Radiotherapy is important in the treatment of neoplasm of the central nervous system, but various side effects, particularly neoplastic, have been described. Recently, post-radiation gliomas have been reported.
Methods
The authors review 88 cases of cerebral glioma following radiotherapy in patients operated for neoplasms of the nervous system, including 6 personal cases of post-radiation gliomas treated in the Neurosurgical Division of the Department of Neurological Sciences, “La Sapienza” University, Rome. The criteria used to define this unusual pathologic association are discussed.
Results
There was a male predominance. Post-radiation gliomas were particularly malignant, the average dose was 33 Gy, and average free latency was 9.6 years. The first disease was most frequently acute lymphatic leukemia.
Conclusions
Post-radiation gliomas have particular features but do not present a histologic or clinical behavior different from analogous spontaneous gliomas. The fact that 88 cases have been reported in recent years suggests that a thorough biological, clinical studies be carried out on this association.
AlbertR.E., OmranA.R., BrauerE.W., FreedR.: Follow-up study of patients treated by X-ray for tinea capitis.Am. J. Public Health, 56: 2114–2120, 1966.
2.
AlboV., MillerD., LeikenS., SatherH., HammondD.: Nine brain tumours (BT) as a late effect in children “cured” of acute lymphoblastic leukemia (ALL) from a single protocol study (Abstr.) Proc.Am. Soc. Clin. Oncol, 4: 172, 1935.
3.
AndersonJ.R., TreipC.S.: Radiation induced intracranial neoplasms: A report of three possible cases.Cancer, 53: 426–429, 1984.
4.
BachmanD.S., OstrowP.T.: Fatal long-term sequela following radiation “cure” for ependymoma.Ann. Neurol., 4: 319–321, 1978.
5.
BarnesA.R.E., LiwniczB.H., SchellhasH.E., AltshullerG., AronB.S., LippertW.R.: Successful treatment of placental choriocarcinoma metastatic to brain followed by primary brain glioblastoma.Gynecol. Oncol., 13: 108–114, 1982.
BeuteB.J., FobbenE.S., HubschmannO., ZablowA., EanelliT., SolitareG.: Cerebellar gliosarcoma: report of a probable radiation-induced neoplasm.A.J.N.R., 12: 554–556, 1991.
8.
ChungC.K., StrykerJ.A., CruseR., VanucciR., TowfighiJ.: Glioblastoma multiforme following prophylactic cranial irradiation and intrathecal methotrexate in a child with acute lymphoblastic leukemia.Cancer, 47: 2563–2566, 1980.
9.
CliftonM.D., AmrominG.D., PerryM.C., AbadirR., WattsC., LevyN.: Spinal cord glioma following irradiation for Hodgkin's disease.Cancer, 45: 2051–2055, 1980.
10.
CohenM.S., KushnerM.J., DellS.: Frontal lobe astrocytoma following radiotherapy for medulloblastoma.Neurology, 31: 616–619, 1981.
11.
DierssenG., AlvarezG., FigolsJ.: Anaplastic astrocytoma associated with previous radiotherapy: report of three cases.Neurosurgery, 6: 1095–1097, 1988.
12.
FontanaM., StantonC., PompiliA., AmadoriS., MandelliF., MeloniG., RiccioA., RubinsteinL.J.: Late multifocal gliomas in adolescents previously treated for acute lymphoblastic leukemia.Cancer, 60: 1510–1518, 1987.
13.
GuthjahrP., DietenchE.: Risiko zweiter maligner neoplasien nach erfolgreicher Tumorbehandlung in Kindersalter.Deutch. Med. Wochenshr., 104: 969–972, 1979.
14.
HaselowR.E., NesbitM., DehnerL.P., KnanF.M., McHughR., LevittS.H.: Second neoplasm following megavoltage radiation in a pediatric population.Cancer, 42: 1185–1191, 1978.
15.
HufnagelT.J., KimJ.H., LesserR., MillerJ.M., AbrahamsJ. J., PiepmeierJ., ManuelidisE.E.: Malignat glioma of the optic chiasm eight year after radiotherapy for prolactinoma.Arch. Ophthalmol., 106: 1701–1705, 1988.
16.
JonesA.: Supervoltage X-ray therapy after of intracranial tumours.Ann. R. Soc. Surg. Engl., 27: 310–354, 1960.
17.
JudgeM.R., EdenO.B., O'NeillP.: Cerebral glioma after cranial prophylaxis for acute lymhoblastic leukemia.Br. Med. J. Clin. Res., 289: 1038–1039, 1984.
18.
KitanakaC., ShitaraN., NakagomiT., NakamuraH., GenkaS., NakagawaK., AkanumaA., AoyamaH., TakakuraK.: Postradiation astrocytoma, Report of two cases.J. Neurosurg., 70: 469–474, 1989.
19.
KlerigaE., SherJ.H., NallainathanS.K., SteinS.C., SacherM.: Development of cerebellar malignant astrocytoma at site of a medulloblastoma treated 11 yearsa earlier.J. Neurosurg., 49: 445–449, 1978.
20.
KomakiS., KomakiR., CholH., Correa-PazF.: Radiation- and drug-induced intracranial neoplasm with angiographic demonstration.Neurol. Med. Chir., (Tokyo)17: 55–62, 1977.
21.
LiwniczB.H., BergerT.S., LiwniczR.G.B.: Radiation associated gliomas. A report of four cases and analysis of postradiation tumors of the central nervous system.Neurosurgery, 17: 436–445, 1985.
22.
Maat-SchiemanM.L.C., BotsG.T.A.M., ThomeerR.T.W.M.: Malignant astrocytoma following radiotherapy for craniopharyngioma.Br. J. Radiol., 58: 480–482, 1985.
23.
MaloneM., LumleyH., ErdohaziM.: Astrocytoma as a second malignancy in patients with acute lymphoblastic leukemia.Cancer, 57: 1979–1985, 1986.
24.
MannL., YatesP.C., AinslieJ.P.: Unusual case of double primary orbital tumour.Br. J., Ophthalmol., 37: 758–762, 1953.
25.
MarusG., LevinV., RutherfordG.S.: Malignai glioma following radiotherapy for unrelated primary tumors.Cancer, 58: 886–894, 1986.
26.
McWhirterW.R., PearnJ.H., SmithH., O'Regan: Cerebral astrocytoma as a complication of acute lymphoblastic leukaemia. Med., J.Aust., 45: 96–97, 1986.
27.
MeadowsA.T., BaumE., Fossati-BellaniF.: Second malignat neoplasm in children: un update from the late effects study group.J. Clin. Oncol., 3: 532–538, 1985.
28.
ModanB., Baidatz MartH., StewitzR., LevinS.G.: Radiation induced head and neck tumors.Lancet, 1: 277–279, 1974.
PalmaL., VagnozziR., AnninoL., CiappettaP., MaleciA., CantoreG.P.: Post-radiation glioma in a child. Case report and review of the literature.Child's Nervous System, 4: 296–301, 1988.
31.
PearlG.S., MirraS.S., MilesM.L.: Glioblastoma multiforme occurring 13 years after treatment of a medulloblastoma.Neurosurgery, 6: 546–551, 1980.
32.
PlattJ.H., BlueJ.M., ScholdS.C., BurgerP.C.: Glioblastoma multiforme after radiotherapy for acromegaly.Neurosurgery, 13: 85–89, 1983.
33.
PreissigS.H., BohmfalkG.L., ReichelG.W., SmithM.T.: Anaplastic astrocytoma following radiation for a glomus jugulare tumor.Cancer, 43: 2243–2247, 1979.
34.
Raffel C., Edwards M.S.B., Davis R.L., Ablin A.R., Postirradiation cerebellar glioma: Case report.J. Neurosurg., 63: 300–303, 1985.
35.
RappaportZ.H., LorenD., Ben-AhronA.: Radiation-induced cerebellar glioblastoma multiforme subsequent to treatment of an atrocytoma of the cervical spinal cord.Neurosurgery, 4: 606–608, 1991.
36.
RimmI.L., LiF.C., TarbellN.J., WinstonK.R., SallanS.E.: Brain tumors after cranial irradiation for childhood acute lymphoblastic leukemia: A 13-year experience from Dana-Farber Cancer Institute and The Children's Hospital.Cancer, 59: 1506–1508, 1987.
37.
RobinsonR.G.: A second brain tumour and iradiation. J. Neurol, Neurosurg.Psychiatry, 41: 1005–1912, 1978.
38.
RussellD., RubinsteinL.J.: Pathology of tumours of the nervous system.5th edition, pp. 21–23, 454-455, 505-506, 537, 888-889. Edward Arnold, London, 1984.
39.
SaengerE.L., SilvermanF.N., SterlingT., TurnerM.E.Neoplasia following therapeutic irradiation for benign conditions in childhood.Radiology, 74: 889–904, 1960.
40.
SalvatiM., ArticoM., CarusoR., RocchiG., Ramundo OralandoE., NucciF.: A report on radiation-induced gliomas.Cancer, 67: 392–397, 1991.
41.
SalvatiM., CiappettaP., RacoA., CaponeR., ArticoM., SantoroA.: Radiation-induced schwannomas of the neuraxis. Report of three cases.Tumori, 78: 143–146, 1992.
42.
SandersJ., SaleG.E., RambergR., CliftR., BucknerC.D., ThomasE.D.: Glioblastoma multiforme in a patient with acute lymphoblastic leukemia who recived a marrow transplant.Transplant Proc., 14: 770–774, 1982.
43.
SchmidbauerM., BudkaH., BrucknerR., VorkapicP.: Glioblastoma developing at the site of a cerebellar medulloblastoma treated 6 years earlier.J. Neurosurg., 67: 915–918, 1987.
44.
ShapiroS., McalyJ.J.: Late anaplastic glioma in children previously treated for acute lymphoblastic leukemia.Pediatr. Neurosci., 15: 176–189, 1989.
ShoreR.E., AlbertR.E., PasternackB.S.: Follow-up study of patients treated by X-ray epilation for tinea capitis.Arch. Environ. Health., 31: 21–28, 1976.
47.
SneadO.C., AckerJ.D., MorawetzR.W., BentonJ.W.: High resolution computerized tomography with coronal and sagittal reconstruction in the diagnosis of brain tumors in children.Child's Brain, 9: 1–9, 1982.
48.
SofferD., GomoriJ.M., PomeranzS., SiegalT.: Gliomas following low-dose irradiation to the head: report of three cases.J. Neuro-Oncol., 8: 67–72, 1998.
49.
SoggR.L., DonaldsonS.S., YorkeCh.: Malignant astrocytoma following radiotherapy of a craniopharyngioma.J., Neurosurg., 48: 622–627, 1978.
50.
StenbokP.: Spinal cord glioma after multiple fluoroscopies during artificial pneumothorax treatment of pulmonary tubercolosis.J. Neurosurg., 52: 838–841, 1980.
51.
UshioY., AntaN., YoshimineT., NagatamiM., MogamiH.: Glioblastoma after radiotherapy for craniopharyngioma: case report.Neurosurgery, 21: 33–38, 1987.
52.
WaltersT.R.: Childhood acute lymphocytic leukemia with a second neoplasm.Am. J. Pediatr. Hematol. Oncol., 1: 285–287, 1979.
53.
ZampieriP., ZoratP.L., MingrinoS., SoattinG.B.: Radiation-associated cerebral gliomas. Report of two cases and review of the literature.J. Neurosurg. Sci., 3: 271–279, 1989.
54.
ZochodneD.W., CairncrossJ.G., ArceF.P., MacDonaldJ.C.F., BlumeW.T., GiruinJ.P., KaufmannJ.C.E.: Astrocytoma following scalp radiotherapy in infancy.Can. J. Neurol, Sci., 11: 475–478, 1984
55.
ZuccarelloM., SawayaR., deCourten-MyersG.: Glioblastoma after radiation-therapy for meningioma: Case report and review of the literature.Neurosurgery, 19: 114–119, 1986.
56.
ZulchK.J.: Brain tumors: Their biology and pathology. pp. 148–149, 3rd edn., Springer-Verlag, Berlin, 1986.
