Incidental detection of late subsequent intracranial neoplasms with magnetic resonance imaging among adult survivors of childhood cancer

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• 作者：Noah D. Sabin (1)
  Aimee K. Santucci (2)
  Paul Klimo Jr. (5) (6)
  Melissa M. Hudson (3)
  Deokumar Srivastava (4)
  Nan Zhang (4)
  Larry E. Kun (1)
  Matthew J. Krasin (1)
  Ching-Hon Pui (3)
  Zoltan Patay (1)
  Wilburn E. Reddick (1)
  Robert J. Ogg (1)
  Claudia M. Hillenbrand (1)
  Leslie L. Robison (2)
  Kevin R. Krull (2)
  Gregory T. Armstrong (2)
  
• 关键词：Survivors of childhood cancer ; Cranial radiation therapy ; Subsequent intracranial neoplasms ; Meningiomas
• 刊名：Journal of Cancer Survivorship
• 出版年：2014
• 出版时间：September 2014
• 年：2014
• 卷：8
• 期：3
• 页码：329-335
• 全文大小：251 KB
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• 作者单位：Noah D. Sabin (1)
  Aimee K. Santucci (2)
  Paul Klimo Jr. (5) (6)
  Melissa M. Hudson (3)
  Deokumar Srivastava (4)
  Nan Zhang (4)
  Larry E. Kun (1)
  Matthew J. Krasin (1)
  Ching-Hon Pui (3)
  Zoltan Patay (1)
  Wilburn E. Reddick (1)
  Robert J. Ogg (1)
  Claudia M. Hillenbrand (1)
  Leslie L. Robison (2)
  Kevin R. Krull (2)
  Gregory T. Armstrong (2)
  
  1. Department of Radiological Sciences, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA
  2. Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA
  5. Semmes-Murphey Neurologic and Spine Institute, 6325 Humphreys Boulevard, Memphis, TN, 38120, USA
  6. Department of Neurosurgery, University of Tennessee Health Science Center, 847 Monroe Avenue, Memphis, TN, 38163, USA
  3. Department of Oncology, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA
  4. Department of Biostatistics, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA
  
• ISSN：1932-2267

文摘

Purpose Survivors of childhood cancer are at an increased risk of developing subsequent neoplasms. In long-term survivors of childhood malignancies treated with and without cranial radiation therapy (CRT), undergoing unenhanced magnetic resonance imaging (MRI) of the brain, we estimated detection of intracranial neoplasms. Methods To investigate neurocognitive outcomes, 219 survivors of childhood cancer underwent unenhanced screening MRI of the brain. Of the survivors, 164 had been treated for acute lymphoblastic leukemia (ALL) (125 received CRT) and 55 for Hodgkin lymphoma (HL) (none received CRT). MRI examinations were reviewed and systematically coded by a single neuroradiologist. Demographic and treatment characteristics were compared for survivors with and without subsequent neoplasms. Results Nineteen of the 219 survivors (8.7?%) had a total of 31 subsequent intracranial neoplasms identified by neuroimaging at a median time of 25 years (range 12-6?years) from diagnosis. All neoplasms occurred after CRT, except for a single vestibular schwannoma within the cervical radiation field in a HL survivor. The prevalence of subsequent neoplasms after CRT exposure was 14.4?% (18 of 125). By noncontrast MRI, intracranial neoplasms were most suggestive of meningiomas. Most patients presented with no specific, localizing neurological complaints. In addition to the schwannoma, six tumors were resected based on results of MRI screening, all of which were meningiomas on histologic review. Conclusion Unenhanced brain MRI of long-term survivors of childhood cancer detected a substantial number of intracranial neoplasms. Screening for early detection of intracranial neoplasms among aging survivors of childhood cancer who received CRT should be evaluated. Implications for Cancer Survivors The high prevalence of incidentally detected subsequent intracranial neoplasms after CRT in long-term survivors of childhood cancer and the minimal symptoms reported by those with intracranial tumors in our study indicate that brain MRI screening of long-term survivors who received CRT may be warranted. Prospective studies of such screening are needed.