CHILDHOOD CANCER SURVIVOR STUDY

儿童癌症幸存者研究

• 批准号: 6096096
• 负责人: LESLIE L ROBISON
• 金额: $ 51.08万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-07-20 至 1999-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6096096
• 关键词: adult human (21+); cancer information system; cancer risk; cardiovascular disorder; child (0-11); cooperative study; drug adverse effect; family genetics; fertility; health behavior; human morbidity; human mortality; human subject; human therapy evaluation; longitudinal human study; neoplasm /cancer chemotherapy; neoplasm /cancer diagnosis; neoplasm /cancer radiation therapy; neoplasm /cancer relapse /recurrence; neoplasm /cancer surgery; neoplasm /cancer therapy; pediatric neoplasm /cancer; questionnaires; radiation therapy dosage; reproduction

Improvements in therapy for children with cancer have increased the probability of five year survival from less than 30% in 1960 to over 65% in 1986. Because of the young age of these cases, and thus the potential longevity, the delayed consequences of therapy may have a greater impact on their lives, and society at large, than the acute complications of the cytotoxic therapies they have already experienced. The childhood cancer Survivor Study (CCSS) will investigate the long-term effects of cancer and its associated therapies. A retrospective cohort study will be conducted, through a multi-institutional collaboration, which will involve the identification and active follow up of a cohort of approximately 25,000 survivors of cancer, diagnosed under 21 years of age, between 1970 and 1986. The proposed five year project will study children and young adults exposed to specific therapeutic modalities, including radiation, chemotherapy, and/or surgery, for an increased risk of late- occurring events associated with excess mortality and morbidity. For comparison purposes, a variety of data sources will be utilized including: siblings, within cohort, and vital/health statistics. To varying degrees, it has been shown that long-term survivors are at risk of developing second neoplasms, organ dysfunction (e.g. cardiac, gonadal), early death, decreased fertility, offspring with adverse events, and having a family history of cancer. The primary specific aims of the CCSS are not only to expand upon these known late-effects, but to investigate specific hypotheses relating to new risk factors for adverse events and provide information which will facilitate the development of primary and secondary prevention strategies. The cohort will be of sufficient size and heterogeneity with respect to the type of childhood cancer and exposure to radiation, chemotherapeutic agents, and/or surgery to allow for the study of endpoints of interest in this population. Specific risk factors of interest include: (i) original diagnosis; (ii) intensity and duration of exposure to therapeutic radiation and chemotherapeutic agents; (iii) patient characteristics such as sex and age at exposure; and (iv) genetic factors as measured by family history and type of childhood cancer. The size of the study population will allow for assessment of interaction between some of the major risk factors of interest. This project is designed to overcome the limitations (including sample size, selection biases, and lack of heterogeneity of exposures) encountered in single institutional studies of pediatric cancer survivors. The results will provide important information which may be used in the design of future therapeutic strategies and/or interventions to decrease the occurrence or impact of deleterious effects related to treatment exposures and host factors. In addition, the existence of the cohort will provide a dynamic framework and resource for epidemiologists, molecular biologists, oncologists, behavioral scientists, and other disciplines to investigate future questions regarding consequences of therapy, genetic associations, disease processes and causation, and quality of life questions.

改善癌症儿童的治疗已增加 五年生存的概率从1960年不到30％到65％以上 在1986年。由于这些情况的年龄很小，因此潜力 寿命，治疗的延迟后果可能会产生更大的影响 在他们的生活和整个社会上，都比 他们已经经历过的细胞毒性疗法。 儿童癌症幸存者研究（CCSS）将长期研究 癌症及其相关疗法的影响。回顾性队列 研究将通过多机构合作进行 这将涉及一组的识别和积极随访 大约25,000名癌症幸存者，被诊断出21岁以下， 在1970年至1986年之间。拟议的五年项目将研究儿童 和暴露于特定治疗方式的年轻人，包括 放射，化学疗法和/或手术，以增加晚期的风险 发生的事件与过度死亡率和发病率有关。为了 比较目的，将使用多种数据源，包括： 兄弟姐妹，在队列内和重要/健康统计数据。 在不同程度上，已经表明长期幸存者处于危险之中 开发第二种肿瘤，器官功能障碍（例如心脏，性腺）， 早期死亡，生育能力降低，后代因不良事件而 有癌症家族史。 CCSS的主要特定目的 不仅是为了扩展这些已知的晚期效果，还要调查 与不良事件的新风险因素有关的特定假设和 提供将有助于开发主要和的信息 二级预防策略。 相对于 儿童期癌症的类型和暴露于辐射，化学治疗的类型 代理和/或手术，以研究感兴趣的终点 这个人口。感兴趣的特定风险因素包括：（i）原始 诊断; （ii）暴露于治疗的强度和持续时间 辐射和化学治疗剂； （iii）患者特征这样 作为暴露时的性别和年龄； （iv）家族测量的遗传因素 儿童癌症的历史和类型。研究人群的大小 将允许评估一些主要风险之间的相互作用 感兴趣的因素。该项目旨在克服限制 （包括样本量，选择偏见以及缺乏异质性 在小儿癌的单个制度研究中遇到的暴露） 幸存者。结果将提供可能是 用于未来的治疗策略和/或干预措施的设计 减少与 治疗暴露和宿主因素。另外，存在 队列将为流行病学家提供动态框架和资源 分子生物学家，肿瘤学家，行为科学家和其他 学科调查有关后果的未来问题 治疗，遗传关联，疾病过程和因果关系以及 生活质量问题。