Two pediatric patients with secondary glioblastoma following radiotherapy for acute lymphoblastic leukemia: a case report
Abstract Background Although radiation therapy (RT) has been established as a leading treatment for cancer patients, alongside surgery and chemotherapy, radiation itself is a well-known risk factor for carcinogenesis (Kamran et al., Cancer. 122(12):1809–21, 2016). A second malignant neoplasm may occ...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-06-01
|
| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-025-03858-3 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850138032183705600 |
|---|---|
| author | Nanae Chiba Noriyoshi Takahashi Hiroaki Ogawa Takaya Yamamoto Rei Umezawa Masayuki Kanamori Hidenori Endo Keiichi Jingu |
| author_facet | Nanae Chiba Noriyoshi Takahashi Hiroaki Ogawa Takaya Yamamoto Rei Umezawa Masayuki Kanamori Hidenori Endo Keiichi Jingu |
| author_sort | Nanae Chiba |
| collection | DOAJ |
| description | Abstract Background Although radiation therapy (RT) has been established as a leading treatment for cancer patients, alongside surgery and chemotherapy, radiation itself is a well-known risk factor for carcinogenesis (Kamran et al., Cancer. 122(12):1809–21, 2016). A second malignant neoplasm may occur even with a small radiation dose (Diallo et al., Int J Radiat Oncol, 74(3):876–83, 2009). Relling et al. estimated that the cumulative risk of the development of malignant brain tumors following prophylactic cranial RT for acute lymphoblastic leukemia (ALL) patients is around 0.5%-1.5% at 15 years (Walter et al., J Clin Oncol Off J Am Soc Clin Oncol, 16(12):3761–7, 1998). The most frequent tumor types of radiation-induced malignant brain tumors are meningioma, glioblastoma (GBM), and sarcoma (Onishi et al., 2024). GBM––the most aggressive type of glioma––is classified as a high-grade glioma as per the WHO classification of tumors (Holland, Proc Natl Acad Sci U S A 97(12):6242–4, 2000; Louis et al., Neuro-Oncol 23(8):1231–51, 2021). GBM still draws attention due to its poor prognosis. The median overall survival (OS) of adult patients with GBM is approximately 12 months, and less than 5% of the patients might survive more than 5 years (Hertler et al., Eur J Cancer 189:112,913, 2023). Whereas the definitive treatment for GBM patients is surgery, adjuvant RT, and chemotherapy, the appropriate re-irradiation dose for patients with radiation-induced GBM (RIGBM) is still controversial since a more critical decision on the radiation dose needs to be made considering that the incidence of brain necrosis increases as the radiation dose increases (Lawrence et al., Int J Radiat Oncol 76(3):S20–7, 2010). Case presentation Two patients at the age of 15 years were found to have RIGBM. The stable health duration until they developed RIGBM was 9–11 years after the first RT for ALL. Total resection was performed in Case 1 and a biopsy was first performed in Case 2 and then total resection was performed. Concurrent chemotherapy and external beam RT (50 Gy in 25 fractions for 5 weeks, 2 Gy in a dose per fraction) were performed in both patients. One patient (Case 1) survived without recurrence for more than 104 months after the initiation of radiation, whereas other patient died due to progression. Conclusion To our knowledge, this is the first case report on long-term survival of a young patient with RIGBM. This case report sheds light on long-term survivors among pediatric RIGBM and the optimal radiation dose in the settings of re-irradiation. |
| format | Article |
| id | doaj-art-e46d833d88a047009a87e38b23adf18c |
| institution | OA Journals |
| issn | 1477-7819 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj-art-e46d833d88a047009a87e38b23adf18c2025-08-20T02:30:41ZengBMCWorld Journal of Surgical Oncology1477-78192025-06-0123111010.1186/s12957-025-03858-3Two pediatric patients with secondary glioblastoma following radiotherapy for acute lymphoblastic leukemia: a case reportNanae Chiba0Noriyoshi Takahashi1Hiroaki Ogawa2Takaya Yamamoto3Rei Umezawa4Masayuki Kanamori5Hidenori Endo6Keiichi Jingu7Department of Radiation Oncology, Tohoku University HospitalDepartment of Radiation Oncology, Tohoku University HospitalDepartment of Radiation Oncology, Miyagi Cancer CenterDepartment of Radiation Oncology, Tohoku University Graduate School of MedicineDepartment of Radiation Oncology, Tohoku University Graduate School of MedicineDepartment of Neurosurgery, Tohoku University Graduate School of MedicineDepartment of Neurosurgery, Tohoku University Graduate School of MedicineDepartment of Radiation Oncology, Tohoku University Graduate School of MedicineAbstract Background Although radiation therapy (RT) has been established as a leading treatment for cancer patients, alongside surgery and chemotherapy, radiation itself is a well-known risk factor for carcinogenesis (Kamran et al., Cancer. 122(12):1809–21, 2016). A second malignant neoplasm may occur even with a small radiation dose (Diallo et al., Int J Radiat Oncol, 74(3):876–83, 2009). Relling et al. estimated that the cumulative risk of the development of malignant brain tumors following prophylactic cranial RT for acute lymphoblastic leukemia (ALL) patients is around 0.5%-1.5% at 15 years (Walter et al., J Clin Oncol Off J Am Soc Clin Oncol, 16(12):3761–7, 1998). The most frequent tumor types of radiation-induced malignant brain tumors are meningioma, glioblastoma (GBM), and sarcoma (Onishi et al., 2024). GBM––the most aggressive type of glioma––is classified as a high-grade glioma as per the WHO classification of tumors (Holland, Proc Natl Acad Sci U S A 97(12):6242–4, 2000; Louis et al., Neuro-Oncol 23(8):1231–51, 2021). GBM still draws attention due to its poor prognosis. The median overall survival (OS) of adult patients with GBM is approximately 12 months, and less than 5% of the patients might survive more than 5 years (Hertler et al., Eur J Cancer 189:112,913, 2023). Whereas the definitive treatment for GBM patients is surgery, adjuvant RT, and chemotherapy, the appropriate re-irradiation dose for patients with radiation-induced GBM (RIGBM) is still controversial since a more critical decision on the radiation dose needs to be made considering that the incidence of brain necrosis increases as the radiation dose increases (Lawrence et al., Int J Radiat Oncol 76(3):S20–7, 2010). Case presentation Two patients at the age of 15 years were found to have RIGBM. The stable health duration until they developed RIGBM was 9–11 years after the first RT for ALL. Total resection was performed in Case 1 and a biopsy was first performed in Case 2 and then total resection was performed. Concurrent chemotherapy and external beam RT (50 Gy in 25 fractions for 5 weeks, 2 Gy in a dose per fraction) were performed in both patients. One patient (Case 1) survived without recurrence for more than 104 months after the initiation of radiation, whereas other patient died due to progression. Conclusion To our knowledge, this is the first case report on long-term survival of a young patient with RIGBM. This case report sheds light on long-term survivors among pediatric RIGBM and the optimal radiation dose in the settings of re-irradiation.https://doi.org/10.1186/s12957-025-03858-3Secondary malignant neoplasmRadiation-induced glioblastomaPediatric patientsAcute lymphoblastic leukemiaRe-irradiation |
| spellingShingle | Nanae Chiba Noriyoshi Takahashi Hiroaki Ogawa Takaya Yamamoto Rei Umezawa Masayuki Kanamori Hidenori Endo Keiichi Jingu Two pediatric patients with secondary glioblastoma following radiotherapy for acute lymphoblastic leukemia: a case report World Journal of Surgical Oncology Secondary malignant neoplasm Radiation-induced glioblastoma Pediatric patients Acute lymphoblastic leukemia Re-irradiation |
| title | Two pediatric patients with secondary glioblastoma following radiotherapy for acute lymphoblastic leukemia: a case report |
| title_full | Two pediatric patients with secondary glioblastoma following radiotherapy for acute lymphoblastic leukemia: a case report |
| title_fullStr | Two pediatric patients with secondary glioblastoma following radiotherapy for acute lymphoblastic leukemia: a case report |
| title_full_unstemmed | Two pediatric patients with secondary glioblastoma following radiotherapy for acute lymphoblastic leukemia: a case report |
| title_short | Two pediatric patients with secondary glioblastoma following radiotherapy for acute lymphoblastic leukemia: a case report |
| title_sort | two pediatric patients with secondary glioblastoma following radiotherapy for acute lymphoblastic leukemia a case report |
| topic | Secondary malignant neoplasm Radiation-induced glioblastoma Pediatric patients Acute lymphoblastic leukemia Re-irradiation |
| url | https://doi.org/10.1186/s12957-025-03858-3 |
| work_keys_str_mv | AT nanaechiba twopediatricpatientswithsecondaryglioblastomafollowingradiotherapyforacutelymphoblasticleukemiaacasereport AT noriyoshitakahashi twopediatricpatientswithsecondaryglioblastomafollowingradiotherapyforacutelymphoblasticleukemiaacasereport AT hiroakiogawa twopediatricpatientswithsecondaryglioblastomafollowingradiotherapyforacutelymphoblasticleukemiaacasereport AT takayayamamoto twopediatricpatientswithsecondaryglioblastomafollowingradiotherapyforacutelymphoblasticleukemiaacasereport AT reiumezawa twopediatricpatientswithsecondaryglioblastomafollowingradiotherapyforacutelymphoblasticleukemiaacasereport AT masayukikanamori twopediatricpatientswithsecondaryglioblastomafollowingradiotherapyforacutelymphoblasticleukemiaacasereport AT hidenoriendo twopediatricpatientswithsecondaryglioblastomafollowingradiotherapyforacutelymphoblasticleukemiaacasereport AT keiichijingu twopediatricpatientswithsecondaryglioblastomafollowingradiotherapyforacutelymphoblasticleukemiaacasereport |