Irradiation-Induced Secondary Tumors following Pediatric Central Nervous System Tumors: Experiences of a Single Institute in Taiwan (1975-2013)
| Autor: | Feng Chi Chang, Yi Wei Chen, Donald Ming-Tak Ho, Muh Lii Liang, Chu Yi Lee, Tai-Tong Wong, Hsin Hung Chen, Shih-Chieh Lin, Ming Chao Huang, Sang Hue Yen, Yi Yen Lee |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Oncology
Male Risk Cancer Research medicine.medical_specialty Neoplasms Radiation-Induced Time Factors Adolescent medicine.medical_treatment Central nervous system Taiwan Kaplan-Meier Estimate Pediatrics Craniospinal Irradiation Central Nervous System Neoplasms 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Cumulative incidence Child Retrospective Studies Radiation Radiotherapy business.industry Cancer Retrospective cohort study Radiotherapy Dosage medicine.disease Radiation therapy medicine.anatomical_structure Treatment Outcome 030220 oncology & carcinogenesis Latency stage Child Preschool Radiation Oncology Secondary tumors Female Cranial Irradiation business 030217 neurology & neurosurgery |
| Zdroj: | International journal of radiation oncology, biology, physics. 101(5) |
| ISSN: | 1879-355X |
| Popis: | Complications can occur following a prolonged latency period after radiation therapy for cancer, and this is a growing concern because secondary tumors are potentially fatal. Few studies have examined secondary tumors in patients who received radiation therapy as children.This retrospective study examined 1697 pediatric patients with central nervous system tumors who received treatment at Taipei Veterans General Hospital from January 1, 1975, to December 31, 2013. Secondary tumors developed in 27 of 681 patients who received cranial irradiation. Overall survival was estimated using the Kaplan-Meier method, and the significance of differences was determined by the log-rank test.The overall cumulative incidence of secondary tumors at 25 years was 3.96%, and there were similar numbers of male patients (n = 16) and female patients (n = 11). The mean age at diagnosis was 8.8 years (range, 3-16.5 years), the median dose of cranial irradiation was 52.5 Gy (mean, 53.4 Gy), the mean latency period was 14.6 years (range, 2-33 years), and the mean age at diagnosis of a secondary tumor was 23.1 years. The secondary tumors were mainly meningiomas (n = 13), sarcomas (n = 7), and high-grade gliomas (n = 6), and the mean latency periods were 19.66, 8.00, and 10.83 years, respectively. The overall survival rate from these secondary tumors was significantly different (P .05). Age at irradiation of7 years and craniospinal irradiation significantly increased the risk of a secondary tumor (P .05). Secondary tumors developed in 11 of 128 patients (8.6%) with primary medulloblastomas, which was higher than the overall cumulative incidence.Clinicians should consider the increased risk of secondary tumors in long-term cancer survivors who received craniospinal irradiation as children. Using a selective dose de-escalation strategy or deferring radiation therapy for young patients at highest risk of secondary cancers should be studied. |
| Databáze: | OpenAIRE |
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