also for adult patients after high dose cranial irradiation.

scholarly journals Radiation-induced meningiomas

2018 ◽  
Vol 21 (4) ◽  
pp. 245-248
Author(s):  
Emerson Magno F. De Andrade ◽  
Raphael Vicente Alves ◽  
Mariano Ebran Fiore ◽  
Airton Batista De Araújo Jr ◽  
Antônio Carlos Montanaro ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Pediatric Population ◽  
Late Complication ◽  
Latency Period ◽  
Cranial Irradiation ◽  
Surgical Removal ◽  
Benign Meningioma ◽  
Total Radiation Dose ◽  
Radiation Induced

A late complication following cranial irradiation is the induction of tumors, most of which are intracranial meningiomas. The latency period between radiation exposure and diagnosis of radiation- induced meningioma varies with the timing of the initial radiation exposure and total radiation dose. The authors report two cases of meningiomas as a result of highdose irradiation received for a PNET. Both patients underwent surgical removal of the tumor and immunohistochemical examination revealed a benign meningioma. These cases illustrate the importance of continued follow up after cranial irradiation in the pediatric population.

scholarly journals RONC-19. TWO CASES OF RE-IRRADIATION FOR LATE RECURRENT OR RADIATION-INDUCED TUMOR AFTER RADIATION THERAPY FOR PEDIATRIC BRAIN TUMORS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii459-iii459
Author(s):  
Takashi Mori ◽  
Shigeru Yamaguchi ◽  
Rikiya Onimaru ◽  
Takayuki Hashimoto ◽  
Hidefumi Aoyama
Keyword(s):  
Radiation Therapy ◽  
Brain Tumors ◽  
Tumor Resection ◽  
Intensity Modulated Radiation Therapy ◽  
Late Recurrence ◽  
Pediatric Brain Tumors ◽  
Suprasellar Region ◽  
Radiation Induced ◽  
Pediatric Brain

Abstract BACKGROUND As the outcome of pediatric brain tumors improves, late recurrence and radiation-induced tumor cases are more likely to occur, and the number of cases requiring re-irradiation is expected to increase. Here we report two cases performed intracranial re-irradiation after radiotherapy for pediatric brain tumors. CASE 1: 21-year-old male. He was diagnosed with craniopharyngioma at eight years old and underwent a tumor resection. At 10 years old, the local recurrence of suprasellar region was treated with 50.4 Gy/28 fr of stereotactic radiotherapy (SRT). After that, other recurrent lesions appeared in the left cerebellopontine angle, and he received surgery three times. The tumor was gross totally resected and re-irradiation with 40 Gy/20 fr of SRT was performed. We have found no recurrence or late effects during the one year follow-up. CASE 2: 15-year-old female. At three years old, she received 18 Gy/10 fr of craniospinal irradiation and 36 Gy/20 fr of boost to the posterior fossa as postoperative irradiation for anaplastic ependymoma and cured. However, a anaplastic meningioma appeared on the left side of the skull base at the age of 15, and 50 Gy/25 fr of postoperative intensity-modulated radiation therapy was performed. Two years later, another meningioma developed in the right cerebellar tent, and 54 Gy/27 fr of SRT was performed. Thirty-three months after re-irradiation, MRI showed a slight increase of the lesion, but no late toxicities are observed. CONCLUSION The follow-up periods are short, however intracranial re-irradiation after radiotherapy for pediatric brain tumors were feasible and effective.

Access to radiation oncology centers with brain tumor treatment expertise for patients with resectable brain tumors.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18509-e18509
Author(s):  
Mehee Choi ◽  
Brian P. Martin ◽  
Lisa Misell ◽  
Joseph M. Zabramski ◽  
David G. Brachman
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Access To Care ◽  
Radiation Treatment ◽  
Fold Increase ◽  
Tumor Treatment ◽  
Brain Radiotherapy ◽  
The Us ◽  
Brain Radiation

e18509 Background: Many patients with brain tumors face challenges with access to care. For rural patients, prolonged travel times may limit access to appropriate radiotherapy. Radiation centers (RCs) offering specialized brain radiotherapy, e.g., stereotactic radiosurgery (SRS), are geographically limited. Utilization of brain brachytherapy at the time of resection offers an option for such patients, but technical challenges have limited the adoption. To address the limitations of traditional brachytherapy, a device with Cs-131 seeds embedded in a bioresorbable collagen tile (GammaTile, GT Medical Technologies, Tempe, AZ USA) was developed. GammaTile (GT) is FDA-cleared for permanent implantation at the time of resection for all recurrent intracranial tumors and for newly diagnosed malignant intracranial neoplasms. To investigate if wider availability of this treatment could possibly lower the geographic barrier to access to care, we mapped the US population against existing RCs with brain tumor expertise and neurosurgery centers (NSCs) performing craniotomies. Methods: We analyzed 2018 CMS claims data using CPT codes for single- and multi-fraction SRS to identify RCs with brain tumor treatment expertise and mapped these against the population. Using similar methodology, using CPT codes for craniotomies, we identified NSCs, as any facility performing craniotomies is potentially eligible to implant GT. Results: 135 RCs used CPT codes for SRS. 193-, 119-, 82-, and 52-million Americans lived >30-, >60-, >90-, and >120-minutes from one of these centers, respectively. 530 NSCs preform craniotomies, including ≥1 in every state, a 4-fold increase over the number of RCs offering SRS. Conclusions: For many patients, substantial travel distances limit their access to RCs with brain tumor treatment expertise. In contrast, the 530 craniotomy-performing NSCs have far greater geographic dispersion. The option of undergoing brain radiation with GT implantation at the time of brain tumor craniotomy brings treatment closer to millions, ensures compliance, and reduces additional travel for follow-up radiation treatment.[Table: see text]

Radiation-induced heart disease: surveillance and management

ESC CardioMed ◽  
2018 ◽  
pp. 1153-1156
Author(s):  
Ersilia M. DeFilippis ◽  
Anju Nohria
Keyword(s):  
Heart Disease ◽  
Disease Surveillance ◽  
Cardiovascular Effects ◽  
Pericardial Disease ◽  
Long Term Follow Up ◽  
Radiation Induced ◽  
Artery Disease ◽  
Effects Of Radiation

Radiation-induced heart disease is a major cause of morbidity and mortality among cancer survivors. It encompasses many clinical entities, including pericardial disease, coronary artery disease, valvular disease, cardiomyopathy, conduction system abnormalities, autonomic dysfunction, and peripheral vascular disease. As the cardiovascular effects of radiation manifest many years after treatment, long-term follow-up with regular screening is essential. This chapter reviews the epidemiology and pathogenesis of radiation-induced heart disease as well as existing consensus recommendations regarding surveillance and management.

scholarly journals NTOX-02. DEVELOPMENT OF CYSTIC MALACIA AFTER HIGH DOSE CRANIAL IRRADIATION OF PEDIATRIC CNS EMBRYONAL TUMORS IN LONG-TERM FOLLOW-UP

2016 ◽  
Vol 18 (suppl_6) ◽  
pp. vi141-vi141
Author(s):  
Fumiyuki Yamasaki ◽  
Manish Kolakshyapati ◽  
Takeshi Takayasu ◽  
Ryo Nosaka ◽  
Kazuhiko Sugiyama ◽  
...  
Keyword(s):  
Cranial Irradiation ◽  
High Dose ◽  
Embryonal Tumors ◽  
Long Term Follow Up
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