Risk factors associated with secondary sarcomas in childhood cancer survivors: a report from the childhood cancer survivor study.
Risk factors associated with secondary sarcomas in childhood cancer survivors: a report from the childhood cancer survivor study.
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DOI：
10.1016/j.ijrobp.2011.11.022
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发表时间：
2012-09-01
影响因子：
7
通讯作者：
Diller, Lisa
中科院分区：
文献类型：
--
作者：
Henderson, Tara O.;Rajaraman, Preetha;Stovall, Marilyn;Constine, Louis S.;Olive, Aliza;Smith, Susan A.;Mertens, Ann;Meadows, Anna;Neglia, Joseph P.;Hammond, Sue;Whitton, John;Inskip, Peter D.;Robison, Leslie L.;Diller, Lisa
儿童癌症幸存者患继发性肉瘤的风险增加。为了更好地识别那些有风险的人，化疗和放疗的治疗剂量与继发性肉瘤之间的关系应该量化。我们对14372名儿童癌症幸存者进行了继发性肉瘤的巢式病例对照研究（105例，422例匹配对照）。第二恶性肿瘤（SMN）部位的放射剂量和化疗的使用是根据详细的医疗记录评估的。比值比（ORs）和95%置信区间通过条件逻辑回归估计。过量优势比（EOR）建模为辐射剂量、化疗和宿主因素的函数。肉瘤发生的中位时间为11.8年（范围：5.3-31.3年）。任何辐射暴露都与随后发生肉瘤的风险增加相关（OR = 4.1, 95% CI = 1.8-9.5）。观察到剂量-反应关系，剂量在10 - 29.9 Gy （OR = 15.6, 95% CI = 4.5-53.9）、30 - 49.9 Gy （OR = 16.0, 95% CI 3.8-67.8）和bbb50 Gy （OR = 114.1, 95% CI 13.5-964.8）时风险升高。蒽环类药物暴露与肉瘤风险相关（OR = 3.5, 95% CI = 1.6-7.7），调整辐射剂量、其他化疗和原发癌症。调整治疗后，首次诊断为霍奇金淋巴瘤（HL； OR=10.7, 95% CI = 3.1-37.4）或原发性肉瘤（OR=8.4, 95% CI = 3.2-22.3）的幸存者更有可能发展为肉瘤。在评估的危险因素中，辐射暴露是儿童癌症幸存者继发性肉瘤发展的最重要因素；蒽环类化疗暴露也与风险增加有关。
Childhood cancer survivors have an increased risk of secondary sarcomas. To better identify those at risk, the relationship between therapeutic dose of chemotherapy and radiation and secondary sarcoma should be quantified. We conducted a nested case-control study of secondary sarcomas (105 cases, 422 matched controls) in a cohort of 14,372 childhood cancer survivors. Radiation dose at the second malignant neoplasm (SMN) site and use of chemotherapy were estimated from detailed review of medical records. Odds ratios (ORs) and 95% confidence intervals were estimated by conditional logistic regression. Excess odds ratio (EOR) was modeled as a function of radiation dose, chemotherapy, and host factors. Sarcomas occurred a median of 11.8 years (range: 5.3-31.3 years) from original diagnosis. Any exposure to radiation was associated with increased risk of subsequent sarcoma (OR = 4.1, 95% CI = 1.8-9.5). A dose-response relation was observed, with elevated risks at doses between 10 - 29.9 Gy (OR = 15.6, 95% CI = 4.5-53.9), 30 - 49.9 Gy (OR = 16.0, 95% CI 3.8-67.8) and >50 Gy (OR = 114.1, 95% CI 13.5-964.8). Anthracycline exposure was associated with sarcoma risk (OR = 3.5, 95% CI = 1.6-7.7) adjusting for radiation dose, other chemotherapy, and primary cancer. Adjusting for treatment, survivors with a first diagnosis of Hodgkin lymphoma (HL; OR=10.7, 95% CI = 3.1-37.4) or primary sarcoma (OR=8.4, 95% CI = 3.2-22.3) were more likely to develop a sarcoma. Of the risk factors evaluated, radiation exposure was the most important for secondary sarcoma development in childhood cancer survivors; anthracycline chemotherapy exposure was also associated with increased risk.
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影响因子：
158.5
作者：
TUCKER, MA;DANGIO, GJ;FRAUMENI, JF
通讯作者：
FRAUMENI, JF
影响因子：
8.4
作者：
Karlsson, P;Holmberg, E;Wallgren, A
通讯作者：
Wallgren, A
影响因子：
3.8
作者：
Rubino, C;Shamsaldin, A;de Vathaire, F
通讯作者：
de Vathaire, F
DOI：
10.1093/jnci/88.5.270
发表时间：
1996-03-06
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
Hawkins, MM;Wilson, LMK;Stovall, MA
通讯作者：
Stovall, MA
影响因子：
6.4
作者：
Menu-Branthomme, A;Rubino, C;de Vathaire, F
通讯作者：
de Vathaire, F