Survivors of childhood cancer exposed to cranial radiotherapy are at risk of developing meningiomas later in life, leading to neurologic sequelae and mortality, according to a study published in the Journal of Clinical Oncology.1
The relationship between pediatric exposure to cranial radiotherapy and the subsequent development of meningiomas and related morbidities is not well-understood, making screening guidelines difficult to develop. For this study, researchers reviewed data from 4221 patients included in the Childhood Cancer Survivor Study (CCSS) to determine mortality rates and morbidities associated with the development of meningiomas.
The median age at analysis was 32 years; 169 survivors reported 199 meningiomas among them. Risk factors for subsequent meningiomas included being of a younger age at primary diagnosis, higher exposure to radiation, and being female. Every 5 Gy increased cranial radiotherapy dose carried an increased hazard ratio of 1.12.
Most patients with subsequent meningiomas had benign cases (97%); the 5-year survival rate was 91%. There were, however, high rates of neurologic sequelae among survivors diagnosed with subsequent meningioma, including “seizures, auditory-vestibular-visual deficits, focal neurologic dysfunction, and severe headaches.”
One-fifth of patients had at least 1 new neurologic sequela 6 months before or after meningioma diagnosis.
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According to this study’s authors, subsequent meningiomas among pediatric cancer survivors lead to increased mortality and a high rate of neurologic sequelae. Effective screening in this population may improve morbidities and mortality.
- Bowers DC, Moskowitz CS, Chou JF, et al. Morbidity and mortality associated with meningioma after cranial radiotherapy: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2017 Mar 24. doi: 10.1200/JCO.2016.70.1896 [Epub ahead of print]