Felicetti Francesco, Fortunati Nicoletta, Garbossa Diego, Biasin Eleonora, Rudà Roberta, Daniele Dino, Arvat Emanuela, Corrias Andrea, Fagioli Franca, Brignardello Enrico
Transition Unit for Childhood Cancer Survivors, Department of Oncology, AOU Città della Salute e della Scienza di Torino, Via Cherasco 15, 10126, Turin, Italy.
J Cancer Res Clin Oncol. 2015 Jul;141(7):1277-82. doi: 10.1007/s00432-015-1920-7. Epub 2015 Jan 22.
Childhood cancer survivors (CCS) treated with cranial radiation therapy (CRT) are at risk of developing meningiomas. The aim of this study was to evaluate the cumulative incidence of meningiomas in a cohort of CCS who previously underwent CRT.
We considered all CCS who received CRT and were followed up at the "Transition Unit for Childhood Cancer Survivors" in Turin. Even though asymptomatic, they had at least one brain computed tomography or magnetic resonance imaging performed at a minimum interval of 10 years after treatment for pediatric cancer.
We identified 90 patients (median follow-up 24.6 years). Fifteen patients developed meningioma (median time from pediatric cancer, 22.5 years). In four patients, it was suspected on the basis of neurological symptoms (i.e., headache or seizures), whereas all other cases, including five giant meningiomas, were discovered in otherwise asymptomatic patients. Multiple meningiomas were discovered in four CCS. Ten patients underwent surgical resection. An atypical meningioma (grade II WHO) was reported in four patients. One patient with multiple meningiomas died for a rapid growth of the intracranial lesions. A second neoplasm (SN) other than meningioma was diagnosed in five out of the 15 patients with meningioma and in ten out of the 75 CCS without meningioma. Cox multivariate analysis showed that the occurrence of meningioma was associated with the development of other SNs, whereas age, sex, or CRT dose had no influence.
CCS at risk of the development of meningioma deserve close clinical follow-up, especially those affected by other SNs.
接受颅部放射治疗（CRT）的儿童癌症幸存者（CCS）有发生脑膜瘤的风险。本研究的目的是评估一组既往接受过CRT的CCS中脑膜瘤的累积发病率。
我们纳入了所有接受CRT并在都灵“儿童癌症幸存者过渡病房”接受随访的CCS。尽管无症状，但他们在小儿癌症治疗后至少每10年进行一次脑部计算机断层扫描或磁共振成像检查。
我们确定了90例患者（中位随访时间24.6年）。15例患者发生了脑膜瘤（从小儿癌症起算的中位时间为22.5年）。4例患者是基于神经症状（即头痛或癫痫发作）怀疑患有脑膜瘤，而所有其他病例，包括5例巨大脑膜瘤，都是在无症状患者中发现的。4例CCS发现有多发性脑膜瘤。10例患者接受了手术切除。4例患者报告为非典型脑膜瘤（世界卫生组织II级）。1例有多发性脑膜瘤的患者因颅内病变快速生长而死亡。在15例患有脑膜瘤的患者中有5例以及在75例未患脑膜瘤的CCS中有10例被诊断出患有除脑膜瘤以外的第二种肿瘤（SN）。Cox多变量分析显示，脑膜瘤的发生与其他SN的发生相关，而年龄、性别或CRT剂量没有影响。
有发生脑膜瘤风险的CCS值得密切临床随访，尤其是那些受其他SN影响的患者。
