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Tandem High-Dose Chemotherapy Increases the Risk of Secondary Malignant Neoplasm in Pediatric Solid Tumors.
Tandem High-Dose Chemotherapy Increases the Risk of Secondary Malignant Neoplasm in Pediatric Solid Tumors.
- Source :
-
Cancer research and treatment [Cancer Res Treat] 2024 Apr; Vol. 56 (2), pp. 642-651. Date of Electronic Publication: 2023 Nov 24. - Publication Year :
- 2024
-
Abstract
- Purpose: This study aimed to investigate the incidence and risk factors for secondary malignant neoplasms (SMN) in pediatric solid tumors, focusing on the effects of tandem high-dose chemotherapy (HDCT).<br />Materials and Methods: Patients (aged < 19 years) diagnosed with or treated for pediatric solid tumors between 1994 and 2014 were retrospectively analyzed. The cumulative incidence of SMN was estimated using competing risk methods by considering death as a competing risk.<br />Results: A total of 1,435 patients (413 with brain tumors and 1,022 with extracranial solid tumors) were enrolled. Seventy-one patients developed 74 SMNs, with a 10-year and 20-year cumulative incidence of 2.680±0.002% and 10.193±0.024%, respectively. The types of SMN included carcinoma in 28 (37.8%), sarcoma in 24 (32.4%), and hematologic malignancy in 15 (20.3%) cases. Osteosarcoma and thyroid carcinoma were the most frequently diagnosed tumors. Multivariate analysis showed that radiotherapy (RT) > 2, 340 cGy, and tandem HDCT were significant risk factors for SMN development. The SMN types varied according to the primary tumor type; carcinoma was the most frequent SMN in brain tumors and neuroblastoma, whereas hematologic malignancy and sarcomas developed more frequently in patients with sarcoma and retinoblastoma, respectively.<br />Conclusion: The cumulative incidence of SMN in pediatric patients with solid tumors was considerably high, especially in patients who underwent tandem HDCT or in those who received RT > 2,340 cGy. Therefore, the treatment intensity should be optimized based on individual risk assessment and the long-term follow-up of pediatric cancer survivors.
- Subjects :
- Child
Humans
Retrospective Studies
Risk Factors
Incidence
Neoplasms, Second Primary epidemiology
Neoplasms, Second Primary etiology
Neoplasms, Second Primary diagnosis
Neuroblastoma
Sarcoma drug therapy
Sarcoma epidemiology
Sarcoma etiology
Bone Neoplasms
Brain Neoplasms
Hematologic Neoplasms complications
Carcinoma complications
Subjects
Details
- Language :
- English
- ISSN :
- 2005-9256
- Volume :
- 56
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Cancer research and treatment
- Publication Type :
- Academic Journal
- Accession number :
- 37997325
- Full Text :
- https://doi.org/10.4143/crt.2023.999