Childhood cancer, endocrine disorders, and cohort studies

Oeffinger, Kevin C.; Sklar, Charles A.

doi:10.1016/s0140-6736(14)60114-8

Cited by 9 publications

(5 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The different cohorts published have followed different methodologies to collect sequelae among CCS. Despite these methodological differences, cohorts of CCS report a comparable risk of medical problems, which strengthens the reliability of the observations reported [ 5 ].…”

Section: Childhood Cancer Survivor Cohortssupporting

confidence: 79%

“…The main risk factors for underactive thyroid remain dose of radiation, female sex, and older age at diagnosis [ 40 ]. Over time, hyperthyroidism, as well as a higher risk of thyroid neoplasms, has often been observed [ 5 ]. The incidence of thyroid nodules among HD survivors has varied from 2 to 65% [ 41 ], being identified even 20 years after radiotherapy [ 3 ].…”

Section: Radiotherapymentioning

confidence: 99%

See 1 more Smart Citation

Endocrine Late Effects in Childhood Cancer Survivors

Casano‐Sancho

Izurieta-Pacheco

2022

Cancers

View full text Add to dashboard Cite

Childhood cancer management has improved considerably over the years, leading to a significant improvement in survival of up to 80%. However, childhood cancer survivors are at the highest risk of developing sequelae resulting from treatment, with endocrine complications being frequently observed among survivors. Multiple predisposing factors for endocrine sequelae have been identified, including age at diagnosis, treatment received, radiation, tumor type, and genetic polymorphisms, which could explain the individual predisposition to develop drug toxicity. Novel agents targeting tumor growth and immune checkpoint inhibitors have recently become the cornerstone for the treatment of different cancers, triggering a myriad of immune-related endocrinopathies. Endocrine sequelae of cancer therapy will have an impact on not only childhood but also on the survival and quality of life of these highly complex patients. Therefore, lifelong monitoring of childhood cancer survivors at risk of endocrine diseases is paramount. Encouraging oncologists and endocrinologists to develop new follow-up and early detection guidelines that minimize sequelae among these patients has become a priority, promoting integration between pediatric and adult units since many sequelae may manifest only after years to decades of follow-up.

show abstract

Section: Childhood Cancer Survivor Cohortssupporting

confidence: 79%

Section: Radiotherapymentioning

confidence: 99%

Endocrine Late Effects in Childhood Cancer Survivors

Casano‐Sancho

Izurieta-Pacheco

2022

Cancers

View full text Add to dashboard Cite

show abstract

“…5 Consequently, data generated from childhood and adolescent cancer survivorship cohorts over the past 4 decades in North America and Europe have heavily influenced modern HL treatment regimens for all age groups. 6 Despite advances in HL treatment and high survival rates, 7 the AYA patient population faces many well-known barriers to care, 8 as mortality and survival trends of AYA patients continue to lag behind those of pediatric patients with HL. This difference may be attributed to many factors, but, in general, pediatric and AYA patients have similar histologic subtypes, with most patients presenting with nodular sclerosis, whereas older adults have an increased incidence of mixed cellularity and lymphocyte depletion.…”

Section: Introductionmentioning

confidence: 99%

The management of Hodgkin lymphoma in adolescents and young adults: burden of disease or burden of choice?

Flerlage

Metzger

Bhakta

2018

Blood

View full text Add to dashboard Cite

Adolescents and young adults (AYAs) comprise the largest age group affected by Hodgkin lymphoma (HL). Despite excellent overall survival of AYA patients with HL due to advances in treatment regimens, therapy-associated late effects continue to be a concern in HL survivors, especially for younger patients who have decades of life remaining. Since the first clinical trial for HL with chemotherapy in 1964, subsequent protocols have attempted to reduce chemotherapy-induced toxicities and yet maintain high overall survival rates. Today, new analytic methods applied to data from survivorship cohorts, such as the recently described cumulative burden of disease metric, can be used to inform changes for future protocols. Although pediatric and adult trial consortia have followed this process, the AYA population, an age cohort split between pediatric and adult health care services, faces many barriers to care and is the least likely to be enrolled in clinical trials. AYA patients with HL theoretically have a choice to be treated in pediatric or adult protocols when presented with these options. Recent efforts by the National Clinical Trials Network, the Children's Oncology Group, and others have been made to ensure that the burden of choice for the AYA population is not greater than the burden of disease.

show abstract

“…16,48 Importantly, the prevalence and incidence of chronic conditions that we previously reported for the entire CCSS cohort has been confirmed by studies using medical evaluations or population-based registries with the notable difference that estimates based upon self-report underestimate what is identified by medical evaluations. 15,48,[55][56][57][58] As in any cohort study with longitudinal follow-up, rates of participation are important. Within CCSS, there is some evidence that subjects with longitudinal data for chronic condition outcomes may be somewhat more likely to be ill than those who do not have longitudinal reporting, and thus there is potential for overestimating rates of adverse health outcomes.…”

Section: Discussionmentioning

confidence: 99%

Impact of Risk-Adapted Therapy for Pediatric Hodgkin Lymphoma on Risk of Long-Term Morbidity: A Report From the Childhood Cancer Survivor Study

Oeffinger

Stratton

Hudson

et al. 2021

JCO

View full text Add to dashboard Cite

PURPOSE To determine the incidence of serious chronic health conditions among survivors of pediatric Hodgkin lymphoma (HL), compare by era of therapy and by selected cancer therapies, and provide estimates of risks associated with contemporary therapy. METHODS Assessing 2,996 5-year HL survivors in the Childhood Cancer Survivor Study diagnosed from 1970 to 1999, we examined the cumulative incidence of severe to fatal chronic conditions (grades 3-5) using self-report conditions, medically confirmed subsequent malignant neoplasms, and cause of death based on the National Death Index. We used multivariable regression models to estimate hazard ratios (HRs) per decade and by key treatment exposures. RESULTS HL survivors were of a mean age of 35.6 years (range, 12-58 years). The cumulative incidence of any grade 3-5 condition by 35 years of age was 31.4% (95% CI, 29.2 to 33.5). Females were twice as likely (HR, 2.1; 95% CI, 1.8 to 2.4) to have a grade 3-5 condition compared with males. From the 1970s to the 1990s, there was a 20% reduction (HR, 0.8; 95% CI, 0.7 to 0.9) in decade-specific risk of a grade 3-5 condition ( P trend = .002). In survivors who had a recurrence and/or hematopoietic cell transplant, the risk of a grade 3-5 condition was substantially elevated, similar to that of survivors treated with high-dose, extended-field radiotherapy (HR, 1.2; 95% CI, 0.9 to 1.5). Compared with survivors treated with chest radiotherapy ≥ 35 Gy in combination with an anthracycline or alkylator, a contemporary regimen for low-intermediate risk HL was estimated to lead to a 40% reduction in risk of a grade 3-5 condition (HR, 0.6; 95% CI, 0.4 to 0.8). CONCLUSION This study demonstrates that risk-adapted therapy for pediatric HL has resulted in a significant reduction in serious long-term outcomes.

show abstract

Childhood cancer, endocrine disorders, and cohort studies

Cited by 9 publications

References 10 publications

Endocrine Late Effects in Childhood Cancer Survivors

Endocrine Late Effects in Childhood Cancer Survivors

The management of Hodgkin lymphoma in adolescents and young adults: burden of disease or burden of choice?

Impact of Risk-Adapted Therapy for Pediatric Hodgkin Lymphoma on Risk of Long-Term Morbidity: A Report From the Childhood Cancer Survivor Study

Contact Info

Product

Resources

About