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【medical-news】放疗增加儿童脑瘤风险
Wed Nov 1, 2006 2:29pm ET
By Megan Rauscher
NEW YORK (Reuters Health) - In survivors of childhood cancer, exposure to radiation therapy, especially before 5 years of age, is "the most important" risk factor for the development of a new primary tumor of the central nervous system (CNS), according to new data from the Childhood Cancer Survivor Study.
The most common CNS tumors in these children are gliomas and meningiomas, which are primarily located in the brain but can occur elsewhere.
"A small fraction of children may develop new cancers later in life as a result of these exposures," Dr. Joseph P. Neglia of the University of Minnesota Medical School and Cancer Center in Minneapolis told Reuters Health. "A very small fraction (less than 1 percent) will develop brain tumors."
The higher risk of second (CNS tumors) in children who undergo radiation at a very young age may reflect a greater susceptibility of the developing brain, he and his colleagues suggest in the Journal of the National Cancer Institute.
In a study of 14,361 patients who survived for 5 years after their childhood cancer, 116 developed subsequent primary CNS tumors. Forty gliomas appeared about 9 years after the original diagnosis; 66 meningiomas occurred at about 17 years after the initial cancer.
Treatment with radiation was associated with a greater than 6-fold increased risk of subsequent glioma and a nearly 10-fold increased risk of subsequent meningioma.
"Risk of a subsequent CNS tumor increased as the dose of radiation used for treatment of the original cancer increased," Dr. Neglia told Reuters Health. The children who were youngest when they underwent radiation had the highest risk of developing another CNS cancer, he added.
This study makes clear the strong impact of radiation therapy on the occurrence of subsequent tumors of the CNS. Despite the risks, however, the use of radiation "is justified in these settings," the researchers note, "because 60 percent of deaths among survivors of childhood cancer who are 5 or more years results from recurrence or progression of their original disease."
They conclude that "prolonged follow-up of all childhood cancer survivors, particularly those exposed to radiation is crucial to the early detection of these tumors and should be considered part of the effective therapy of the primary disease."
"It is also important," Neglia added, "for all pediatric cancer survivors to know their medical history, the therapy they received, and the recommendations for their follow-up."
"Many centers have Long-Term Survivor Clinics specifically dedicated to the needs of these survivors. While the most malignant tumors occur early, other tumors (meningiomas) continued to occur throughout follow-up. Screening for a secondary tumor of the CNS could be considered on a case-by-case basis by a patient and their physician."
SOURCE: Journal of the National Cancer Institute, November 1, 2006.
http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyID=2006-11-01T192923Z_01_KIM170133_RTRUKOC_0_US-RADIATION-TUMOR-CHILDREN.xml&pageNumber=1&imageid=&cap=&sz=13&WTModLoc=NewsArt-C1-ArticlePage1 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。
Radiation raises new brain tumor risk in children
Wed Nov 1, 2006 2:29pm ET
By Megan Rauscher
放疗增加儿童脑瘤风险
NEW YORK (Reuters Health) - In survivors of childhood cancer, exposure to radiation therapy, especially before 5 years of age, is "the most important" risk factor for the development of a new primary tumor of the central nervous system (CNS), according to new data from the Childhood Cancer Survivor Study.
纽约（路透社健康）儿童癌症幸存者研究最新数据显示，在儿童癌症幸存者中，尤其是5岁以下儿童，放疗是新中枢神经系统原发癌产生的最重要风险因素。
The most common CNS tumors in these children are gliomas and meningiomas, which are primarily located in the brain but can occur elsewhere.
这些儿童中最常见的是神经胶质瘤和脑膜瘤等中枢神经（CNS）肿瘤，最初发生在大脑但可迁移全身。
"A small fraction of children may develop new cancers later in life as a result of these exposures," Dr. Joseph P. Neglia of the University of Minnesota Medical School and Cancer Center in Minneapolis told Reuters Health. "A very small fraction (less than 1 percent) will develop brain tumors."
Minneapolis肿瘤中心和明尼苏达州大学医学院，Joseph P. Neglia博士说：“一小部分儿童可能在以后因为放疗照射产生新的肿瘤。很小部分（小于1％）会形成脑瘤。”
The higher risk of second (CNS tumors) in children who undergo radiation at a very young age may reflect a greater susceptibility of the developing brain, he and his colleagues suggest in the Journal of the National Cancer Institute.
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