ArticlePediatric blood & cancer2022
Second cancer risk in childhood cancer survivors treated with intensity-modulated radiation therapy: An updated analysis of more than 10 years of follow-up.
Article in Pediatric blood & cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 18 citations in OpenAlex.
- Clinical features and recurrence patterns of pediatric idiopathic orbital inflammatory disease.BMC ophthalmology · 2025Article
- High-Dose-Rate Brachytherapy for Vaginal Rhabdomyosarcoma (RMS): Lessons Learned at a Single Institution.International journal of radiation oncology, biology, physics · 2025Article
- Extremity rhabdomyosarcoma in children, adolescents and young adults: A report from Children's Oncology Group trials.Cancer · 2025Article
- A dosimetric and robustness analysis of proton arc therapy with early energy layer and spot assignment for lung cancer versus conventional intensity modulated proton therapy.Acta oncologica (Stockholm, Sweden) · 2024Article
- Second Malignancy Probabilities in Patients With Breast Cancer Treated With Conventional Versus Hypofractionated External Beam Radiation Therapy in the Adjuvant Setting.Clinical oncology (Royal College of Radiologists (Great Britain)) · 2024Article
- Paediatric radiotherapy in the United Kingdom: an evolving subspecialty and a paradigm for integrated teamworking in oncology.The British journal of radiology · 2024Article
- Risk of second primary cancer from proton arc therapy of pediatric brain tumors.Physics and imaging in radiation oncology · 2023Article
- Intensity Modulated Radiotherapy and Volumetric Modulated Arc Therapy in the Treatment of Breast Cancer: An Updated Review.Journal of breast cancer · 2022Review
- Recent Updates on Radiation Therapy for Pediatric Optic Pathway Glioma.Brain tumor research and treatment · 2022Review
- Retrospective Comparative Study on Dose Gradients and Peripheral Dose Management in Advanced Radiotherapy Systems.Journal of medical physicsArticle
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundIt is unclear how intensity-modulated radiation therapy (IMRT) impacts long-term risk of second malignant neoplasms (SMNs) in childhood cancer patients. PROCEDURE: Patients aged ≤21 years treated with IMRT between 1998 and 2009 and who survived ≥5 years after IMRT were included. SMN site in relation to isodose level (IDL) of IMRT was evaluated. Standardized incidence ratios (SIR) and excess absolute risks (EAR) were calculated. Cumulative incidences were estimated with death as a competing risk.
resultsThree-hundred twenty-five patients were included with median follow-up of 11.2 years from IMRT (interquartile range: 9.4-14.0) among patients alive at the end of follow-up. Two hundred (62%) patients had ≥10 years of follow-up and 284 (87%) patients were alive at the time of analysis. Fifteen patients developed SMNs (11 solid, four hematologic). Median time from IMRT to solid SMN was 11.0 years (range: 6.8-19.2) with 10- and 15-year cumulative incidences 1.8% (95% CI: 0.7-3.9) and 3.5% (95% CI: 1.4-7.5), respectively; SIR was 13.7 (95% CI: 6.9-24.6) and EAR was 2.8 per 1000 person-years (95% CI: 1.0-4.6). Eight solid SMNs developed within the IMRT field (100% IDL [n = 5], 80% IDL [n = 1], 50% IDL [n = 1], 40% IDL [n = 1]), one within the 70%-80% IDL of a conventional field, one was out-of-field, and one could not be determined.
conclusionsWith median follow-up of >10 years, many solid SMNs after IMRT in childhood cancer survivors develop in the high-dose region. These data serve as a foundation for comparison with other modalities of radiation treatment (e.g., proton therapy).
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