Journal of Clinical Oncology  
Search for:
Limit by:
  Browse by Subject or Issue
Home Search or Browse JCO My JCO Subscriptions Customer Service Site Map

Originally published as JCO Early Release 10.1200/JCO.2009.27.0090 on November 15 2010

Journal of Clinical Oncology, Vol 28, No 36 (December 20), 2010: pp. 5287-5293
© 2010 American Society of Clinical Oncology.

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Save to my personal folders
Right arrow Download to citation manager
Right arrowRights & Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Taylor, A. J.
Right arrow Articles by Hawkins, M. M.
Right arrow Search for Related Content
Right arrow PubMed Citation
Right arrow Articles by Taylor, A. J.
Right arrow Articles by Hawkins, M. M.
Social Bookmarking
 Add to CiteULike   Add to Complore   Add to Connotea   Add to Delicious   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Pediatric Oncology

Population-Based Risks of CNS Tumors in Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study

Aliki J. Taylor, Mark P. Little, David L. Winter, Elaine Sugden, David W. Ellison, Charles A. Stiller, Marilyn Stovall, Clare Frobisher, Emma R. Lancashire, Raoul C. Reulen, Michael M. Hawkins

From the University of Birmingham, Edgbaston, Birmingham; Imperial College, Faculty of Medicine, Norfolk Place, London; Churchill Hospital; University of Oxford, Oxford, United Kingdom; St Jude Children's Research Hospital, Memphis, TN; and University of Texas M. D. Anderson Cancer Center, Houston, TX.

Corresponding author: Michael M. Hawkins, DPhil, Centre for Childhood Cancer Survivor Studies, School of Health and Population Sciences, University of Birmingham, Public Health Building, Edgbaston, Birmingham, B15 2TT, United Kingdom; e-mail: M.M.Hawkins{at}

Purpose CNS tumors are the most common second primary neoplasm (SPN) observed after childhood cancer in Britain, but the relationship of risk to doses of previous radiotherapy and chemotherapy is uncertain.

Methods The British Childhood Cancer Survivor Study is a national, population-based, cohort study of 17,980 individuals surviving at least 5 years after diagnosis of childhood cancer. Linkage to national, population-based cancer registries identified 247 SPNs of the CNS. Cohort and nested case-control studies were undertaken.

Results There were 137 meningiomas, 73 gliomas, and 37 other CNS neoplasms included in the analysis. The risk of meningioma increased strongly, linearly, and independently with each of dose of radiation to meningeal tissue and dose of intrathecal methotrexate. Those whose meningeal tissue received 0.01 to 9.99, 10.00 to 19.99, 20.00 to 29.99, 30.00 to 39.99 and ≥ 40 Gy had risks that were two-fold, eight-fold, 52-fold, 568-fold, and 479-fold, respectively, the risks experienced by those whose meningeal tissue was unexposed. The risk of meningioma among individuals receiving 1 to 39,40 to 69, and at least 70 mg/m2 of intrathecal methotrexate was 15-fold, 11-fold, and 36-fold, respectively, the risk experienced by those unexposed. The standardized incidence ratio for gliomas was 10.8 (95% CI, 8.5 to 13.6). The risk of glioma/primitive neuroectodermal tumors increased linearly with dose of radiation, and those who had CNS tissue exposed to at least 40 Gy experienced a risk four-fold that experienced by those who had CNS tissue unexposed.

Conclusion The largest-ever study, to our knowledge, of CNS tumors in survivors of childhood cancer indicates that the risk of meningioma increases rapidly with increased dose of radiation to meningeal tissue and with increased dose of intrathecal methotrexate.

Written on behalf of the British Childhood Cancer Survivor Study Group.

Supported in part by Cancer Research UK; the Kay Kendall Leukaemia Fund; the Department of Health and Scottish Ministers; and Contract No. FP6-036465 from the European Commission (M.P.L.).

Funding sources have had no involvement in the study design, the collection, analysis, or interpretation of data; the writing of the report; or the decision to submit the paper for publication. The views expressed in this publication are those of the authors and not necessarily those of our funders.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Delicious Delicious   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?

This article has been cited by other articles:

Home page
Neuro OncolHome page
K. Tsui, A. Gajjar, C. Li, D. Srivastava, A. Broniscer, C. Wetmore, L. E. Kun, T. E. Merchant, D. W. Ellison, B. A. Orr, et al.
Subsequent neoplasms in survivors of childhood central nervous system tumors: risk after modern multimodal therapy
Neuro Oncology, March 1, 2015; 17(3): 448 - 456.
[Abstract] [Full Text] [PDF]

Home page
Neuro OncolHome page
Q. T. Ostrom, L. Bauchet, F. G. Davis, I. Deltour, J. L. Fisher, C. E. Langer, M. Pekmezci, J. A. Schwartzbaum, M. C. Turner, K. M. Walsh, et al.
The epidemiology of glioma in adults: a "state of the science" review
Neuro Oncology, July 1, 2014; 16(7): 896 - 913.
[Abstract] [Full Text] [PDF]

Home page
JRSM OpenHome page
E. Sugden, A. Taylor, P. Pretorius, C. Kennedy, and R. Bhangoo
Meningiomas occurring during long-term survival after treatment for childhood cancer
JRSM Open, April 1, 2014; 5(4): 2054270414524567 - 2054270414524567.
[Abstract] [Full Text] [PDF]

Home page
Ann Clin Lab SciHome page
M. D. Johnson, K. Piech, and S. Emandian
Radiation-Associated Meningioma in The Elderly: Development of Meningioma with Olfactory Neuroblastoma Recurrence 10 Years after Irradiation
Ann. Clin. Lab. Sci., September 1, 2013; 43(4): 460 - 463.
[Abstract] [Full Text] [PDF]

Home page
Neuro OncolHome page
M. Z. Braganza, C. M. Kitahara, A. Berrington de Gonzalez, P. D. Inskip, K. J. Johnson, and P. Rajaraman
Ionizing radiation and the risk of brain and central nervous system tumors: a systematic review
Neuro Oncology, November 1, 2012; 14(11): 1316 - 1324.
[Abstract] [Full Text] [PDF]

Home page
ASH Education BookHome page
L. L. Robison
Late Effects of Acute Lymphoblastic Leukemia Therapy in Patients Diagnosed at 0-20 Years of Age
Hematology, December 1, 2011; 2011(1): 238 - 242.
[Abstract] [Full Text] [PDF]

Home page
Cancer Prev ResHome page
P. Rajaraman
Hunting for the Causes of Meningioma--Obesity Is a Suspect
Cancer Prevention Research, September 1, 2011; 4(9): 1353 - 1355.
[Abstract] [Full Text] [PDF]

 Librarians &
 Rights &
 PDA Services

Copyright © 2010 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
Terms and Conditions of Use
  HighWire Press HighWire Press™ assists in the publication of JCO Online