HG-77RADIATION-INDUCED HIGH GRADE GLIOMA FOLLOWING I-125 BRACHYTHERAPY IN A PEDIATRIC PATIENT

Abstract

HG-77. RADIATION-INDUCED HIGH GRADE GLIOMA FOLLOWING I-125 BRACHYTHERAPY IN A PEDIATRIC PATIENT Daniela Garcez, Eduardo Netto, and Duarte Salgado; Instituto Portugues de Oncologia de Lisboa Francisco Gentil E.P.E., Lisboa, Portugal INTRODUCTION: Brachytherapy has been used in brain tumors since 1960. Only a few studies have been published about late occurence of second malignancies due to brachytherapy for brain tumors. Therefore, this procedureappears to be an attractive alternative in multimodality cancer management in selected pediatric cases. CASE PRESENTATION: We report the case of a 33 years old female patient diagnosed with an anaplastic ependymoma grade III (right frontal lobe) when she was 8 years old. After a total resection she underwent craniospinal radiotherapy (36Gy) with a focal boost (54Gy). A local relapse was identified three years later and pathological diagnosis, after total resection, was ependymoblastoma. She received I-125 brachytherapy for 3 months followed by 8 cycles of CCNU, cisplatin and vincristine. She remained in total remission for almost 20 years. In 2015 she was admitted due to progressive apathy. An MRI scan showed a large contrast enhancing tumor (8x7cm) in the right frontal lobewith mass effect and midline shift. After subtotal resection the pathological diagnosis was anaplastic oligodendroglioma. CONCLUSION: Despite the obvious advantages that I-125 brachytherapy presents, the use in the pediatric population remains controversial.Radiation-induced tumors area serious issue andareusuallyagressiveand sometimes fatal. The enhanced risk of associating standard external beam radiotherapy with brachytherapy should be carefully considered in the pediatric population. Neuro-Oncology 18:iii48–iii77, 2016. doi:10.1093/neuonc/now073.73 #The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.