Second malignant neoplasms after a first cancer in childhood : temporal pattern of risk according to type of treatment.
The variation in the risk of solid second malignant neoplasms (SMN) with time since first cancer during childhood has been previously reported.
However, no study has been performed that controls for the distribution of radiation dose and the aggressiveness of past chemotherapy, which could be responsible for the observed temporal variation of the risk.
The purpose of this study was to investigate the influence of the treatment on the long-term pattem of the incidence of solid SMN after a first cancer in childhood.
We studied a cohort of 4400 patients from eight centres in France and the UK.
Patients had to be alive 3 years or more after a first cancer treated before the age of 17 years and before the end of 1985.
For each patient in the cohort, the complete clinical, chemotherapy and radiotherapy history was recorded.
For each patient who had received external radiotherapy, the dose of radiation received by 151 sites of the body were estimated.
After a mean follow-up of 15 years, 113 children developed a solid SMN, compared to 12.3 expected from general population rates.
A similar distribution pattern was observed among the 1045 patients treated with radiotherapy alone and the 2064 patients treated with radiotherapy plus chemotherapy ; the relative risk, but not the excess absolute risk, of solid SMN decreased with time after first treatment ; the excess absolute risk increased during a period of at least 30 years after the first cancer. (...)
Mots-clés Pascal : Tumeur maligne, Hémopathie maligne, Radiothérapie, Chimiothérapie, Anticancéreux, Traitement associé, Traitement, Second cancer, Facteur risque, Epidémiologie, Etude cohorte, France, Europe, Complication, Toxicité, Enfant, Homme
Mots-clés Pascal anglais : Malignant tumor, Malignant hemopathy, Radiotherapy, Chemotherapy, Antineoplastic agent, Combined treatment, Treatment, Second cancer, Risk factor, Epidemiology, Cohort study, France, Europe, Complication, Toxicity, Child, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0225608
Code Inist : 002B02U02. Création : 16/11/1999.