View in EDS

Radiation, Atherosclerotic Risk Factors, and Stroke Risk in Survivors of Pediatric Cancer: A Report From the Childhood Cancer Survivor Study.

Saved in:
Bibliographic Details
Title: Radiation, Atherosclerotic Risk Factors, and Stroke Risk in Survivors of Pediatric Cancer: A Report From the Childhood Cancer Survivor Study.
Authors: Mueller, Sabine1 muellers@neuropeds.ucsf.edu, Fullerton, Heather J.2, Stratton, Kayla3, Leisenring, Wendy3, Weathers, Rita E.4, Stovall, Marilyn4, Armstrong, Gregory T.5, Goldsby, Robert E.6, Packer, Roger J.7, Sklar, Charles A.8, Bowers, Daniel C.9, Robison, Leslie L.5, Krull, Kevin R.5
Source: International Journal of Radiation Oncology, Biology, Physics. Jul2013, Vol. 86 Issue 4, p649-655. 7p.
Subjects: Childhood cancer, Atherosclerotic plaque, Physiological effects of radiation, Stroke risk factors, Medical research, Hypothesis, Retrospective studies
Abstract: Purpose: To test the hypotheses that (1) the increased risk of stroke conferred by childhood cranial radiation therapy (CRT) persists into adulthood; and (2) atherosclerotic risk factors further increase the stroke risk in cancer survivors. Methods and Materials: The Childhood Cancer Survivor Study is a multi-institutional retrospective cohort study of 14,358 5-year survivors of childhood cancer and 4023 randomly selected sibling controls with longitudinal follow-up. Age-adjusted incidence rates of self-reported late-occurring (≥5 years after diagnosis) first stroke were calculated. Multivariable Cox proportional hazards models were used to identify independent stroke predictors. Results: During a mean follow-up of 23.3 years, 292 survivors reported a late-occurring stroke. The age-adjusted stroke rate per 100,000 person-years was 77 (95% confidence interval [CI] 62-96), compared with 9.3 (95% CI 4-23) for siblings. Treatment with CRT increased stroke risk in a dose-dependent manner: hazard ratio 5.9 (95% CI 3.5-9.9) for 30-49 Gy CRT and 11.0 (7.4-17.0) for 50+ Gy CRT. The cumulative stroke incidence in survivors treated with 50+ Gy CRT was 1.1% (95% CI 0.4-1.8%) at 10 years after diagnosis and 12% (95% CI 8.9-15.0%) at 30 years. Hypertension increased stroke hazard by 4-fold (95% CI 2.8-5.5) and in black survivors by 16-fold (95% CI 6.9-36.6). Conclusion: Young adult pediatric cancer survivors have an increased stroke risk that is associated with CRT in a dose-dependent manner. Atherosclerotic risk factors enhanced this risk and should be treated aggressively. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Engineering Source
FullText Text:
  Availability: 0
Header DbId: egs
DbLabel: Engineering Source
An: 89121164
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Radiation, Atherosclerotic Risk Factors, and Stroke Risk in Survivors of Pediatric Cancer: A Report From the Childhood Cancer Survivor Study.
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Mueller%2C+Sabine%22">Mueller, Sabine</searchLink><relatesTo>1</relatesTo><i> muellers@neuropeds.ucsf.edu</i><br /><searchLink fieldCode="AR" term="%22Fullerton%2C+Heather+J%2E%22">Fullerton, Heather J.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Stratton%2C+Kayla%22">Stratton, Kayla</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Leisenring%2C+Wendy%22">Leisenring, Wendy</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Weathers%2C+Rita+E%2E%22">Weathers, Rita E.</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Stovall%2C+Marilyn%22">Stovall, Marilyn</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Armstrong%2C+Gregory+T%2E%22">Armstrong, Gregory T.</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Goldsby%2C+Robert+E%2E%22">Goldsby, Robert E.</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Packer%2C+Roger+J%2E%22">Packer, Roger J.</searchLink><relatesTo>7</relatesTo><br /><searchLink fieldCode="AR" term="%22Sklar%2C+Charles+A%2E%22">Sklar, Charles A.</searchLink><relatesTo>8</relatesTo><br /><searchLink fieldCode="AR" term="%22Bowers%2C+Daniel+C%2E%22">Bowers, Daniel C.</searchLink><relatesTo>9</relatesTo><br /><searchLink fieldCode="AR" term="%22Robison%2C+Leslie+L%2E%22">Robison, Leslie L.</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Krull%2C+Kevin+R%2E%22">Krull, Kevin R.</searchLink><relatesTo>5</relatesTo>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Radiation+Oncology%2C+Biology%2C+Physics%22">International Journal of Radiation Oncology, Biology, Physics</searchLink>. Jul2013, Vol. 86 Issue 4, p649-655. 7p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Childhood+cancer%22">Childhood cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Atherosclerotic+plaque%22">Atherosclerotic plaque</searchLink><br /><searchLink fieldCode="DE" term="%22Physiological+effects+of+radiation%22">Physiological effects of radiation</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke+risk+factors%22">Stroke risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+research%22">Medical research</searchLink><br /><searchLink fieldCode="DE" term="%22Hypothesis%22">Hypothesis</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: To test the hypotheses that (1) the increased risk of stroke conferred by childhood cranial radiation therapy (CRT) persists into adulthood; and (2) atherosclerotic risk factors further increase the stroke risk in cancer survivors. Methods and Materials: The Childhood Cancer Survivor Study is a multi-institutional retrospective cohort study of 14,358 5-year survivors of childhood cancer and 4023 randomly selected sibling controls with longitudinal follow-up. Age-adjusted incidence rates of self-reported late-occurring (≥5 years after diagnosis) first stroke were calculated. Multivariable Cox proportional hazards models were used to identify independent stroke predictors. Results: During a mean follow-up of 23.3 years, 292 survivors reported a late-occurring stroke. The age-adjusted stroke rate per 100,000 person-years was 77 (95% confidence interval [CI] 62-96), compared with 9.3 (95% CI 4-23) for siblings. Treatment with CRT increased stroke risk in a dose-dependent manner: hazard ratio 5.9 (95% CI 3.5-9.9) for 30-49 Gy CRT and 11.0 (7.4-17.0) for 50+ Gy CRT. The cumulative stroke incidence in survivors treated with 50+ Gy CRT was 1.1% (95% CI 0.4-1.8%) at 10 years after diagnosis and 12% (95% CI 8.9-15.0%) at 30 years. Hypertension increased stroke hazard by 4-fold (95% CI 2.8-5.5) and in black survivors by 16-fold (95% CI 6.9-36.6). Conclusion: Young adult pediatric cancer survivors have an increased stroke risk that is associated with CRT in a dose-dependent manner. Atherosclerotic risk factors enhanced this risk and should be treated aggressively. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=egs&AN=89121164
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/j.ijrobp.2013.03.034
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 7
        StartPage: 649
    Subjects:
      – SubjectFull: Childhood cancer
        Type: general
      – SubjectFull: Atherosclerotic plaque
        Type: general
      – SubjectFull: Physiological effects of radiation
        Type: general
      – SubjectFull: Stroke risk factors
        Type: general
      – SubjectFull: Medical research
        Type: general
      – SubjectFull: Hypothesis
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
    Titles:
      – TitleFull: Radiation, Atherosclerotic Risk Factors, and Stroke Risk in Survivors of Pediatric Cancer: A Report From the Childhood Cancer Survivor Study.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Mueller, Sabine
      – PersonEntity:
          Name:
            NameFull: Fullerton, Heather J.
      – PersonEntity:
          Name:
            NameFull: Stratton, Kayla
      – PersonEntity:
          Name:
            NameFull: Leisenring, Wendy
      – PersonEntity:
          Name:
            NameFull: Weathers, Rita E.
      – PersonEntity:
          Name:
            NameFull: Stovall, Marilyn
      – PersonEntity:
          Name:
            NameFull: Armstrong, Gregory T.
      – PersonEntity:
          Name:
            NameFull: Goldsby, Robert E.
      – PersonEntity:
          Name:
            NameFull: Packer, Roger J.
      – PersonEntity:
          Name:
            NameFull: Sklar, Charles A.
      – PersonEntity:
          Name:
            NameFull: Bowers, Daniel C.
      – PersonEntity:
          Name:
            NameFull: Robison, Leslie L.
      – PersonEntity:
          Name:
            NameFull: Krull, Kevin R.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 15
              M: 07
              Text: Jul2013
              Type: published
              Y: 2013
          Identifiers:
            – Type: issn-print
              Value: 03603016
          Numbering:
            – Type: volume
              Value: 86
            – Type: issue
              Value: 4
          Titles:
            – TitleFull: International Journal of Radiation Oncology, Biology, Physics
              Type: main
ResultId 1