Risk of subsequent gliomas and meningiomas among 69,460 5-year survivors of childhood and adolescent cancer in Europe: the PanCareSurFup study.
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Heymer Emma J, Hawkins Michael M, Winter David L, Teepen Jop C, Sunguc Ceren, Ronckers Cécile M, Allodji Rodrigue S, Alessi Daniela, Sugden Elaine, Belle Fabiën N, Bagnasco Francesca, Byrne Julianne, Bárdi Edit, Garwicz Stanislaw, Grabow Desiree, Jankovic Momcilo, Kaatsch Peter, Kaiser Melanie, Michel Gisela, Schindera Christina, Haddy Nadia, Journy Neige, Česen Mazić Maja, Skinner Roderick, Kok Judith L, Gunnes Maria W, Wiebe Thomas, Sacerdote Carlotta, Maule Milena M, Terenziani Monica, Jakab Zsuzsanna, Winther Jeanette F, Lähteenmäki Päivi M, Zadravec Zaletel Lorna, Haupt Riccardo, Kuehni Claudia E, Kremer Leontien C, de Vathaire Florent, Hjorth Lars, Reulen Raoul C
Аннотация
METHODS: Using data from 69,460 5-year childhood cancer survivors (diagnosed 1940-2008), across Europe, standardized incidence ratios (SIRs) and cumulative incidence were calculated.
RESULTS: In total, 279 glioma and 761 meningioma were identified. CNS tumour (SIR: 16.2, 95% CI: 13.7, 19.2) and leukaemia (SIR: 11.2, 95% CI: 8.8, 14.2) survivors were at greatest risk of glioma. The SIR for CNS tumour survivors was still 4.3-fold after age 50 (95% CI: 1.9, 9.6), and for leukaemia survivors still 10.2-fold after age 40 (95% CI: 4.9, 21.4). Following cranial radiotherapy (CRT), the cumulative incidence of a glioma in CNS tumour survivors was 2.7%, 3.7% and 5.0% by ages 40, 50 and 60, respectively, whilst for leukaemia this was 1.2% and 1.7% by ages 40 and 50. The cumulative incidence of a meningioma after CRT in CNS tumour survivors doubled from 5.9% to 12.5% between ages 40 and 60, and in leukaemia survivors increased from 5.8% to 10.2% between ages 40 and 50.
DISCUSSION: Clinicians following up survivors should be aware that the substantial risks of meningioma and glioma following CRT are sustained beyond age 40 and be vigilant for symptoms.