Risk of second brain tumor after conservative surgery and radiotherapy for pituitary adenoma: Update after an additional 10 years

G. Minniti, D. Traish, S. Ashley, A. Gonsalves, Michael Brada

Research output: Contribution to journalArticle

251 Citations (Scopus)

Abstract

We assessed the risk of second brain tumors in a cohort of patients with pituitary adenoma treated with conservative surgery and external beam radiotherapy. Four hundred and twenty-six patients (United Kingdom residents) with pituitary adenomas received radiotherapy at the Royal Marsden Hospital (RMH) between 1982 and 1994. They were followed up for 5749 person-years. The cumulative incidence of second intracranial tumors and systemic malignancy was compared with population incidence rates through the Thames Cancer Registry and the National Health Service Central Register (previously OPCS) to record death and the potential causes. Eleven patients developed a second brain tumor, including five meningiomas, four high grade astrocytomas, one meningeal sarcoma, and one primitive neuroectodermal tumor. The cumulative risk of second brain tumors was 2.0% [95% confidence interval (CI), 0.9-4.4%] at 10 yr and 2.4% (95% CI, 1.2-5.0%) at 20 yr, measured from the date of radiotherapy. The relative risk of second brain tumor compared with the incidence in the normal population was 10.5 (95% CI, 4.3-16.7). The relative risk was 7.0 for neuroepithelial and 24.3 for meningeal tumors. The relative risks were 24.2 (95% CI, 4.8-43.5), 2.9 (95% CI, 0-8.5), and 28.6 (95% CI, 0.6-56.6) during the intervals 5-9, 10-19, and more than 20 yr after radiotherapy (four cases occurred >20 yr after treatment). There was no evidence of excess risk of second systemic malignancy. An additional 10-yr update confirmed our previous report of an increased risk of second brain tumors in patients with pituitary adenoma treated with surgery and radiotherapy. The 2.4% risk at 20 yr remains low and should not preclude the use of radiotherapy as an effective treatment option. However, an increased risk of second brain tumors continues beyond 20 and 30 yr after treatment.

Original languageEnglish
Pages (from-to)800-804
Number of pages5
JournalJournal of Clinical Endocrinology and Metabolism
Volume90
Issue number2
DOIs
Publication statusPublished - Feb 2005

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Radiotherapy
Pituitary Neoplasms
Brain Neoplasms
Surgery
Tumors
Brain
Confidence Intervals
Incidence
Meningeal Neoplasms
Primitive Neuroectodermal Tumors
Neoplasms
Death Certificates
Second Primary Neoplasms
Astrocytoma
National Health Programs
Meningioma
Sarcoma
Population
Registries
Cause of Death

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Risk of second brain tumor after conservative surgery and radiotherapy for pituitary adenoma : Update after an additional 10 years. / Minniti, G.; Traish, D.; Ashley, S.; Gonsalves, A.; Brada, Michael.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 90, No. 2, 02.2005, p. 800-804.

Research output: Contribution to journalArticle

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