Our Summary

This study is the largest review of data on benign tumors that grow on the peripheral nerves following radiation therapy. These tumors, while not common, are a delayed side effect of radiation treatment.

The researchers looked at 40 cases where radiation had led to the growth of these benign tumors. The majority of these tumors were schwannomas, a type that forms on the nerves outside the brain and spinal cord. Others were neurofibromas, which impact the nerves and skin, and one case was a ganglioneuroma, a very rare tumor that usually affects children and young adults.

The average age at which patients had received radiation treatment was around 15 years, and it took an average of around 25 years for these secondary tumors to appear. The average radiation dose patients had received was 26.3 Gy.

The team found that patients tended to live for a long time after being diagnosed with these secondary tumors, with many living for more than 10 years. They also discovered that surgery to completely remove the tumor was the most effective treatment option.

The researchers concluded that doctors should be aware of the risk of these secondary tumors in patients who’ve had radiation therapy, and that they need to monitor these patients long-term. Currently, the best treatment for these tumors is complete surgical removal.

FAQs

  1. What are radiation-induced benign peripheral nerve sheath tumors?
  2. What is the average latency period from radiotherapy to the onset of secondary tumors?
  3. What is the main treatment for radiation-induced benign peripheral nerve sheath tumors?

Doctor’s Tip

A doctor may advise a patient undergoing tumor resection to ensure complete surgical resection as it is the mainstay for the treatment of radiation-induced benign peripheral nerve sheath tumors. Additionally, long-term follow-up periods should be considered to monitor for the risk of incidence of secondary tumors. It is important to discuss with your healthcare provider about the potential benefits and risks of surgery, as well as any additional treatment options that may be available.

Suitable For

Patients who are typically recommended for tumor resection include those with radiation-induced benign peripheral nerve sheath tumors, such as schwannomas, neurofibromas, and ganglioneuromas. These tumors often develop after radiation exposure at a young age, with a latency period of several decades. Surgical resection with negative margins is the mainstay treatment for these tumors, and it has been shown to improve overall survival rates. Patients who have been treated with radiotherapy should undergo long-term follow-up to monitor for the development of secondary tumors.

Timeline

  • Patient undergoes radiation therapy at an average age of 14.9 years for primary lesions
  • Latency period of 24.5 years between radiotherapy and onset of secondary tumors
  • Development of radiation-induced benign peripheral nerve sheath tumors, such as schwannomas, neurofibromas, or ganglioneuromas
  • Average irradiation dose delivered is 26.3 Gy
  • Median overall survival not reached, with 10-year survival rates of 65.2%
  • Surgical negative margin is a positive prognostic factor for these tumors
  • Complete surgical resection is the main treatment option
  • Long-term follow-up periods are necessary to monitor for incidence of secondary tumors.

What to Ask Your Doctor

  1. What is the specific type of tumor that needs to be resected?
  2. What is the recommended treatment plan for the tumor resection?
  3. What are the risks and potential complications associated with the surgery?
  4. How long is the recovery time expected to be after the tumor resection?
  5. Are there any alternative treatment options available for this type of tumor?
  6. Will additional treatments, such as chemotherapy or radiation therapy, be needed after the surgery?
  7. What is the long-term prognosis for this type of tumor?
  8. How frequently will follow-up appointments be needed after the tumor resection?
  9. Are there any lifestyle changes or precautions that need to be taken after the surgery?
  10. Are there any support resources or organizations available for patients with this type of tumor?

Reference

Authors: Yamanaka R, Hayano A. Journal: World Neurosurg. 2017 Aug;104:713-722. doi: 10.1016/j.wneu.2017.05.066. Epub 2017 May 19. PMID: 28532923