The burden of radiation-induced central nervous system tumors: A single institution's experience

Radiation-induced tumors of the central and peripheral nervous systems are becoming a noticeable subset of tumors seen at referral institutions. This paper outlines a single institution's experience with 22 examples of secondary meningiomas, gliomas, and sarcomas that developed in adults. These tumors are being increasingly encountered by physicians, but the greatest burden is on the patients themselves, who not only experience the life-altering effects of the original tumor and the subsequent delayed cognitive effects of radiotherapy, but later develop a second intracranial neoplasm. We detail a particularly poignant example of a 34-year-old man who developed a high-grade sarcoma with rhabdomyosarcomatous and osteogenic elements. Local control was difficult over the next year, and he eventually developed cerebrospinal fluid dissemination and succumbed. Although radiation-induced neoplasm remain relatively infrequent numerically, each case reminds us of the need for new, less toxic, and more targeted therapies for brain neoplasms.