ArticleNeuro-oncology2015
Subsequent neoplasms in survivors of childhood central nervous system tumors: risk after modern multimodal therapy.
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Article in Neuro-oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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26citing papers in PubMed, 1 pooled it
5.1field-weighted citation impact, top 5% of its field
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Risk of secondary malignant neoplasms in children following proton therapy vs. photon therapy for primary CNS tumors: A systematic review and meta-analysis.Frontiers in oncology · 2022Pooled it
- Prognostic relevance of clinical and molecular risk factors in children with high-risk medulloblastoma treated in the phase II trial PNET HR+5.Neuro-oncology · 2021Trial
- Second primary malignancies among childhood medulloblastoma survivors: a population-based competing risk analysis.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Identifying tumor type and cell type-specific gene expression alterations in pediatric central nervous system tumors.Nature communications · 2024Article
- [Secondary tumors following radiation therapy and chemotherapy : Incidence of cavernous hemangiomas].Radiologie (Heidelberg, Germany) · 2023Review
- Tumor type and cell type-specific gene expression alterations in diverse pediatric central nervous system tumors identified using single nuclei RNA-seq.Research square · 2023Article
- Novel Medical Therapies in Meningiomas.Advances in experimental medicine and biology · 2023Article
- Characteristics and therapeutic strategies of radiation-induced glioma: case series and comprehensive literature review.Journal of neuro-oncology · 2022Review
- Decade-long disease, secondary malignancy, and brainstem injury outcomes in pediatric and young adult medulloblastoma patients treated with proton radiotherapy.Neuro-oncology · 2022Article
- Review
- Review
- Thalamic tumors in children: case series from our institution and literature review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2021Review
- Late effects of cancer treatment: consequences for long-term brain cancer survivors.Neuro-oncology practice · 2021Review
- Tumor Growth in the High Frequency Medulloblastoma Mouse Model Ptch1Frontiers in oncology · 2021Article
- Biological Role of MYCN in Medulloblastoma: Novel Therapeutic Opportunities and Challenges Ahead.Frontiers in oncology · 2021Review
- Treatment-related calvarial lesions in pediatric brain tumor survivors.Pediatric blood & cancer · 2020Article
- Late Morbidity and Mortality Among Medulloblastoma Survivors Diagnosed Across Three Decades: A Report From the Childhood Cancer Survivor Study.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2019Article
- Medulloblastoma therapy generates risk of a poorly-prognostic H3 wild-type subgroup of diffuse intrinsic pontine glioma: a report from the International DIPG Registry.Acta neuropathologica communications · 2018Article
- Germline SUFU mutation carriers and medulloblastoma: clinical characteristics, cancer risk, and prognosis.Neuro-oncology · 2018Article
- Low- and middle-income countries can reduce risks of subsequent neoplasms by referring pediatric craniospinal cases to centralized proton treatment centers.Biomedical physics & engineering express · 2018Article
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Authors and funding
15 authors at 3 institutions in 1 country.
Karen TsuiDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Amar GajjarDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Chenghong LiDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Deokumar SrivastavaDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Alberto BroniscerDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Cynthia WetmoreDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Larry E KunDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Thomas E MerchantDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
David W EllisonDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Brent A OrrDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Frederick A BoopDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Paul KlimoDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Jordan RossDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Leslie L RobisonDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Gregory T ArmstrongDepartment of Oncology, St Jude Children's Research Hospital, Memphis, Tennessee (K.T., A.B., A.G., C.W.); Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee (C.L., D.S.); Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, Tennessee (L.E.K., T.E.M.); Department of Pathology, St Jude Children's Research Hospital, Memphis, Tennessee (D.W.E., B.A.O.); Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee (F.A.B., P.K.); Semmes-Murphey Neurologic and Spine Institute, Memphis, Tennessee (F.A.B., P.K.); Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee (F.A.B., P.K.); University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee (J.R.); Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee (L.L.R., G.T.A.).
Semmes Murphey Foundation · USUniversity of Tennessee Health Science Center · USSt. Jude Children's Research Hospital · US
Funding
Viral Vector Technology (VVTSR)P30CA021765 · NCI · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · PI CHARLES ROBERTS · 1985 to 2026
$166.9MMach-LETSGO: Machine-LEarning of Treatment, Survey, and Genetics towards Obtaining Correct Classification of Chronic Conditions in Adult Survivors in the Childhood Cancer Survivor Study - CCSS SupplU24CA055727 · NCI · UNIVERSITY OF MINNESOTA TWIN CITIES · PI Gregory Armstrong · 1999 to 2026
$96.7MPROFESSIONAL ONCOLOGY EDUCATION PROGRAMR25CA023944 · NCI · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · PI SUZANNE A. GRONEMEYER · 1986 to 2026
$8.3MCHILDHOOD CANCER SURVIVOR STUDYU01CA055727 · NCI · UNIVERSITY OF MINNESOTA TWIN CITIES · PI ROBISON, LESLIE L · 1993 to 1999
–NCI NIH HHS CA55727NCI NIH HHS P30 CA021765NCI NIH HHS R25 CA023944NCI NIH HHS U24 CA055727
Abstract
backgroundMultimodal therapy has improved survival for some childhood CNS tumors. However, whether risk for subsequent neoplasms (SNs) also increases is unknown. We report the cumulative incidence of, and risk factors for, SNs after a childhood primary CNS tumor and determine whether treatment that combines radiation therapy (RT) with chemotherapy increases risk for SNs.
methodsAnalyses included 2779 patients with a primary CNS tumor treated at St Jude Children's Research Hospital between 1985 and 2012. Cumulative incidence and standardized incidence ratios (SIRs) were estimated for SNs confirmed by pathology report. Cumulative incidence among the 237 five-year medulloblastoma survivors treated with multimodal therapy (RT + chemotherapy) was compared with a historical cohort of 139 five-year survivors treated with RT but no chemotherapy in the Childhood Cancer Survivor Study.
resultsEighty-one survivors had 97 SNs. The cumulative incidence of first SN was 3.0% (95% CI: 2.3%-3.9%) at 10 years, and 6.0% (95% CI: 4.6%-7.7%) at 20 years from diagnosis. Risks were highest for subsequent glioma, all grades (SIR = 57.2; 95% CI: 36.2-85.8) and acute myeloid leukemia (SIR = 31.8; 95% CI: 10.2-74.1). Compared with RT alone, RT + chemotherapy did not increase risk for SNs (hazard ratio: 0.64; 95% CI: 0.38-1.06). Among five-year survivors of medulloblastoma treated with multimodal therapy, cumulative incidence of SN was 12.0% (95% CI: 6.4%-19.5%) at 20 years, no different than survivors treated with RT alone (11.3%, P = .44).
conclusionThe cumulative incidence of SNs continues to increase with time from treatment with no obvious plateau, but the risk does not appear to be higher after exposure to multimodal therapy compared with RT alone. Continued follow-up of survivors as they age is essential.
Indexed as
AdolescentAdultBrain NeoplasmsChildChild, PreschoolCombined Modality TherapyFemaleHumansIncidenceMaleMedulloblastomaNeoplasms, Second PrimaryRisk FactorsSurvivorsYoung Adultchemotherapychildhood CNS tumor survivorsmedulloblastomaradiationsubsequent neoplasms
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