Second malignant neoplasms in children treated for rhabdomyosarcoma. Intergroup Rhabdomyosarcoma Study Committee.

1993 ◽  
Vol 11 (2) ◽  
pp. 262-270 ◽  
Author(s):  
R Heyn ◽  
V Haeberlen ◽  
W A Newton ◽  
A H Ragab ◽  
R B Raney ◽  
...  

PURPOSE This study was performed to determine the incidence and risk factors involved in the development of a second malignant neoplasm (SMN) after treatment of primary rhabdomyosarcoma (RMS) in patients enrolled onto Intergroup Rhabdomyosarcoma Studies I and II (IRS I and II). PATIENTS AND METHODS There were 1,770 patients with primary RMS entered onto IRS I and II between 1972 and 1984. They were treated with chemotherapy and, in most instances, radiotherapy according to randomized or assigned regimens based on clinical grouping. Median follow-up time for these patients was 8.4 years. Incidence density (ID) was calculated for each study and for treatment and age groups. The 10-year cumulative incidence was estimated for each study. RESULTS Twenty-two SMNs have been reported through 1991. The most common tumor type was a bone sarcoma followed by acute nonlymphoblastic leukemia (ANLL). The median time to the development of an SMN was 7 years (range, 1 11/12 to 15 9/12 years). The 10-year cumulative incidence rate was 1.7% for both studies. ID and cumulative incidence estimates were highest for patients who received both an alkylating agent and radiotherapy. The majority of patients for whom family histories were available had either neurofibromatosis themselves or a family history that suggested the Li-Fraumeni syndrome (LFS). CONCLUSION The results of this study suggest that genetic abnormalities play a prominent role in the development of an SMN after therapy for a primary RMS. Chemotherapy with an alkylating agent and radiotherapy play significant roles in the development of an SMN compared with patients who received only one of these therapeutic modalities.

Author(s):  
G.E. Pogosyan ◽  

Among socially significant diseases that are characterized by high prevalence rates, malignant neoplasms occupy the leading positions. Thyroid cancer is the most common malignant neoplasm of the endocrine system. Purpose of the study. Analysis of recurrent disability due to thyroid cancer in the adult population in Moscow (2015–2019). Materials and research methods. The structure of repeated disability due to thyroid cancer by sex, age and disability group was studied. The dynamics of the number of the PPI contingent was traced and the level of repeated disability due to this pathology was determined. The number of observations was 4660 PPI. Research results. It was found that in the structure of repeated disability due to thyroid cancer, women predominated by gender. The trend towards an increase in the number of PPI took place in all major age groups of the adult population. The prevalence of PPI with group III disability, the proportion of which was 66.0% (PPI with group II – 32.5%, PPI with group I – 1.5%). The visibility indicator in 2019 in relation to 2015 (taken as 100%) was equal in the general contingent of PPI among disabled people of group I – 142.9%, group II – 374.1%, group III – 249.3% ...


2018 ◽  
Vol 1 (Supplement) ◽  
pp. 43
Author(s):  
D.G. Mincă ◽  
C. Cîrstoiu ◽  
F.L. Furtunescu ◽  
R.V. Costea

Abstract Introduction. Cancers of bone and articular cartilage are relatively rare, and a global analysis was not performed up to present in Romania due to the lack of a national registry for these diseases. This study aimed to explore the hospital burden due to malignant neoplasm of bone and articular cartilage in Romania and the general characteristics of the hospitalized cases. Materials and methods. We used the data reported in the routine statistic system during 2012 and 2016 and we analyzed the number of cases discharged from hospitals by age group, gender, and duration of hospitalization. Results. The number of hospitalized cancers of bone and articular cartilages decreased by 17% in the last five years (2012-2016) but this decrease was higher in other/ unspecified cancers (22%) and lower in limb cancers (10%). Among the 1872 cases reported in 2016, 47% were limbs’ cancers and the rest, cancers of others/ unspecified sites. Males accounted for 62% of all cancers (58% of limbs cancers and 65% of other cancers, p=0.001, Chi2 test). Distribution by age showed that 17%, 62% and 21% of the cancers occurred in age-groups 0-14, 15-64 and 65+ respectively, but limbs cancers occurred in a significantly higher proportion in children (29% vs. 7% of other cancers, p<0.001). 16983 days of hospitalization were reported in 2016 for this pathology, with an average length of stay of 9.07 days (9.37 and 8.81 days in limbs and other cancers respectively). Conclusions. More detailed analysis of routine reported data is required for understanding the characteristics and trends of bone cancers in Romania.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10010-10010
Author(s):  
Maria Clarissa de Faria Soares Rodrigues ◽  
Carlos Rodriguez-Galindo ◽  
Karina Braga Ribeiro ◽  
A. Lindsay Frazier

10010 Background: The probability of cure is very high for children with germ cell tumors (GCT), but late effects from cisplatinum can be quite significant. In addition to the immediate effects of oto-, neuro and nephrotoxicity, data from men treated for testicular cancer shows that the rate of second malignant neoplasm (SMN) is doubled and that a man treated before age 20 has a 50% chance of SMN by age 75. This study was designed to assess the risk of SMN among individuals treated for malignant GCT during childhood. Methods: We included all patients 0-19 years old with a primary diagnosis of malignant GCT registered in the Surveillance, Epidemiology and End Results (SEER) in the period 1973-2008. We analyzed tumors occurring at least 12 months after the first primary. Standardized incidence ratios (SIR) and 95% confidence intervals (CI) were calculated using SEER Stat, version 8.0.1. Results: The cohort comprised 1997 patients (798 women and 1,199 men); 86.3% had primary gonadal tumors (91% in men and 79.5% in women). The median age at diagnosis of the primary malignancy was 17 years (17 for males ; 15 for females), and for second malignancies was 27 (27 for males; 30 for females). Fifty eight SMNs were observed (21 in females; 37 in males). Among women, higher risk was observed to developing breast cancer (n=5; SIR=1.29; 95% CI= 0.42-3.02), thyroid cancer (n=5; SIR= 3.40; 95% CI= 1.1-7.93) and brain cancer (n=3; SIR= 9.19; 95% CI=1.89-26.85). Twenty-seven out of 37 second primary tumors observed in men were contralateral testicular tumors, conferring a 16.2 fold higher risk of developing this neoplasm (95% CI= 10.67-23.58). When the analysis excluded testis as a second site, a higher risk was noted for the development of pancreatic cancer (SIR=19.06; 95% CI=2.31-68.83) and leukemia (SIR=3.55; 95% CI=0.43-12.81). Conclusions: Rates of SMN are elevated in both men and women treated as children for pediatric germ cell tumors. Men need to be made aware of risk in contralateral testicle. The rates of SMN may continue to rise with longer follow up. The attribution of treatment type to risk of SMNs is not possible due to the lack of this information in SEER database.


2021 ◽  
Vol 11 ◽  
Author(s):  
Hongnan Zhen ◽  
Zhikai Liu ◽  
Hui Guan ◽  
Jiabin Ma ◽  
Wenhui Wang ◽  
...  

ObjectiveRhabdomyosarcoma (RMS) is a rare malignant tumor. The main treatment modality is comprehensive with chemotherapy, radiotherapy, and surgery. With the advancement in recent decades, patient survival has been prolonged, and long-term complications are attracting increasing attention among both physicians and patients. This study aimed to present the survival of patients with RMS and analyze the risk factors for the development of a second malignant neoplasm (SMN).MethodsThe Surveillance, Epidemiology, and End Results (SEER) Program 18 registry database from 1973 to 2015 of the National Cancer Institute of the United States was used for the survival analyses, and the SEER 9 for the SMN analysis.ResultsThe 5-, 10-, and 20-year overall survival rates of the patients with RMS were 45%, 43%, and 33%, respectively. The risk of SMN was significantly higher in patients with RMS compared to the general population (SIR=1.95, 95% CI: 1.44 – 2.57, p &lt; 0.001). The risk of developing SMN was increased in multiple locations, including the bones and joints (SIR = 35.25) soft tissues including the heart (SIR = 22.5), breasts (SIR = 2.10), male genital organs (SIR = 118.14), urinary system (SIR = 2.36), brain (SIR = 9.21), and all nervous system organs (SIR = 8.59). The multivariate analysis indicated that RMS in the limbs and earlier diagnosis time were independent risk factors for the development of SMN. Patients with head and neck (OR = 0.546, 95% CI: 0.313 – 0.952, p = 0.033) and trunk RMS (OR = 0.322, 95% CI: 0.184 – 0.564. p &lt; 0.001) and a later diagnosis time were less likely to develop SMN (OR = 0.496, 95% CI: 0.421 – 0.585, p &lt; 0.001).ConclusionThis study describes the risk factors associated with the development of SMN in patients with RMS, which is helpful for the personalized screening of high-risk patients with RMS.


2020 ◽  
Vol 65 (4) ◽  
pp. 65-79
Author(s):  
M. Osipov ◽  
E. Fomin ◽  
M. Sokolnikov

Purpose: To assess the contribution of low doses of diagnostic radiation due to computed tomography to carcinogenic risk among population of Ozersk. Material and methods: The study describes the results of the analysis of data from the radiation-epidemiological register created in the laboratory of radiation epidemiology of the Southern Urals Biophysics Institute of Ozersk. The register contains information on 26,626 CT examinations of Ozersk residents of all age groups, including children under 1 year old, carried out in medical departments of the Chelyabinsk region during the period from 1993 to 2018. Results: Based on the analyzed medical and dosimetric information from the CT Register database, the chances of malignant neoplasms among patients exposed to diagnostic irradiation during computed tomography were assessed taking into account the presence of the main radiation and non-radiation factors (age, sex, occupational exposure, number of CT examinations, effective dose and DLP). Conclusion: In a cohort of Ozersk residents who were exposed to low doses of diagnostic radiation during computed tomography, a statistically significant effect of sex and age attained to malignant neoplasm was obtained. Also, a significant relationship was found between the effective dose from diagnostic CT and the likelihood of subsequent cancer development diagnosed no earlier than 2 years after the first CT examination. At the same time, the DLP did not statistically significantly increase the chances of developing a malignant neoplasm in the study cohort for both the population and the personnel of the Mayak PA.


2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 494-494
Author(s):  
Sophia C. Kamran ◽  
Stephanie A. Curreri ◽  
Vinayak Muralidhar ◽  
Paul L. Nguyen ◽  
Neil E. Martin ◽  
...  

494 Background: Re-irradiation (re-RT) with external beam RT following prior pelvic RT has not been reported, given both an absence of guidelines and concerns for toxicity. We sought to characterize bladder and bowel toxicities among patients treated with high-dose palliative re-RT for genitourinary secondary malignant neoplasms (SMN) or local recurrence (LR) following prior RT for pelvic cancer and to assess the response to re-RT with regard to palliation of symptoms. Methods: With IRB approval, the records of 28 consecutive patients with advanced pelvic malignancies given palliative re-RT between 2008-2014 were retrospectively analyzed. Descriptive analyses focused on toxicities and symptom control; responses were evaluated by two independent observers. Results: The cohort contained 27 males and 1 female. Initial cancers included 19 prostate, 4 ureteral, 2 bladder, 2 rectal and 1 penile carcinoma and 1 large cell lymphoma. Median initial RT dose was 63.5 Gy (range, 30-75.6 Gy; 8 unknown). The median time between initial RT and re-RT was 9.5 years (range, 0.2-32 years). At re-RT, there were 16 LRs and 12 SMNs including 14 bladder, 11 prostate, 3 ureteral and 1 penile cancers. Indications for re-RT were most commonly pain and bleeding. Given the severity of symptoms and bulk of disease at the time of re-RT, hypofractionated higher-dose RT was given. Median re-RT dose was 50 Gy (range, 27.5-66 Gy). For patients who received < 60 Gy, the median daily re-RT dose was 250 cGy. Re-RT was well-tolerated; there were no grade 2-4 toxicities. After treatment, 24 patients (92%) had complete resolution of their symptoms. Relief was durable in 67% of patients. Median overall survival was 5.8 months (range, 0.3-38.9 months) and 89% of patients were followed until death. Median follow-up was 5.2 months (range, 0.23-30.2 months). Conclusions: This institutional series suggests that moderate- to high-dose re-RT with median cumulative doses ≥ 100 Gy may achieve successful palliation of pelvic symptoms without undue toxicity in patients previously treated with high-dose RT. These results require validation in a larger prospective cohort.


2021 ◽  
Author(s):  
HONGNAN ZHEN ◽  
ZHIKAI LIU ◽  
HUI GUAN ◽  
JIABIN MA ◽  
WENHUI WANG ◽  
...  

Abstract Objective Rhabdomyosarcoma (RMS) is a rare malignant tumor. The main treatment modality is comprehensive with chemotherapy, radiation therapy, and surgery. With the advancement in recent decades, patient survival has been prolonged, and long-term complications are attracting increasing attention among both physicians and patients. This study aimed to present the survival of patients with RMS and analyze the risk factors for the development of a second malignant neoplasm (SMN). Methods The Surveillance, Epidemiology, and End Results (SEER) Program 18 registry database from 1973 to 2015 of the National Cancer Institute of the United States was used for the survival analyses, and the SEER 9 for the SMN analysis. Results The 5-, 10-, and 20-year overall survival rates of the patients with RMS were 45%, 43%, and 33%, respectively. The risk of SMN was significantly higher in patients with RMS compared to the general population (SIR = 1.95, 95% CI: 1.44–2.57, p < 0.001). The risk of developing SMN was increased in multiple locations, including the bones and joint (SIR = 35.25) and soft tissues including the heart (SIR = 22.5), breasts (SIR = 2.10), male genital organs (SIR = 118.14), urinary system (SIR = 2.36), brain (SIR = 9.21), and brain and other nervous system organs (SIR = 8.59). The multivariate analysis indicated that RMS in the limbs and earlier diagnosis time were independent risk factors for the development of SMN. Patients with head and neck (OR = 0.546, 95% CI: 0.313–0.952, p = 0.033) and trunk RMS (OR = 0.322, 95% CI: 0.184–0.564. p < 0.001) and a later diagnosis time were less likely to develop SMN (OR = 0.496, 95% CI: 0.421–0.585, p < 0.001). Conclusion This study describes the risk factors associated with the development of SMN in patients with RMS, which is helpful for the personalized screening of high-risk patients with RMS.


1992 ◽  
Vol 10 (1) ◽  
pp. 156-163 ◽  
Author(s):  
S P Hunger ◽  
J Sklar ◽  
M P Link

PURPOSE The long-term effects of childhood cancer and its therapy are a problem of increasing concern. One of the most important of these late effects is the development of second malignant neoplasms (SMNs), which occur in approximately 8% of children within 20 years of diagnosis of a malignancy. These secondary cancers may result (individually or in combination) from increased genetic susceptibility, the mutagenic effects of chemotherapy and/or radiation therapy, or chance. Whereas the development of acute nonlymphocytic leukemia (ANLL) as an SMN is a well-recognized phenomenon, acute lymphoblastic leukemia (ALL) has been infrequently described as an SMN in either adults or children. PATIENTS AND METHODS We report three patients treated at our institution in whom ALL developed as an SMN after treatment for neuroblastoma, Wilms' tumor, and Hodgkin's disease. These cases prompted us to review the published literature for cases of secondary ALL in childhood. Patients whose initial malignancy was diagnosed at age less than 16 years were classified as pediatric patients. SMNs were defined as cancers of clearly distinct histologic type occurring 6 or more months after diagnosis of the first malignant neoplasm. RESULTS Including the three index cases, a total of 18 children with secondary ALL are reviewed, and the clinical features are discussed and compared with those of secondary ANLL. CONCLUSIONS This review summarizes the published case histories of secondary ALL. The data suggest that ALL represents approximately 5% to 10% of the cases of acute leukemia that arise as SMNs in both adults and children.


Cancer ◽  
1980 ◽  
Vol 46 (12) ◽  
pp. 2603-2606 ◽  
Author(s):  
Anna T. Meadows ◽  
Louise C. Strong ◽  
Frederick P. Li ◽  
Giulio J. D'Angio ◽  
Odile Schweisguth ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document