Survival After Second Primary Neoplasms of the Brain or Spinal Cord in Survivors of Childhood Cancer: Results From the British Childhood Cancer Survivor Study

Taylor, Aliki; Frobisher, Clare; Ellison, David W.; Reulen, Raoul C.; Winter, D.; Taylor, Roger; Stiller, Charles; Lancashire, Emma; Tudor, Edward; Baggott, Christina; May, Shaun M.; Hawkins, Mike

doi:10.1200/jco.2009.22.4386

Cited by 25 publications

(27 citation statements)

References 32 publications

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“…However, we observed a low number of SMNs that are known to appear late: meningiomas, with median latency of 23 years [36]; melanomas, with median latency of 14.6 years [16]; lung carcinomas, with median latency of 25.7 years [35]; or digestive carcinomas and  C. Berger et al NMSCs. Our findings show a high risk for bone and soft tissue secondary sarcomas, which resembles the results of other authors [14,16], but our elevated SIR (57.1) for thyroid carcinomas is higher than in other studies [9,12,14,37] and is probably related to the high number of patients treated with TBI in our cohort (14 …”

Section: Noted That Any Discrepancies Between Our Study and The Othermentioning

confidence: 65%

Second Malignant Neoplasms Following Childhood Cancer: A Study of a Recent Cohort (1987–2004) from the Childhood Cancer Registry of The Rhône-Alpes Region (ARCERRA) in France

Berger

Casagranda

Mialou

et al. 2011

Pediatric Hematology and Oncology

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Studies of second malignant neoplasms (SMNs) in childhood are generally conducted in old cohorts. The aim of this study was to determine the actual incidence of all SMNs in a recent cohort. The authors studied a cohort of 2907 children included in the population-based Childhood Cancer Registry of the Rhône-Alpes Region for a first cancer diagnosed between 1987 and 2004. Total follow-up was 22,722 person-years, with a median follow-up of 9.8 years (range, 00.0-22.8 years). Fifty-four SMNs were reported in 52 patients. Overall median latency was 5.9 years. Cumulative incidence rates were 2.2% at 10 years and 3.9% at 15, with an overall standardized incidence ratio (SIR) of 13.9 (95% confidence interval [CI], 10.4-18.3) and absolute excess risk of 2.2. The SMNs were 12 thyroid carcinomas (SIR 57.1); 9 bone tumors (SIR 32.0); 8 leukemias (SIR 11.9); 5 lymphomas, all related to Epstein-Barr virus following allograft, (SIR 6.7); 5 CNS tumors (SIR 10.5); 4 soft tissue sarcomas (SIR 17.4); 4 carcinomas (no breast cancer); and 7 other cancers. Twelve SMNs appeared after total body irradiation, 16 after focal radiotherapy, and 8 leukemias after chemotherapy. The risk of secondary cancer was highest after retinoblastomas (SIR 41.8), Hodgkin lymphomas (SIR 20.8), leukemias (SIR 18.4), soft tissue sarcomas, CNS tumors, and bone tumors. These recent cohort findings show, on one hand, a high incidence of SMNs but do not capture breast cancers because of the relatively short follow-up and, on the other hand, a different distribution of first and second cancers.

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Section: Noted That Any Discrepancies Between Our Study and The Othermentioning

confidence: 65%

Second Malignant Neoplasms Following Childhood Cancer: A Study of a Recent Cohort (1987–2004) from the Childhood Cancer Registry of The Rhône-Alpes Region (ARCERRA) in France

Berger

Casagranda

Mialou

et al. 2011

Pediatric Hematology and Oncology

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“…7, 13, 35, 36 Three of the studies were cohort studies and one was a single institution report. Two studies included the median age at first cancer diagnosis: 2·5 years and 4·3 years.…”

Section: Resultsmentioning

confidence: 99%

“…11–13 A study utilizing the Surveillance, Epidemiology, and End Results (SEER) database reported a 10 year survival rate of 13·6% after subsequent CNS tumors after a primary diagnosis of pediatric solid tumors. 14 A report by Morris and co-workers reported that death due to subsequent neoplasms of the CNS was the second most common cause of death among five year survivors of CNS tumors, ranking only behind recurrence of the primary tumor.…”

Section: Introductionmentioning

confidence: 99%

Subsequent neoplasms of the CNS among survivors of childhood cancer: a systematic review

Bowers

Nathan

Constine

et al. 2013

The Lancet Oncology

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Childhood cancer survivors are at risk for development of subsequent neoplasms of the central nervous system (CNS). Better understanding of the rates, risk factors for and outcomes of subsequent neoplasms of the CNS among survivors of childhood cancer may lead to the development of more informed screening guidelines. Two independent investigators independently performed a systematic search of studies from the MEDLINE and EMBASE databases (1966 – 2012) for studies examining subsequent neoplasms of the CNS among childhood cancer survivors. Articles were selected to answer 3 questions: What is the risk of CNS tumors following radiation to the cranium for a pediatric cancer as compared with the general population? What are the outcomes in children with subsequent neoplasms of the CNS who have been treated with CNS directed radiation for a pediatric cancer? Are outcomes of subsequent neoplasms different from primary neoplasms of the same histology? Our search identified 72 reports, of which 18 publications were included in this review. These studies reported that childhood cancer survivors have an 8.1 – 52.3 times higher incidence of subsequent CNS neoplasms compared with the general population. Nearly all cancer survivors who developed a CNS neoplasm had been exposed to cranial radiation; some studies demonstrate a correlation between radiation dose and risk of subsequent CNS tumors. Five year survival rates for subsequent high-grade gliomas and meningiomas range from 0 – 19.5% and 73 – 100%, respectively, which are similar to those observed in patients with primary gliomas or meningiomas. The quality of evidence was limited by variation in study design, heterogeneity of details regarding treatment and outcomes, limited follow-up and relatively small sample sizes. We concluded that survivors of childhood cancer who were treated with cranial radiation therapy have an elevated risk for subsequent CNS neoplasms. The current literature is insufficient to comment about the potential harms and benefits of routine screening for subsequent CNS neoplasms.

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“…2,11) Identical rates of grade II or III radiation-induced meningiomas and survival were reported compared to adult primary meningiomas. 28) In our institute, all radiation-induced meningiomas that have been presented to date have been WHO grade II. The atypical features of our cases might be related to the shorter follow-up periods of our surviving patients after treatment for childhood leukemia.…”

Section: Discussionmentioning

confidence: 99%

Radiation-Induced World Health Organization Grade II Meningiomas in Young Patients Following Prophylactic Cranial Irradiation for Acute Lymphoblastic Leukemia in Childhood

Oda

Sato

Watanabe

et al. 2012

Neurol. Med. Chir.(Tokyo)

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Current chemotherapeutic regimens have been used to successfully treat many children with acute lymphoblastic leukemia (ALL), but have resulted in an increased risk of late central nervous system tumors, most commonly meningioma, particularly in patients who have received cranial irradiation. We treated 3 young patients with World Health Organization grade II meningiomas who had previously received cranial irradiation for the treatment of childhood ALL: a cerebellopontine angle tumor in a 19-year-old woman, a petroclival tumor in a 28-year-old man, and a frontal parasagittal tumor in a 19-year-old woman. These cases were difficult to treat due to the aggressive and invasive biology of the tumors. Therefore, we recommend systematic cranial imaging and long follow-up periods for leukemia survivors to detect brain tumors before progression.

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Survival After Second Primary Neoplasms of the Brain or Spinal Cord in Survivors of Childhood Cancer: Results From the British Childhood Cancer Survivor Study

Cited by 25 publications

References 32 publications

Second Malignant Neoplasms Following Childhood Cancer: A Study of a Recent Cohort (1987–2004) from the Childhood Cancer Registry of The Rhône-Alpes Region (ARCERRA) in France

Second Malignant Neoplasms Following Childhood Cancer: A Study of a Recent Cohort (1987–2004) from the Childhood Cancer Registry of The Rhône-Alpes Region (ARCERRA) in France

Subsequent neoplasms of the CNS among survivors of childhood cancer: a systematic review

Radiation-Induced World Health Organization Grade II Meningiomas in Young Patients Following Prophylactic Cranial Irradiation for Acute Lymphoblastic Leukemia in Childhood

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