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Radiation-induced
gliomas: report of 10 cases and review of the literature
Salvati M, Frati A, Russo N, Caroli E, Polli FM, Minniti G, Delfini R
Department of
Neurosurgery-INM Neuromed, Pozzilli (Is), University of Rome La Sapienza, Via
Cardinal Agliardi 15, 00165 Rome, Italy
Background. Radiotherapy and more recently radiosurgery represent
important therapeutic methods for the treatment of tumors and arterovenous
malformations affecting the central nervous system, even though several
significant side-effects have been described (radionecrosis, tumors,
etc.).
Gliomas induced by radiation therapy are decidedly unusual, and the first
descriptions of this association only appeared in the 1960s.
Methods.
The pertinent literature was reviewed to yield 116 cases in which a glioma
developed after radiotherapy for cranial pathologies (included 10 personal cases
treated in our Institution).
One of our patients had undergone radiosurgery for a cavernous angioma.
Results.
Patients who developed a radiation-induced glioma were younger, as a group, than
those affected with so-called "spontaneous" gliomas.
The tumor originated in the previously irradiated area, after average doses of
32 Gy and an average latency period of 9.6 years in accordance with the findings
reported by the authors and in our experience as well.
Radiotherapy had most frequently been performed for acute lymphoblastic
leukemia.
Our Case 10 is the fourth case of intracranial tumor arising after radiosurgery
to be described in the literature.
Conclusions.
Though rare, gliomas may represent a late complication of radiation
treatment.
The behavior of the radiation-induced variety of glioma does not seem to differ
significantly from that of its "spontaneous" counterpart.
Late complications of the radiosurgery are probably underestimated because of
the relatively recent introduction of this technique.
On the contrary, these should be scrupulously evaluated when deciding whether to
employ this method for therapeutic purposes for relatively benign or congenital
lesions (which generally affect young patients with a long life expectancy).
PMID:
12865017 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12865017&dopt=Abstract |
