Second Malignant Neoplasms in Digestive Organs After Childhood Cancer: A Cohort-Nested Case-Control Study
| Autor: | Elisabeth Adjadj, Harald Anderson, Markhaba Tukenova, Florent de Vathaire, Odile Oberlin, Risto Sankila, Michael M. Hawkins, Hélène Pacquement, D.L. Winter, Gudrun Svahn-Tapper, Nadia Haddy, Torgil Möller, Frøydis Langmark, Laufey Tryggvadottir, Stanislaw Garwicz, Chiraz El Fayech, Ibrahima Diallo, Carole Rubino |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Pediatrics Neoplasms Radiation-Induced Adolescent Second malignancy in digestive tract medicine.medical_treatment Childhood cancer Antineoplastic Agents Digestive System Neoplasms Risk Assessment Cohort Studies Young Adult Neoplasms medicine Humans Chemotherapy Radiology Nuclear Medicine and imaging Survivors Child Gynecology Analysis of Variance Radiation Radiotherapy business.industry Age Factors Cancer Dose-Response Relationship Radiation Neoplasms Second Primary Radiotherapy Dosage Odds ratio medicine.disease United Kingdom Radiation therapy Oncology Case-Control Studies Latency stage Cohort Nested case-control study Female France business Radiology Nuclear Medicine and Medical Imaging |
| Zdroj: | International Journal of Radiation Oncology, Biology, Physics; 82(3), pp 383-390 (2012) |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2011.05.069 |
| Popis: | Purpose: Cancers of the digestive system constitute a major risk for childhood cancer survivors treated with radiotherapy once they reach adulthood. The aim of this study was to determine therapy-related risk factors for the development of a second malignancy in the digestive organs (SMDO) after a childhood cancer. Methods and Materials: Among 4,568 2-year survivors of a childhood solid cancer diagnosed before 17 years of age at eight French and British centers, and among 25,120 patients diagnosed as having a malignant neoplasm before the age of 20 years, whose data were extracted from the Nordic Cancer Registries, we matched 58 case patients (41 men and 17 women) of SMDO and 167 controls, in their respective cohort, for sex, age at first cancer, calendar year of occurrence of the first cancer, and duration of follow-up. The radiation dose received at the site of each second malignancy and at the corresponding site of its matched control was estimated. Results: The risk of developing a SMDO was 9.7-fold higher in relation to the general populations in France and the United Kingdom. In the case-control study, a strong dose-response relationship was estimated, compared with that in survivors who had not received radiotherapy; the odds ratio was 5.2 (95% CI, 1.7-16.0) for local radiation doses between 10 and 29 Gy and 9.6 (95% CI, 2.6-35.2) for doses equal to or greater than 30 Gy. Chemotherapy was also found to increase the risk of developing SMDO. Conclusions: This study confirms that childhood cancer treatments strongly increase the risk of SMDO, which occur only after a very long latency period. (C) 2012 Elsevier Inc. (Less) |
| Databáze: | OpenAIRE |
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