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Late Effects

Central Nervous System




After cranial radiation therapy (RT) there is a significantly increased risk that patients will develop intracranial meningiomas in the long term.

Banerjee et al at the University Hospital of Oulu, Finland reported on a group (60 patients consecutively treated) of long term survivors treated with cranial RT for leukemia as children between the ages of 1 and 8 years9:

  • Overall incidence of meningiomas in these patients was 22%.
  • No other types of brain tumors were seen in these survivors.
  • The following factors did NOT affect the risk of development of meningiomas:
    • Age at the time of RT
    • Gender
    • Chemotherapy (intensity/Rx regime)
    • Dose of RT

Risk of meningiomas was strongly linked with the length of follow up. 

  • Long latency period (mean, 25 years; range, 14-34 years)
  • Increasing incidence with time after therapy
  • 20 years after the treatment  the incidence was 47%


Meningiomas after cranial RT tend to be:

  • Multiple
  • Atypical
  • More likely to recur after surgery

The image below shows a radiation induced meningioma (M).  This is a large dural based abnormality which grew slowly in a patient who was given prophylactic cranial radiotherapy for childhood leukemia.

The treatment is surgical whenever possible.


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