التفاصيل البيبلوغرافية
| العنوان: |
Radiation, Atherosclerotic Risk Factors, and Stroke Risk in Survivors of Pediatric Cancer: A Report From the Childhood Cancer Survivor Study |
| المؤلفون: |
Mueller, Sabine, Fullerton, Heather J, Stratton, Kayla, Leisenring, Wendy, Weathers, Rita E, Stovall, Marilyn, Armstrong, Gregory T, Goldsby, Robert E, Packer, Roger J, Sklar, Charles A, Bowers, Daniel C, Robison, Leslie L, Krull, Kevin R |
| المصدر: |
International Journal of Radiation Oncology • Biology • Physics, vol 86, iss 4 |
| بيانات النشر: |
eScholarship, University of California |
| سنة النشر: |
2013 |
| المجموعة: |
University of California: eScholarship |
| مصطلحات موضوعية: |
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Prevention, Clinical Research, Pediatric Research Initiative, Pediatric, Pediatric Cancer, Aging, Brain Disorders, Cancer, Stroke, Rehabilitation, Adolescent, Adult, Age Factors, Atherosclerosis, Case-Control Studies, Child, Preschool, Cranial Irradiation, Female, Follow-Up Studies, Humans, Hypertension, Incidence, Infant, Male, Neoplasms, Proportional Hazards Models, Retrospective Studies |
| جغرافية الموضوع: |
649 - 655 |
| الوصف: |
PurposeTo 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 materialsThe 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.ResultsDuring 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).ConclusionYoung 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. |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
unknown |
| العلاقة: |
qt1dk6d91d; https://escholarship.org/uc/item/1dk6d91dTest |
| الإتاحة: |
https://escholarship.org/uc/item/1dk6d91dTest |
| حقوق: |
public |
| رقم الانضمام: |
edsbas.4B46F3F1 |
| قاعدة البيانات: |
BASE |
