Role of cancer treatment in long-term overall and cardiovascular mortality after childhood cancer.

Détails

ID Serval
serval:BIB_C96B47BEFCA8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Role of cancer treatment in long-term overall and cardiovascular mortality after childhood cancer.
Périodique
Journal of Clinical Oncology
Auteur⸱e⸱s
Tukenova M., Guibout C., Oberlin O., Doyon F., Mousannif A., Haddy N., Guérin S., Pacquement H., Aouba A., Hawkins M., Winter D., Bourhis J., Lefkopoulos D., Diallo I., de Vathaire F.
ISSN
1527-7755 (Electronic)
ISSN-L
0732-183X
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
28
Numéro
8
Pages
1308-1315
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
PURPOSE: The purpose of this study was to assess the role of treatment in long-term overall and cardiovascular mortality after childhood cancer.
PATIENTS AND METHODS: We studied 4,122 5-year survivors of a childhood cancer diagnosed before 1986 in France and the United Kingdom. Information on chemotherapy was collected, and the radiation dose delivered to the heart was estimated for 2,870 patients who had received radiotherapy.
RESULTS: After 86,453 person-years of follow-up (average, 27 years), 603 deaths had occurred. The overall standardized mortality ratio (SMR) was 8.3-fold higher (95% CI, 7.6-fold to 9.0-fold higher) in relation to the general populations in France and the United Kingdom. Thirty-two patients had died as a result of cardiovascular diseases (ie, 5.0-fold [95% CI, 3.3-fold to 6.7-fold] more than expected). The risk of dying as a result of cardiac diseases (n = 21) was significantly higher in individuals who had received a cumulative anthracycline dose greater than 360 mg/m(2) (relative risk [RR], 4.4; 95% CI, 1.3 to 15.3) and in individuals who received an average radiation dose that exceeded 5 Gy (RR, 12.5 and 25.1 for 5 to 14.9 Gy and > 15 Gy, respectively) to the heart. A linear relationship was found between the average dose of radiation to the heart and the risk of cardiac mortality (estimated excess [corrected] RR at 1 Gy, 60%).
CONCLUSION: This study is the first, to our knowledge, to establish a relationship between the radiation dose received by the heart during radiotherapy for a childhood cancer and long-term cardiac mortality. This study also confirms a significant excess risk of cardiac mortality associated with a high cumulative dose of anthracyclines.
Mots-clé
Adolescent, Adult, Anthracyclines/administration & dosage, Anthracyclines/adverse effects, Antineoplastic Agents/adverse effects, Cardiovascular Diseases/etiology, Cardiovascular Diseases/mortality, Cause of Death, Child, Child, Preschool, Dose-Response Relationship, Drug, Dose-Response Relationship, Radiation, Female, Follow-Up Studies, France/epidemiology, Great Britain/epidemiology, Humans, Male, Middle Aged, Mortality, Multivariate Analysis, Neoplasms/drug therapy, Neoplasms/radiotherapy, Radiotherapy/adverse effects, Survivors
Pubmed
Web of science
Création de la notice
01/12/2014 17:09
Dernière modification de la notice
20/08/2019 15:44
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