PURPOSE: Literature dedicated to growth patterns and growth rate influencing factors of radiation-induced meningiomas (RIMs) is limited. To deliver new insights into the topic, a volumetric growth analysis of RIMs was performed. METHODS: This single-center, retrospective cohort study included patients diagnosed with intracranial meningioma who received radiation treatment at least > 5 years before the RIM diagnosis. Volumetric analysis of individual RIMs was performed using 3D volumetry at the time of RIM diagnosis and during follow-up. RIM growth was determined by calculating absolute (AGR), and relative (RGR) growth rates. Prognostic factors associated with RIM growth were evaluated. RESULTS: A total of 26 patients with 33 meningiomas were enrolled in the study and radiologically/clinically followed up during a median duration of 5.6 years (IQR 3.9-8.8 years). Median AGR was 0.19 cm3 per year and the median RGR was 34.5% per year. Surgically managed RIMs were more likely fast-growing compared to observed ones based on the AGR (p < 0.002). The recurrence rate after total resection was 14.3%. Younger age at RIM diagnosis was associated with higher tumor growth (RGR ≥ 30%, p = 0.040). A significant correlation was found between the length of latency period and the RGR (p = 0.005). CONCLUSION: To diagnose RIM as early as possible comprehensive MRI surveillance is required. Younger patients with shorter latency periods may profit from shortened MRI intervals, with further management being dependent on the growth rate and eventual symptomatology.

Department of Neurosurgery 2nd Faculty of Medicine Charles University and University Hospital Motol Prague Czech Republic

Department of Neurosurgery and Neurooncology 1st Faculty of Medicine Charles University and Military University Hospital Prague Czech Republic

Department of Oncology 2nd Faculty of Medicine Charles University and University Hospital Motol Prague Czech Republic

Department of Pathology and Molecular Medicine 2nd Faculty of Medicine Charles University and University Hospital Motol Prague Czech Republic

Department of Pediatric Haematology and Oncology 2nd Faculty of Medicine Charles University and University Hospital Motol Prague Czech Republic

Department of Radiology 2nd Faculty of Medicine Charles University and University Hospital Motol Prague Czech Republic

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Howlader N NA, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds) (2021) National Cancer Institute. Bethesda, MD. https://seer.cancer.gov/csr/1975_2018/ . based on November 2020 SEER data submission, posted to the SEER web site, April 2021. SEER Cancer Statistics Review, 1975–2018.

Zichová A, Eckschlager T, Ganevová M, Malinová B, Lukš A, Kruseová J (2020) Subsequent neoplasms in childhood cancer survivors. Cancer Epidemiol 68:101779. https://doi.org/10.1016/j.canep.2020.101779 DOI

Taylor AJ, Little MP, Winter DL, Sugden E, Ellison DW, Stiller CA, Stovall M, Frobisher C, Lancashire ER, Reulen RC, Hawkins MM (2010) Population-based risks of CNS tumors in survivors of childhood cancer: the British Childhood Cancer Survivor Study. J Clin Oncol 28:5287–5293. https://doi.org/10.1200/jco.2009.27.0090 DOI

Neglia JP, Robison LL, Stovall M, Liu Y, Packer RJ, Hammond S, Yasui Y, Kasper CE, Mertens AC, Donaldson SS, Meadows AT, Inskip PD (2006) New primary neoplasms of the central nervous system in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Natl Cancer Inst 98:1528–1537. https://doi.org/10.1093/jnci/djj411 DOI

Vinchon M, Leblond P, Caron S, Delestret I, Baroncini M, Coche B (2011) Radiation-induced tumors in children irradiated for brain tumor: a longitudinal study. Childs Nerv Syst 27:445–453. https://doi.org/10.1007/s00381-011-1390-4 DOI

Remes TM, Suo-Palosaari MH, Heikkilä VP, Sutela AK, Koskenkorva PKT, Toiviainen-Salo SM, Porra L, Arikoski PM, Lähteenmäki PM, Pokka TM, Arola MO, Riikonen VP, Sirkiä KH, Lönnqvist TRI, Rantala HMJ, Ojaniemi MK, Harila-Saari AH (2019) Radiation-induced meningiomas after childhood brain tumor: a magnetic resonance imaging screening study. J Adolesc Young Adult Oncol 8:593–601. https://doi.org/10.1089/jayao.2019.0010 DOI

Kok JL, Teepen JC, van Leeuwen FE, Tissing WJE, Neggers S, van der Pal HJ, Loonen JJ, Bresters D, Versluys B, van den Heuvel-Eibrink MM, van Dulmen-den Broeder E, van der Heiden-van der Loo M, Aleman BMP, Daniels LA, Haasbeek CJA, Hoeben B, Janssens GO, Maduro JH, Oldenburger F, van Rij C, Tersteeg R, Hauptmann M, Kremer LCM, Ronckers CM (2019) Risk of benign meningioma after childhood cancer in the DCOG-LATER cohort: contributions of radiation dose, exposed cranial volume, and age. Neuro Oncol 21:392–403. https://doi.org/10.1093/neuonc/noy124 DOI

Cahan WG, Woodard HQ, Higinbotham NL, Stewart FW, Coley BL (1998) Sarcoma arising in irradiated bone: report of eleven cases. 1948. Cancer 82:8–34. https://doi.org/10.1002/(sici)1097-0142(19980101)82:1%3c8::aid-cncr3%3e3.0.co;2-w DOI

Godlewski B, Drummond KJ, Kaye AH (2012) Radiation-induced meningiomas after high-dose cranial irradiation. J Clin Neurosci 19:1627–1635. https://doi.org/10.1016/j.jocn.2012.05.011 DOI

Shenoy SN, Munish KG, Raja A (2004) High dose radiation induced meningioma. Br J Neurosurg 18:617–621. https://doi.org/10.1080/02688690400022789 DOI

Harrison MJ, Wolfe DE, Lau TS, Mitnick RJ, Sachdev VP (1991) Radiation-induced meningiomas: experience at the Mount Sinai Hospital and review of the literature. J Neurosurg 75:564–574. https://doi.org/10.3171/jns.1991.75.4.0564 DOI

Yamanaka R, Hayano A, Kanayama T (2017) Radiation-induced meningiomas: an exhaustive review of the literature. World Neurosurg 97:635-644.e638. https://doi.org/10.1016/j.wneu.2016.09.094 DOI

Galloway TJ, Indelicato DJ, Amdur RJ, Swanson EL, Morris CG, Marcus RB (2011) Favorable outcomes of pediatric patients treated with radiotherapy to the central nervous system who develop radiation-induced meningiomas. Int J Radiat Oncol Biol Phys 79:117–120. https://doi.org/10.1016/j.ijrobp.2009.10.045 DOI

Gillespie CS, Islim AI, Taweel BA, Millward CP, Kumar S, Rathi N, Mehta S, Haylock BJ, Thorp N, Gilkes CE, Lawson DDA, Mills SJ, Chavredakis E, Farah JO, Brodbelt AR, Jenkinson MD (2021) The growth rate and clinical outcomes of radiation induced meningioma undergoing treatment or active monitoring. J Neurooncol 153:239–249. https://doi.org/10.1007/s11060-021-03761-3 DOI

Fedorov A, Beichel R, Kalpathy-Cramer J, Finet J, Fillion-Robin JC, Pujol S, Bauer C, Jennings D, Fennessy F, Sonka M, Buatti J, Aylward S, Miller JV, Pieper S, Kikinis R (2012) 3D Slicer as an image computing platform for the Quantitative Imaging Network. Magn Reson Imaging 30:1323–1341. https://doi.org/10.1016/j.mri.2012.05.001 DOI

Islim AI, Kolamunnage-Dona R, Mohan M, Moon RDC, Crofton A, Haylock BJ, Rathi N, Brodbelt AR, Mills SJ, Jenkinson MD (2020) A prognostic model to personalize monitoring regimes for patients with incidental asymptomatic meningiomas. Neuro Oncol 22:278–289. https://doi.org/10.1093/neuonc/noz160 DOI

Lee EJ, Park JH, Park ES, Kim JH (2017) “Wait-and-see” strategies for newly diagnosed intracranial meningiomas based on the risk of future observation failure. World Neurosurg 107:604–611. https://doi.org/10.1016/j.wneu.2017.08.060 DOI

Simpson D (1957) The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 20:22–39. https://doi.org/10.1136/jnnp.20.1.22 DOI

Hashiba T, Hashimoto N, Izumoto S, Suzuki T, Kagawa N, Maruno M, Kato A, Yoshimine T (2009) Serial volumetric assessment of the natural history and growth pattern of incidentally discovered meningiomas. J Neurosurg 110:675–684. https://doi.org/10.3171/2008.8.Jns08481 DOI

Hashimoto N, Rabo CS, Okita Y, Kinoshita M, Kagawa N, Fujimoto Y, Morii E, Kishima H, Maruno M, Kato A, Yoshimine T (2012) Slower growth of skull base meningiomas compared with non-skull base meningiomas based on volumetric and biological studies. J Neurosurg 116:574–580. https://doi.org/10.3171/2011.11.Jns11999 DOI

Nakasu S, Nakasu Y, Fukami T, Jito J, Nozaki K (2011) Growth curve analysis of asymptomatic and symptomatic meningiomas. J Neurooncol 102:303–310. https://doi.org/10.1007/s11060-010-0319-1 DOI

Oyem PC, de Andrade EJ, Soni P, Murayi R, Obiri-Yeboah D, Lopez D, Kshettry VR, Recinos PF (2022) Natural history and volumetric analysis of meningiomas in neurofibromatosis type 2. Neurosurg Focus 52:E5. https://doi.org/10.3171/2022.2.Focus21779 DOI

Withrow DR, Anderson H, Armstrong GT, Hawkins M, Journy N, Neglia JP, de Vathaire F, Tucker MA, Inskip PD, Brenner AV, Stovall MA, Diallo I, Berrington de Gonzalez A, Veiga LHS (2022) Pooled analysis of meningioma risk following treatment for childhood cancer. JAMA Oncol. https://doi.org/10.1001/jamaoncol.2022.4425 DOI

Banerjee J, Pääkkö E, Harila M, Herva R, Tuominen J, Koivula A, Lanning M, Harila-Saari A (2009) Radiation-induced meningiomas: a shadow in the success story of childhood leukemia. Neuro Oncol 11:543–549. https://doi.org/10.1215/15228517-2008-122 DOI

Journy NMY, Zrafi WS, Bolle S, Fresneau B, Alapetite C, Allodji RS, Berchery D, Haddy N, Kobayashi I, Labbé M, Pacquement H, Pluchart C, Schwartz B, Souchard V, Thomas-Teinturier C, Veres C, Vu-Bezin G, Diallo I, de Vathaire F (2021) Risk factors of subsequent central nervous system tumors after childhood and adolescent cancers: findings from the French childhood cancer survivor study. Cancer Epidemiol Biomarkers Prev 30:133–141. https://doi.org/10.1158/1055-9965.Epi-20-0735 DOI

Nakasu S, Fukami T, Nakajima M, Watanabe K, Ichikawa M, Matsuda M (2005) Growth pattern changes of meningiomas: long-term analysis. Neurosurgery 56:946–955 (discussion 946–955)