Second neoplasms following megavoltage radiation for pediatric tumors
- Univ. of Minnesota, Minneapolis, MN (United States)
Because ionizing radiation is a known carcinogen, diligent long term follow-up; in children exposed to therapeutic radiation is required. Since 1954 a large cohort of children receiving megavoltage RT at the University of Minnesota have been closely followed, and we now update our previous reports on the nature and risk of second neoplasms in this patient population. We have followed 487 children who were treated with megavoltage radiation therapy (RT) between 1/1/1954 and 12/31/1980. Patients at the time of RT ranged in age from 2 weeks to 17 years (median 6.2 years) and were treated for a variety of benigh (n=39) and malignant (n=448) conditions. The most common indications for RT were ALL (n=160), primary brain tumors (n=79), Hodgkin`s Disease (n=56), Wilms Tumor (n=36), neuroblastoma (n=33), and Histiocytosis X (n=24). Median follow-up of surviving patients is 19.9 years (range 4.8 to 39.9 years) with a total of 9832 patient years of follow-up accrued. Only 14 (2.9%) of patients were lost to follow-up and were censored at the time of last follow-up. Kaplan Meier actuarial survival estimates for all patients was 93% (95% C.I.90-95%) at 20 years and 86% (95% C.I. 81-90.5%) at 30 years. Forty-two (8.6%) patients developed second neoplasms from 3.8 to 32 years (median 15 years) after RT. The cumulative risk of developing a second neoplasm was 17% at 20 years. The most common second neoplasms were breast cancer (n=8), meningiomas (n-6) and skin cancers (n=7), all of which were within the RT fields, and developed at a median of 18, 16 and 21 years after RT, respectively. Of the 42 patients with second neoplasms, 16 died either of the second neoplasm (n=15) or of recurrent primary tumor (n=1). Risk factors associated with developing a second malignancy included age >10 years at RT (p=0.009), and an initial diagnosis of Hodgkin`s Disease (p<0.0001).
- OSTI ID:
- 471548
- Report Number(s):
- CONF-9510337--
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: Suppl.1 Vol. 32; ISSN IOBPD3; ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
Similar Records
Second acute leukemia and other malignancies following treatment for Hodgkin's disease
Second malignant lesions after therapy for Hodgkin's disease