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首页> 外文期刊>Journal of cancer survivorship: research and practice >Incidental detection of late subsequent intracranial neoplasms with magnetic resonance imaging among adult survivors of childhood cancer
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Incidental detection of late subsequent intracranial neoplasms with magnetic resonance imaging among adult survivors of childhood cancer

机译：成人磁共振成像在儿童癌症成年幸存者中偶然发现后来的颅内肿瘤

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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 12-46 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.
机译：目的：儿童期癌症的幸存者罹患后续肿瘤的风险增加。在接受和不接受颅脑放疗（CRT）的儿童恶性肿瘤的长期幸存者中，他们接受了大脑未增强的磁共振成像（MRI），我们估计了颅内肿瘤的检出率。方法：为调查神经认知结果，对219名儿童癌症幸存者进行了未增强的脑部MRI筛查。在幸存者中，有164名接受了急性淋巴细胞白血病（ALL）的治疗（125名接受了CRT），55名接受了霍奇金淋巴瘤（HL）的治疗（没有接受CRT）。一名神经放射科医生对MRI检查进行了审查并进行了系统编码。比较了有和没有后续肿瘤的幸存者的人口统计学和治疗特征。结果：219名幸存者中有19名（8.7％）在诊断后的中位时间为25年（范围12-46岁）内，通过神经影像学鉴定出总共31例随后的颅内肿瘤。除HL幸存者的子宫颈放射野内的单个前庭神经鞘瘤外，所有肿瘤均发生在CRT后。 CRT暴露后的后续肿瘤患病率为14.4％（125个病例中的18个）。通过非对比MRI，颅内肿瘤最提示脑膜瘤。大多数患者均未表现出特定的局部神经系统不适。除神经鞘瘤外，还根据MRI筛查结果切除了6个肿瘤，所有这些肿瘤在组织学检查中均为脑膜瘤。结论：儿童癌症长期幸存者的未经增强的脑部MRI检测到了大量颅内肿瘤。应评估筛查早期接受CRT的儿童癌症幸存者中颅内肿瘤的能力。对癌症幸存者的意义：在儿童癌症的长期幸存者中，CRT后偶然发现的随后颅内肿瘤的高患病率，以及本研究中颅内肿瘤患者报告的症状极少，表明接受CRT的长期幸存者的脑部MRI筛查可能有保证。需要对此类筛选进行前瞻性研究。

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