Radiotherapy and Late Effects

Palmer, Joshua D.; Hall, Matthew D; Mahajan, Anita; Paulino, Arnold C.; Wolden, Suzanne L.; Constine, Louis S.

doi:10.1016/j.pcl.2020.08.001

Cited by 11 publications

(7 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Treatment type is an important predictor of late morbidity, but unmodifiable risk factors may also play a role [ 117 ]. Sex-related differences in survival may be related to biological factors such as sex hormones and immune response, behavioral factors such as females’ increased self-awareness of their bodies [ 126 ] or tendency towards health-seeking behaviors compared to men [ 127 ], and clinical factors such as differences in screening practices (e.g., colorectal cancer) [ 70 ].…”

Section: Discussionmentioning

confidence: 99%

“…Sex-related differences in survival may be related to biological factors such as sex hormones and immune response, behavioral factors such as females’ increased self-awareness of their bodies [ 126 ] or tendency towards health-seeking behaviors compared to men [ 127 ], and clinical factors such as differences in screening practices (e.g., colorectal cancer) [ 70 ]. Age-related differences in the development of late effects may be fundamentally different between younger and older AYAs, as 15–20 year-olds may still be undergoing growth associated with puberty and the rapid proliferation of tissues brought on by sex hormones [ 117 ]. These tissues are particularly vulnerable to damage caused by radiation, potentially affecting the maturation of organs and systems associated with teenaged growth spurts (e.g., gonads and musculoskeletal system) [ 117 , 128 ].…”

Section: Discussionmentioning

confidence: 99%

“…Age-related differences in the development of late effects may be fundamentally different between younger and older AYAs, as 15–20 year-olds may still be undergoing growth associated with puberty and the rapid proliferation of tissues brought on by sex hormones [ 117 ]. These tissues are particularly vulnerable to damage caused by radiation, potentially affecting the maturation of organs and systems associated with teenaged growth spurts (e.g., gonads and musculoskeletal system) [ 117 , 128 ]. In contrast, AYAs aged 20–39 may be exposed to a different set of carcinogenic exposures at work (e.g., asbestos) or in life (e.g., alcohol and smoking) that might alter their risk profile for late effects.…”

Section: Discussionmentioning

confidence: 99%

“…It is understood generally that cancer treatments, namely, radiotherapy and chemotherapy, are associated with morbidity and premature mortality, and multimodal therapies intensify these risks [47,[117][118][119]. Studies included in this review reported that AYAs in mixed-cancer cohorts experience an estimated 2.6-, 1.9-, and 10.4-fold increase in the risk for SMNs, hospitalization from any health condition, and 25-year all-cause mortality, respectively, compared to control groups [25,81,120].…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

The Burden of Late Effects and Related Risk Factors in Adolescent and Young Adult Cancer Survivors: A Scoping Review

Ryder‐Burbidge

Diaz

Barr

et al. 2021

Cancers

View full text Add to dashboard Cite

Risk factors associated with late effects in survivors of adolescent and young adult (AYA) cancer are poorly understood. We conducted a systematic scoping review to identify cohort studies published in English from 2010–2020 that included: (1) cancer survivors who were AYAs (age 15–39 years) at diagnosis and (2) outcomes of subsequent malignant neoplasms (SMNs), chronic conditions, and/or late mortality (>5 years postdiagnosis). There were 652 abstracts identified and, ultimately, 106 unique studies were included, of which 23, 34, and 54 studies related to the risk of SMNs, chronic conditions, and mortality, respectively. Studies investigating late effects among survivors of any primary cancer reported that AYA cancer survivors were at higher risk of SMN, chronic conditions, and all-cause mortality compared to controls. There was an indication that the following factors increased risk: radiation exposure (n = 3) for SMNs; younger attained age (n = 4) and earlier calendar period of diagnosis (n = 3) for chronic conditions; and non-Hispanic Black or Hispanic (n = 5), low socioeconomic status (n = 3), and earlier calendar period of diagnosis (n = 4) for late mortality. More studies including the full AYA age spectrum, treatment data, and results stratified by age, sex, and cancer type are needed to advance knowledge about late effects in AYA cancer survivors.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The Burden of Late Effects and Related Risk Factors in Adolescent and Young Adult Cancer Survivors: A Scoping Review

Ryder‐Burbidge

Diaz

Barr

et al. 2021

Cancers

View full text Add to dashboard Cite

show abstract

“…11 Children are already considered more radiosensitive as their organs have more rapid cell division (meaning more chance of DNA damage with radiation) and have not yet reached maturity. 12 Not all organs and/or individual patients have the same intrinsic radiosensitivity (α/β ratio). Therefore, mathematical models can be used to investigate how serial and parallel organs behave under differing conditions.…”

Section: Introductionmentioning

confidence: 99%

Normal tissue complication probability modeling to guide individual treatment planning in pediatric cranial proton and photon radiotherapy

et al. 2021

View full text Add to dashboard Cite

Proton therapy (PT) is broadly accepted as the gold standard of care for pediatric patients with cranial cancer. The superior dose distribution of PT compared to photon radiotherapy reduces normal tissue complication probability (NTCP) for organs at risk. As NTCPs for pediatric organs are not well understood, clinics generally base radiation response on adult data. However, there is evidence that radiation response strongly depends on the age and even sex of a patient. Furthermore, questions surround the influence of individual intrinsic radiosensitivity (α/β ratio) on pediatric NTCP. While the clinical pediatric NTCP data is scarce, radiobiological modeling and sensitivity analyses can be used to investigate the NTCP trends and its dependence on individual modeling parameters. The purpose of this study was to perform sensitivity analyses of NTCP models to ascertain the dependence of radiosensitivity, sex, and age of a child and predict cranial side-effects following intensity-modulated proton therapy (IMPT) and intensity-modulated radiotherapy (IMRT). Methods: Previously, six sex-matched pediatric cranial datasets (5, 9, and 13 years old) were planned in Varian Eclipse treatment planning system (13.7). Up to 108 scanning beam IMPT plans and 108 IMRT plans were retrospectively optimized for a range of simulated target volumes and locations. In this work, dose-volume histograms were extracted and imported into BioSuite Software for radiobiological modeling. Relative-Seriality and Lyman-Kutcher-Burman models were used to calculate NTCP values for toxicity endpoints, where TD50, (based on reported adult clinical data) was varied to simulate sex dependence of NTCP. Plausible parameter ranges, based on published literature for adults, were used in modeling. In addition to sensitivity analyses, a 20% difference in TD50 was used to represent the radiosensitivity between the sexes (with females considered more radiosensitive) for ease of data comparison as a function of parameters such as α/β ratio. Results: IMPT plans resulted in lower NTCP compared to IMRT across all models (p < 0.0001). For medulloblastoma treatment, the risk of brainstem necrosis (> 10%) and cochlea tinnitus (> 20%) among females could potentially be underestimated considering a lower TD50 value for females. Sensitivity analyses show that the difference in NTCP between sexes was significant (p < 0.0001). Similarly, both brainstem necrosis and cochlea tinnitus NTCP varied significantly (p < 0.0001) across tested α/β as a function of TD50 values (assumption being that TD50 values are 20% lower in females). If the true α/β of these pediatric tissues is higher than expected (α/β ∼ 3), the risk of tinnitus for IMRT can significantly increase (p < 0.0001).

show abstract

Self-reported physical activity behaviors of childhood cancer survivors: comparison to a general adolescent population in Korea

Yeo

Lee²,

Shin³

et al. 2023

Support Care Cancer

View full text Add to dashboard Cite

Radiotherapy and Late Effects

Cited by 11 publications

References 48 publications

The Burden of Late Effects and Related Risk Factors in Adolescent and Young Adult Cancer Survivors: A Scoping Review

The Burden of Late Effects and Related Risk Factors in Adolescent and Young Adult Cancer Survivors: A Scoping Review

Normal tissue complication probability modeling to guide individual treatment planning in pediatric cranial proton and photon radiotherapy

Self-reported physical activity behaviors of childhood cancer survivors: comparison to a general adolescent population in Korea

Contact Info

Product

Resources

About