Radiation Therapy and Late Mortality From Second Sarcoma, Carcinoma, and Hematological Malignancies After a Solid Cancer in Childhood

Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions

“…7,8 These findings have been confirmed in other large cohort studies and among survivors treated with more current therapy. [9][10][11][12][13][14][15] Early in the study of late effects after cancer therapy, the developing cardiovascular system of children and adolescents was recognized as being particularly vulnerable. 15a In the proceedings of the first National Cancer Institute's Conference on the Delayed Consequences of Cancer Therapy in 1975, Gilladoga et al 16 reported that 9 of 110 children receiving a cumulative dose of either doxorubicin or daunorubicin >500 mg/m 2 experienced severe cardiomyopathy with congestive heart failure (CHF) while undergoing therapy or soon thereafter.…”

Second Malignancies in Children Following Treatment for Neuroblastoma

“…More than two-thirds of children described in this study who developed a radiation-induced malignancy were alive at least 10 years after the diagnosis of the SMN. However, the two studies with longer follow up show that mortality due to SMN increases as the interval from diagnosis increases (Tukenova et al, 2011;Reulen et al, 2010) and in the CCSG study beyond 4-5 years an excess number of deaths is observed and second primary cancers and circulatory deaths together accounted for 77% of causes of death (Reulen et al, 2011). The poor prognosis of secondary leukemia (both lymphoblastic and myeloid) was previously reported by Shivakumar et al (2008).…”

“…A number of studies have indicated that radiation therapy may be a causative factor in the development of SMNs after treatment for childhood cancer, but it has to be taken into account that not all SMNs occurred in the irradiated field. French authors showed a 5.2-fold increased risk of mortality due to an SMN in patients who received an integral radiation dose exceeding 150 joules, and they suggest that irradiation of small volumes does not significantly increase the risk of developing secondary carcinomas or hematologic malignancies (Tukenova et al, 2011).…”

“…On the other hand, the risk of leukemia following radiation alone is lower than after chemotherapy (Tukenova et al, 2011). However, some cases of osteogenic sarcoma, renal cell carcinoma and also thyroid carcinoma, as well as some lymphoblastic leukemia-lymphomas have been reported in patients who were not treated at all, suggesting a possible genetic predisposition (Friedman et al, 2005).…”

Review of the Article by M. Stenger “Decreasing but Still Elevated Risk for Subsequent Neoplasms in Survivors of Childhood Cancers”

“…Сообщалось, что риск развития вторичных опухолей повышается с увеличением интегральной дозы, другим языком -с увеличением энергии ионизирующего излучения, пе-реданного телу [8][9][10]. Многие авторы показали, что уве-личение числа полей не увеличивает интегральную дозу.…”