Second cancer risk in childhood cancer survivors treated with intensity‐modulated radiation therapy (IMRT). Issue 2 (18th October 2014)

• Record Type: Journal Article
• Authors: Casey, Dana L.; Friedman, Danielle N.; Moskowitz, Chaya S.; Hilden, Patrick D.; Sklar, Charles A.; Wexler, Leonard H.; Wolden, Suzanne L.
• Is Part Of: Pediatric blood & cancer. Volume 62:Issue 2(2015:Feb.)
• Page Start: 311
• Page End: 316
• Publication Date: 2014-10-18
• Subjects: Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.25285
• Languages: English
• ISSNs: 1545-5009

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="pbc25285-sec-0001" sec-type="section"> <title>Background</title> <p>Treatment with radiotherapy (RT) is associated with an increased risk of second malignant neoplasms (SMNs) in childhood cancer survivors; it is unclear how treatment with intensity‐modulated radiation therapy (IMRT) impacts this risk. We provide the first report of SMN risk in a cohort of childhood cancer survivors treated with IMRT.</p> </sec> <sec id="pbc25285-sec-0002" sec-type="section"> <title>Procedure</title> <p>Retrospective review of patients ≤21 years of age treated with IMRT at Memorial Sloan Kettering Cancer Center between December 1998 and February 2009. Eligible patients survived at least 5 years from IMRT initiation. The risk of SMN was assessed via standardized incidence ratios (SIRs) and excess absolute risk (EAR). The cumulative incidence was estimated using methods for competing risks.</p> </sec> <sec id="pbc25285-sec-0003" sec-type="section"> <title>Results</title> <p>Among 242 patients, six developed SMNs: four developed second solid cancers (all within the radiation field), and two developed myelodysplastic syndrome. Median time from IMRT initiation to a second solid cancer was 7.2 years (range, 6.8–9.5), with a 10‐year cumulative incidence of 3.3% (95% confidence interval [CI], 1.0–7.8%), SIR of 11.4 (95% CI, 3.1–29.2) and EAR of 1.8 per 1, 000 person‐years (95% CI, −0.1 to 3.8).</p> </sec> <sec id="pbc25285-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Longer follow‐up is required to determine how the risk of SMN after IMRT compares to other modalities of radiation treatment, such as proton therapy. This study provides a preliminary report, which will serve as a baseline for future longitudinal analyses of SMN risk after IMRT. Pediatr Blood Cancer 2015;62:311–316. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>