INTRODUCTION Childhood, adolescent and young adult (CAYA) cancer survivors treated with cranial radiotherapy are at risk for developing subsequent meningiomas. There is insufficient evidence concerning the benefits and harms of screening for subsequent meningiomas, and uncertainty about the most appropriate clinical management of asymptomatic meningiomas. Data describing current clinical decision-making is essential to formulate surveillance recommendations. METHODS We created an online survey to identify the current international clinical practice regarding screening for and management of subsequent asymptomatic meningiomas among CAYA cancer survivors. Fifty-nine physicians from North America and Europe with expertise relevant to meningiomas were invited to participate. RESULTS Thirty-four physicians (58%) completed the survey. The reported number of CAYA cancer survivors that physicians are willing to screen to detect one meningioma varied widely from 0 to 750 (median 50). Physicians expressed concerns regarding harms from MRI screening, including risks of unnecessary interventions (n = 25, 73%) and overdiagnosis (n = 19, 56%). Growth pattern (n = 33, 97%), location (n = 31, 91%) and size (n = 29, 85%) were endorsed as the most important factors influencing the decision to treat asymptomatic meningiomas. A challenging location (n = 14, 52%), indolent tumor growth pattern (n = 13, 48%), and absence of symptoms (n = 12, 44%) were endorsed as the main reasons to monitor without intervention. CONCLUSIONS There is international variation in opinions and clinical practice regarding screening for subsequent asymptomatic meningiomas among at risk CAYA cancer survivors. Decision-making regarding interventions of asymptomatic meningiomas are largely driven by clinical characteristics. These valuable insights into current clinical practice will inform surveillance guidelines for CAYA cancer survivors.

中文翻译：

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儿童，青少年和年轻的成年癌症幸存者随后无症状脑膜瘤的筛查和管理方法有所不同。

引言用颅脑放疗治疗的儿童，青少年和青年（CAYA）癌症幸存者有随后发生脑膜瘤的风险。没有足够的证据表明筛查随后的脑膜瘤的利弊，以及对无症状脑膜瘤的最适当临床管理的不确定性。描述当前临床决策的数据对于制定监测建议至关重要。方法我们创建了一个在线调查，以识别有关CAYA癌症幸存者中后续无症状脑膜瘤的筛查和管理的当前国际临床实践。来自北美和欧洲的59名具有与脑膜瘤相关专业知识的医师被邀请参加。结果34位医师（58％）完成了调查。据报道，医生愿意筛选以检测出一种脑膜瘤的CAYA癌症幸存者人数从0到750不等（中位数为50）。医生对MRI筛查带来的危害表示担忧，包括不必要干预的风险（n = 25，73％）和过度诊断的风险（n = 19，56％）。增长模式（n = 33，97％），位置（n = 31，91％）和大小（n = 29，85％）被认为是影响无症状脑膜瘤治疗决定的最重要因素。极富挑战性的位置（n = 14，52％），肿瘤生长缓慢（n = 13，48％），并且没有症状（n = 12，44％）被认为是无需干预即可监测的主要原因。结论在高风险CAYA癌症幸存者中，有关筛查随后的无症状脑膜瘤的意见和临床实践存在国际差异。有关无症状脑膜瘤干预的决策很大程度上取决于临床特征。这些对当前临床实践的宝贵见解将为CAYA癌症幸存者的监测指南提供依据。