This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Guérin, S. Articles by de Vathaire, F. Search for Related Content PubMed PubMed Citation Articles by Guérin, S. Articles by de Vathaire, F. Social Bookmarking                            What's this?

Treatment-Adjusted Predisposition to Second Malignant Neoplasms After a Solid Cancer in Childhood: A Case-Control Study

Sylvie Guérin, Mike Hawkins, Akhtar Shamsaldin, Catherine Guibout, Ibrahima Diallo, Odile Oberlin, Laurence Brugières, Florent de Vathaire

From L'Institut National de la Santé et de la Recherche Médicale; Gustave-Roussy Institute, Departments of Medical Physics and Radiotherapy and Pediatric Oncology, Villejuif, France; and the Centre for Childhood Cancer Survivor Studies, University of Birmingham, Birmingham, United Kingdom

Address reprint requests to Florent de Vathaire, PhD, INSERM U605, Espace Maurice Tubiana, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France, e-mail: fdv{at}igr.fr

Purpose Previous therapy, genetic susceptibility, and the type of first malignant neoplasm (FMN) are known to be associated with the risk of second malignant neoplasm (SMN) among patients treated for a childhood cancer. The aim of this study was to investigate the independent role of the FMN in the onset of any SMN.

Patients and Methods A case-control study nested in a European cohort of 4,581 patients treated for a solid cancer during childhood was conducted. One hundred forty-six patients with an SMN and 417 controls were matched for sex, age at FMN, chemotherapy, radiotherapy, the local radiation dose received at the site of SMN for patient cases and at the same site for the matched controls, and follow-up.

Results A significantly increased risk of developing any SMN was observed after Hodgkin's lymphoma, retinoblastoma, malignant bone tumor, soft tissue sarcoma (STS), and germ cell tumor as FMN, after adjustment for chemotherapy and family cancer syndrome. No significant risk of developing a carcinoma was observed among patients who had developed Hodgkin's lymphoma as FMN. A significantly increased risk of developing a sarcoma was observed among patients who had developed a retinoblastoma (adjusted odds ratio [OR_a] = 7.5; 95% CI, 1.2 to 46), a malignant bone tumor (OR_a = 13.3; 95% CI, 1.5 to 117), an STS (OR_a = 4.8; 95% CI, 1.3 to 18), or a carcinoma (OR_a = 9.4; 95% CI, 1.1 to 82) as FMN.

Conclusion Survivors of Hodgkin's lymphoma, retinoblastoma, malignant bone tumor, STS, and germ cell tumor should receive close surveillance because they are at increased risk of developing any SMN.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?