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Zweittumoren nach Bestrahlung und Chemotherapie

Auftreten von Kavernomen

Secondary tumors following radiation therapy and chemotherapy

Incidence of cavernous hemangiomas

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Zusammenfassung

Problem

Nach Schädelbestrahlung besteht das Risiko, sekundäre Tumoren des Zentralnervensystems (ZNS) zu entwickeln. Zunehmend werden auch Meningeome und Hypophysentumoren bestrahlt, wodurch das Risiko von Sekundärtumoren durch die Strahlentherapie bei Kindern und Erwachsenen kommuniziert werden muss.

Methodik

In Studien bei Kindern zeigt sich, dass die Bestrahlung eine 7‑ bis 10fache Zunahme nachfolgender ZNS-Tumoren mit einer kumulativen Inzidenz über 20 Jahre im Bereich von 1,03 bis 28,9 bewirkt. Die Latenzzeit für das Auftreten von Sekundärtumoren lag zwischen 5,5 und 30 Jahren, wobei sich Gliome in 5 bis 10 Jahren und Meningeome etwa 15 Jahre nach der Bestrahlung entwickelt haben. Die Latenzzeit für sekundäre ZNS-Tumoren bei Erwachsenen reichte von 5 bis 34 Jahren.

Schlussfolgerung

Nach Bestrahlung können in seltenen Fällen als Sekundärfolgen Tumoren auftreten, meist Meningeome und Gliome, aber auch Kavernome. Die Behandlung und Langzeitergebnisse von strahleninduzierten ZNS-Tumoren zeigten im Verlauf keine schlechteren Ergebnisse als primäre ZNS-Tumoren.

Abstract

Problem

There is a risk of developing secondary central nervous system (CNS) tumors after cranial radiation therapy. Meningiomas and pituitary tumors are also increasingly treated with radiation therapy, which means that the risk of secondary tumors from radiation in children and adults must be communicated.

Methods

Studies in children show that radiation causes a 7- to 10-fold increase in subsequent CNS tumors with a cumulative incidence over 20 years ranging from 1.03 to 28.9. The latency period for the occurrence of secondary tumors ranged from 5.5 to 30 years, with gliomas developing after 5–10 years and meningiomas around 15 years after irradiation. The latency period for secondary CNS tumors in adults ranged from 5 to 34 years.

Conclusion

After radiation treatment, tumors can rarely occur as secondary sequelae, mostly meningiomas and gliomas, but also cavernomas. The treatment and long-term results of radiation-induced CNS tumors showed no worse results than primary CNS tumors over the course of time.

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  1. Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Str., 66424, Homburg-Saar, Deutschland

    Wolfgang Reith & Umut Yilmaz

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  1. Wolfgang Reith
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Correspondence to Wolfgang Reith.

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W. Reith und U. Yilmaz geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Reith, W., Yilmaz, U. Zweittumoren nach Bestrahlung und Chemotherapie. Radiologie 63, 603–608 (2023). https://doi.org/10.1007/s00117-023-01170-3

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