News|Articles|February 11, 2026

Childhood Cancer Survivors Face Long-Term Meningioma Risk

Fact checked by: Alex Biese

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Key Takeaways

CCSS follow-up of 24,886 five-year survivors (1970–1999 diagnoses) identified 471 individuals with 710 meningiomas, including frequent multiplicity (29% ≥2; 16% meningiomatosis).
Chemotherapy-associated risk persisted after accounting for radiation, implicating platinum agents, antimetabolites, intrathecal chemotherapy (notably methotrexate), and 6-mercaptopurine as independent contributors.
Risk stratification showed higher hazards for females (1.6×) and those diagnosed at ages 0–4 (HR 4.0), with lower risk observed in non-Hispanic Black survivors and with alkylator exposure.
Cranial radiation remained the strongest driver, yet absolute risk was extremely low among survivors without cranial radiation, supporting symptom-triggered evaluation over broad screening at present.
Post-meningioma outcomes were clinically meaningful, with all-cause mortality 4.9% at 5 years and 18.4% at 15 years, and meningioma a leading cause of death.

New research shows specific chemotherapies and radiation increase the risk of subsequent brain tumors in long-term childhood cancer survivors.

Researchers at UT Southwestern Medical Center led a study published in JAMA Network Open which found that specific chemotherapies are associated with an increased long-term risk of subsequent tumors in survivors of childhood cancer.

The study, conducted in Dallas, suggested that certain treatments independently increase the risk of single and multiple meningiomas, emphasizing the need for lifelong monitoring as these survivors age, particularly those treated for leukemia and brain tumors.

Main data supporting the findings

The research identified that survivors had a cumulative meningioma incidence of 2.3% at 35 years after their primary cancer diagnosis. While these tumors — which form in the membranes surrounding the brain and spinal cord — are typically benign and treatable, the risk for survivors continues to rise throughout adulthood.

A significant finding of this study is that certain chemotherapy agents contribute to the development of these tumors independently of radiation exposure. The specific agents identified as independent risk factors include platinum agents, antimetabolite chemotherapy, intrathecal methotrexate (and other intrathecal chemotherapy) and 6-mercaptopurine.

The study found that survivors who developed meningiomas did so decades earlier than the general population. In terms of demographics, the risk was 1.6 times higher for females compared to males. Additionally, patients diagnosed with their primary cancer at a younger age were at higher risk; for example, those diagnosed between ages 0 and 4 had a hazard ratio of 4.0. Conversely, the study found a lower risk associated with non-Hispanic Black race and exposure to alkylating agents.

Trial details

This retrospective cohort study utilized data from the Childhood Cancer Survivor Study (CCSS), a multi-institutional group funded by the National Cancer Institute. The study included 24,886 individuals who were diagnosed with cancer before the age of 21 between 1970 and 1999 and had survived at least five years after their initial diagnosis.

The participant group included 471 survivors who were eventually diagnosed with a total of 710 meningiomas. Of these 471 individuals, 263 were female. The median age at the time of the primary cancer diagnosis was 5.6 years, while the median age at the last follow-up was 42.5 years. Researchers used medical records to abstract details regarding chemotherapy and radiation therapy exposures from up to five years after the initial diagnosis. Meningiomas were self-reported by participants and subsequently confirmed through a review of pathology reports.

Among those who developed a subsequent tumor, 137 survivors (29%) were diagnosed with at least two meningiomas, and 80 survivors (16%) met the clinical criteria for meningiomatosis.

Safety

While cranial radiation therapy (CRT) remains a major risk factor — with high doses of radiation showing a hazard ratio of 125.3 — the overall risk of subsequent meningiomas remains low for the broader population of childhood cancer survivors, and extremely low for those who did not receive cranial radiation.

Researchers noted that screening should currently be considered only for adult patients who develop symptoms such as headaches, weakness, and behavioral changes.

However, the study revealed substantial mortality rates following a meningioma diagnosis. The all-cause cumulative mortality was 4.9% at five years, 10.5% at 10 years and 18.4% at 15 years after the first subsequent meningioma was found. Nearly one in five survivors diagnosed with a meningioma died within 15 years, with the meningioma itself being the most common cause of death. These findings support the need for refined long-term counseling and specialized follow-up care for high-risk survivors.

References

“Adult survivors of childhood cancer at higher risk for meningiomas,” news release; https://www.utsouthwestern.edu/newsroom/articles/year-2026/feb-adult-childhood-cancer-survivors-meningiomas.html
“Subsequent Meningiomas Among Survivors of Childhood Cancer,” by Dr. Daniel C. Bowers et al., JAMA Network Open.

Editor's note: This article is for informational purposes only and is not a substitute for professional medical advice, as your own experience will be unique. Use this article to guide discussions with your oncologist. Content was generated with AI and reviewed by a human editor.

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