Risk Factors for Small Adult Height in Childhood Cancer Survivors.

Autor:	Demoor-Goldschmidt C; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Hematology Oncology Department, CHU Angers, Angers, France., Allodji RS; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Oncology Department, Gustave Roussy, Villejuif, France.; University Paris Saclay, Villejuif, France., Journy N; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Oncology Department, Gustave Roussy, Villejuif, France.; University Paris Saclay, Villejuif, France., Rubino C; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Oncology Department, Gustave Roussy, Villejuif, France.; University Paris Saclay, Villejuif, France., Zrafi WS; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Oncology Department, Gustave Roussy, Villejuif, France.; University Paris Saclay, Villejuif, France., Debiche G; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Oncology Department, Gustave Roussy, Villejuif, France., Llanas D; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Oncology Department, Gustave Roussy, Villejuif, France.; University Paris Saclay, Villejuif, France., Veres C; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Oncology Department, Gustave Roussy, Villejuif, France.; University Paris Saclay, Villejuif, France., Thomas-Teinturier C; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Oncology Department, Gustave Roussy, Villejuif, France.; University Paris Saclay, Villejuif, France.; Department of Pediatric Endocrinology, APHP, Hôpitaux Paris-Sud, site Bicêtre, Le Kremlin Bicêtre, France., Pacquement H; Pediatric Oncology Department, Institut Curie, Paris, France., Vu-Bezin G; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Oncology Department, Gustave Roussy, Villejuif, France.; University Paris Saclay, Villejuif, France., Fresneau B; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Oncology Department, Gustave Roussy, Villejuif, France.; University Paris Saclay, Villejuif, France., Berchery D; Radiotherapy Department, Claudius Regaud, Toulouse, France., Bolle S; Pediatric Oncology Department, Gustave Roussy, Villejuif, France., Diallo I; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Oncology Department, Gustave Roussy, Villejuif, France.; University Paris Saclay, Villejuif, France., Haddy N; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Oncology Department, Gustave Roussy, Villejuif, France.; University Paris Saclay, Villejuif, France., de Vathaire F; Cancer and Radiation Team, Center for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.; Pediatric Oncology Department, Gustave Roussy, Villejuif, France.; University Paris Saclay, Villejuif, France.
Jazyk:	angličtina
Zdroj:	Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2020 Jun 01; Vol. 38 (16), pp. 1785-1796. Date of Electronic Publication: 2020 Mar 20.
DOI:	10.1200/JCO.19.02361
Abstrakt:	Purpose: Between 10% and 20% of childhood cancer survivors (CCS) experience impaired growth, leading to small adult height (SAH). Our study aimed to quantify risk factors for SAH or growth hormone deficiency among CCS. Methods: The French CCS Study holds data on 7,670 cancer survivors treated before 2001. We analyzed self-administered questionnaire data from 2,965 CCS with clinical, chemo/radiotherapy data from medical records. SAH was defined as an adult height ≤ 2 standard deviation scores of control values obtained from a French population health study. Results: After exclusion of 189 CCS treated with growth hormone, 9.2% (254 of 2,776) had a SAH. Being young at the time of cancer treatment (relative risk [RR], 0.91 [95% CI, 0.88 to 0.95] by year of age), small height at diagnosis (≤ 2 standard deviation scores; RR, 6.74 [95% CI, 4.61 to 9.86]), pituitary irradiation (5-20 Gy: RR, 4.24 [95% CI, 1.98 to 9.06]; 20-40 Gy: RR, 10.16 [95% CI, 5.18 to 19.94]; and ≥ 40 Gy: RR, 19.48 [95% CI, 8.73 to 43.48]), having received busulfan (RR, 4.53 [95% CI, 2.10 to 9.77]), or > 300 mg/m 2 of lomustine (300-600 mg/m 2 : RR, 4.21 [95% CI, 1.61 to 11.01] and ≥ 600 mg/m 2 : RR, 9.12 [95% CI, 2.75 to 30.24]) were all independent risk factors for SAH. Irradiation of ≥ 7 vertebrae (≥ 15 Gy on ≥ 90% of their volume) without pituitary irradiation increased the RR of SAH by 4.62 (95% CI, 2.77 to 7.72). If patients had also received pituitary irradiation, this increased the RR by an additional factor of 1.3 to 2.4. Conclusion: CCS are at a high risk of SAH. CCS treated with radiotherapy, busulfan, or lomustine should be closely monitored for growth, puberty onset, and potential pituitary deficiency.
Databáze:	MEDLINE
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