Cumulative incidence of radiation-induced cavernomas in long-term survivors of medulloblastoma

Sean M. Lew, Joseph N. Morgan, Estee Psaty, Daniel R. Lefton, Jeffrey C. Allen, Ira Richmond Abbott, III

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Object. The goal of this study was to determine the incidence of radiation-induced cavernomas in children treated for medulloblastoma. Methods. A retrospective chart and film review was performed for all patients treated for medulloblastoma at the Insitute for Neurology and Neurosurgery/Beth Israel Medical Center between August 1996 and the present. The clinical and radiographic histories of pediatric patients (ages 3-21 years at diagnosis) with a histologically confirmed diagnosis of medulloblastoma who received craniospinal radiation therapy were reviewed. Fifty-nine patients were identified, with a mean age at radiation treatment of 7.7 years and a mean follow-up time of 7.2 years. The dose to the craniospinal axis was 24 Gy (31 patients) or 36 Gy (28 patients). The radiation energy in the craniospinal axis was provided by photons in 55 patients and protons in four. All patients received a posterior fossa boost of 54 Gy (46 patients) or 72 Gy (13 patients). Twenty-six lesions developed in 18 patients (31%) during the observation period. The cumulative incidence of lesion development was 5.6, 14, and 43%, at 3, 5, and 10 years, respectively. The sites of occurrence were cerebral (20 cases) and cerebellar (six cases). There was no significant correlation between age at diagnosis, sex, craniospinal radiation dose or energy source, and lesion development. Only one patient required surgical intervention for a symptomatic hemorrhagic lesion in the frontal lobe. Histological analysis in this case was consistent with cavernoma. Conclusions. Cavernomas are common after cranial irradiation in children, and their incidence increases over time. Most of these lesions follow a benign course and do not require intervention.

Original languageEnglish (US)
Pages (from-to)103-107
Number of pages5
JournalJournal of Neurosurgery
Volume104 PEDIATRICS
Issue numberSUPPL. 2
StatePublished - Feb 2006
Externally publishedYes

Fingerprint

Medulloblastoma
Survivors
Radiation
Incidence
Cranial Irradiation
Neurosurgery
Frontal Lobe
Israel
Motion Pictures
Neurology
Photons
Protons
Radiotherapy
Observation
Pediatrics

Keywords

  • Cavernoma
  • Medulloblastoma
  • Pediatric neurosurgery
  • Radiation therapy

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Lew, S. M., Morgan, J. N., Psaty, E., Lefton, D. R., Allen, J. C., & Abbott, III, I. R. (2006). Cumulative incidence of radiation-induced cavernomas in long-term survivors of medulloblastoma. Journal of Neurosurgery, 104 PEDIATRICS(SUPPL. 2), 103-107.

Cumulative incidence of radiation-induced cavernomas in long-term survivors of medulloblastoma. / Lew, Sean M.; Morgan, Joseph N.; Psaty, Estee; Lefton, Daniel R.; Allen, Jeffrey C.; Abbott, III, Ira Richmond.

In: Journal of Neurosurgery, Vol. 104 PEDIATRICS, No. SUPPL. 2, 02.2006, p. 103-107.

Research output: Contribution to journalArticle

Lew, SM, Morgan, JN, Psaty, E, Lefton, DR, Allen, JC & Abbott, III, IR 2006, 'Cumulative incidence of radiation-induced cavernomas in long-term survivors of medulloblastoma', Journal of Neurosurgery, vol. 104 PEDIATRICS, no. SUPPL. 2, pp. 103-107.
Lew SM, Morgan JN, Psaty E, Lefton DR, Allen JC, Abbott, III IR. Cumulative incidence of radiation-induced cavernomas in long-term survivors of medulloblastoma. Journal of Neurosurgery. 2006 Feb;104 PEDIATRICS(SUPPL. 2):103-107.
Lew, Sean M. ; Morgan, Joseph N. ; Psaty, Estee ; Lefton, Daniel R. ; Allen, Jeffrey C. ; Abbott, III, Ira Richmond. / Cumulative incidence of radiation-induced cavernomas in long-term survivors of medulloblastoma. In: Journal of Neurosurgery. 2006 ; Vol. 104 PEDIATRICS, No. SUPPL. 2. pp. 103-107.
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