RADIATION-INDUCED BRAIN-TUMORS - POTENTIAL LATE COMPLICATIONS OF RADIATION-THERAPY FOR BRAIN-TUMORS

The development of neoplasms subsequent to therapeutic cranial irradia tion is a rare but serious and potentially fatal complication. In this study, we retrospectively reviewed the clinical and pathological aspe cts of 11 patients who underwent cranial irradiation (range, 24-110 cG y) to treat their primary disease and thereafter developed secondary t umours within a span of 13 years. All rumours arose within the previou s radiation fields, and satisfied the widely used criteria for the def inition of radiation-induced neoplasms. There was no sex predominance (M: 5, F: 6) and the patients tended to be young at irradiation (1.3-4 2 years; median age: 22 years). The median latency period before the d etection of the secondary tumour was 14.5 years (range: 6.5-24 years). Meningiomas developed in 5 patients, sarcomas in 4, and malignant gli omas in 2. A pre-operative diagnosis of a secondary tumour was correct ly obtained in 10 patients based on the neuro-imaging as well as nucle ar medicine findings. All patients underwent a surgical removal of the secondary tumour, 3 underwent additional chemotherapy, and one receiv ed stereotactic secondary irradiation therapy. During a median of 2 ye ars of follow-up review after the diagnosis of a secondary tumour, 3 p atients died related to the secondary tumours (2 sarcomas, 1 glioblast oma), one died of a recurrent primary glioma, while the remaining 7 ha ve been alive for from 10 months to 12 years after being treated for t he secondary tumours (median: 3 years). Based on these data, the clini copathological characteristics and possible role of treatment for seco ndary tumours are briefly discussed.