放射性诱发的脑膜瘤:253例病例的描述性研究

Radiation-induced meningioma: a descriptive study of 253 cases.

作者信息

Sadetzki Siegal, Flint-Richter Pazit, Ben-Tal Tehila, Nass Dvora

机构信息

Cancer Epidemiology Unit, Gertner Institute, Sheba Medical Center, Tel-Hashomer, Israel.

出版信息

J Neurosurg. 2002 Nov;97(5):1078-82. doi: 10.3171/jns.2002.97.5.1078.

Abstract

OBJECT

Ionizing radiation is the only established risk factor recognized today in the causation of meningioma. The aim of the present report is to describe the demographic and clinical characteristics of a large series of 253 patients with radiation-induced meningiomas (RIMs). These parameters were compared with those of 41 patients with meningiomas in whom there was no previous history of irradiation (non-RIM group) and with other series of patients presented in the literature.

METHODS

The cases of RIM were recruited from a cohort of approximately 11,000 individuals who had been treated with ionizing radiation during childhood for tinea capitis and from a group of individuals who, as adults, applied for compensation because of that treatment. The non-RIM group was identified through the Israeli Cancer Registry. Exposure to radiation was carefully validated among all cases of RIM and absence of previous irradiation was verified for all patients in the non-RIM group. Significantly, a lower patient age at diagnosis, higher prevalence of calvarial tumors, higher proportion of multiple meningiomas, and a nonsignificant higher recurrence rate were observed among patients with RIM compared with the non-RIM group. The mean latency period from date of radiation exposure to development of a meningioma among the RIM group was approximately 36 years.

CONCLUSIONS

The findings of this study agree with those of other studies indicating the demographic, clinical, and even genetic variability between RIM and non-RIM cases. The existence of two different subtypes of meningiomas may have profound implications for screening, early diagnosis, and therapy of meningiomas.

摘要

目的

电离辐射是目前已知的脑膜瘤发病唯一已确定的风险因素。本报告旨在描述253例辐射诱发脑膜瘤(RIM)患者的人口统计学和临床特征。将这些参数与41例无既往放疗史的脑膜瘤患者(非RIM组)以及文献中报道的其他系列患者的参数进行比较。

方法

RIM病例来自一组约11,000名儿童时期因头癣接受过电离辐射治疗的个体,以及一组成年后因该治疗申请赔偿的个体。非RIM组通过以色列癌症登记处确定。在所有RIM病例中仔细核实辐射暴露情况,并在非RIM组的所有患者中核实无既往放疗史。值得注意的是,与非RIM组相比,RIM患者诊断时年龄较低、颅骨肿瘤患病率较高、多发脑膜瘤比例较高,且复发率虽无显著差异但也较高。RIM组从辐射暴露日期到脑膜瘤发生的平均潜伏期约为36年。

结论

本研究结果与其他研究一致,表明RIM和非RIM病例在人口统计学、临床甚至遗传学方面存在差异。脑膜瘤两种不同亚型的存在可能对脑膜瘤的筛查、早期诊断和治疗具有深远意义。

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