Case-control study on the therapy of childhood cancer and the occurrence of second malignant neoplasms in Germany.
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Case-control study on the therapy of childhood cancer and the occurrence of second malignant neoplasms in Germany. / Kaatsch, Peter; Reinisch, Irene; Spix, Claudia; Berthold, Frank; Janka-Schaub, Gritta; Mergenthaler, Andreas; Michaelis, Jörg; Blettner, Maria.
In: CANCER CAUSE CONTROL, Vol. 20, No. 6, 6, 2009, p. 965-980.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Case-control study on the therapy of childhood cancer and the occurrence of second malignant neoplasms in Germany.
AU - Kaatsch, Peter
AU - Reinisch, Irene
AU - Spix, Claudia
AU - Berthold, Frank
AU - Janka-Schaub, Gritta
AU - Mergenthaler, Andreas
AU - Michaelis, Jörg
AU - Blettner, Maria
PY - 2009
Y1 - 2009
N2 - We report on a nested case-control study with 328 cases with second malignant neoplasm (SMN) following childhood cancer and 639 matched controls based on the German Childhood Cancer Registry. In the adjusted overall analysis, the odds ratio (OR) for SMN following any radiotherapy or chemotherapy is 2.1 [95% confidence interval (CI): 1.8-3.3] and 1.8 (95% CI: 0.98-3.1), respectively. The strongest effect is seen for alkylating agents (OR=2.0, 95% CI: 1.2-3.3). The risk of SMN after leukemia is pronounced for antimetabolites (OR=17.2, 95% CI: 1.7-177) and asparaginase (OR=4.3, 95% CI: 1.7-11.0). Following solid tumors, the greatest effect is seen for platinum derivatives (OR=4.1, 95% CI: 1.7-10.1). For anthracyclines, a decreased risk is observed (OR=0.3, 95% CI: 0.1-0.6). Secondary solid tumors are mainly associated with radiotherapy (OR=4.5, 95% CI: 2.5-8.0), especially secondary carcinomas. Secondary acute myeloid leukemia and myelodysplastic syndrome are mainly associated with alkylating agents (OR=8.5, 95% CI: 0.97-74.8), asparaginase (OR=6.8, 95% CI: 2.3-20.6), and platinum derivatives (OR=4.5, 95% CI: 1.5-13.6). The observed risks are in many instances lower than the ones published in previous studies relating to earlier treatment eras of the primary diseases. These differences may be attributed to less toxic but still effective treatment regimes but also to differences in the length of follow-up.
AB - We report on a nested case-control study with 328 cases with second malignant neoplasm (SMN) following childhood cancer and 639 matched controls based on the German Childhood Cancer Registry. In the adjusted overall analysis, the odds ratio (OR) for SMN following any radiotherapy or chemotherapy is 2.1 [95% confidence interval (CI): 1.8-3.3] and 1.8 (95% CI: 0.98-3.1), respectively. The strongest effect is seen for alkylating agents (OR=2.0, 95% CI: 1.2-3.3). The risk of SMN after leukemia is pronounced for antimetabolites (OR=17.2, 95% CI: 1.7-177) and asparaginase (OR=4.3, 95% CI: 1.7-11.0). Following solid tumors, the greatest effect is seen for platinum derivatives (OR=4.1, 95% CI: 1.7-10.1). For anthracyclines, a decreased risk is observed (OR=0.3, 95% CI: 0.1-0.6). Secondary solid tumors are mainly associated with radiotherapy (OR=4.5, 95% CI: 2.5-8.0), especially secondary carcinomas. Secondary acute myeloid leukemia and myelodysplastic syndrome are mainly associated with alkylating agents (OR=8.5, 95% CI: 0.97-74.8), asparaginase (OR=6.8, 95% CI: 2.3-20.6), and platinum derivatives (OR=4.5, 95% CI: 1.5-13.6). The observed risks are in many instances lower than the ones published in previous studies relating to earlier treatment eras of the primary diseases. These differences may be attributed to less toxic but still effective treatment regimes but also to differences in the length of follow-up.
M3 - SCORING: Zeitschriftenaufsatz
VL - 20
SP - 965
EP - 980
JO - CANCER CAUSE CONTROL
JF - CANCER CAUSE CONTROL
SN - 0957-5243
IS - 6
M1 - 6
ER -
