Abstract
By conducting a systemic search of the PubMed database, we performed a comprehensive literature review to characterize secondary gliomas following radiotherapy treatment and to determine the most appropriate treatment strategy. Our analysis included 296 cases of radiation-induced gliomas. The primary lesion was characterized as a hematological malignancy in 104 cases (35.1%), pituitary adenoma in 35 (11.8%), craniopharyngioma in 19 (6.4%), medulloblastoma in 38 (12.8%), germ cell tumor in 13 (4.3%), low-grade glioma in 28 (9.4%), cancer/sarcoma in 12 (4.0%), scalp region disease in 15 (5.0%), meningioma/schwannoma in 13 (4.3%), metastatic brain tumor in 5 (1.6%), and other types (e.g., arteriovenous malformations and angiomas) in 14 (4.7%). The average age of onset for primary lesions was 16.0 ± 15.8years, and the average radiation dose delivered to the primary lesion was 37.6 ± 20.0Gy. Secondary gliomas could be divided into grade I (1), grade II (32), grade III (88), and grade IV (173) tumors. The median overall survival for all glioma cases was 11months (95% confidence interval [CI], 9-12), with a 2-year survival rate of 20.2%. On multivariate analysis, combined modality treatment and the latency period from the radiotherapy treatment to the glioma diagnosis were variables associated with the overall survival of patients with grade III/IV secondary gliomas. For patients treated with cranial radiotherapy, the risk of secondary glioma incidence warrants a longer follow-up period beyond the standard time frame typically designated for determining the risk of primary tumor relapse. Moreover, combination therapy is a potential treatment option for radiation-induced gliomas.
Published Version
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