scholarly journals Population-Based Risks of CNS Tumors in Survivors of Childhood Cancer: The British Childhood Cancer Survivor Study

2010 ◽  
Vol 28 (36) ◽  
pp. 5287-5293 ◽  
Author(s):  
Aliki J. Taylor ◽  
Mark P. Little ◽  
David L. Winter ◽  
Elaine Sugden ◽  
David W. Ellison ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Cancer Survivor ◽  
Population Based ◽  
Childhood Cancer Survivor ◽  
Cns Tumors ◽  
Intrathecal Methotrexate ◽  
Second Primary ◽  
National Population ◽  
Childhood Cancer Survivor Study ◽  
Survivors Of Childhood Cancer

Purpose CNS tumors are the most common second primary neoplasm (SPN) observed after childhood cancer in Britain, but the relationship of risk to doses of previous radiotherapy and chemotherapy is uncertain. Methods The British Childhood Cancer Survivor Study is a national, population-based, cohort study of 17,980 individuals surviving at least 5 years after diagnosis of childhood cancer. Linkage to national, population-based cancer registries identified 247 SPNs of the CNS. Cohort and nested case-control studies were undertaken. Results There were 137 meningiomas, 73 gliomas, and 37 other CNS neoplasms included in the analysis. The risk of meningioma increased strongly, linearly, and independently with each of dose of radiation to meningeal tissue and dose of intrathecal methotrexate. Those whose meningeal tissue received 0.01 to 9.99, 10.00 to 19.99, 20.00 to 29.99, 30.00 to 39.99 and ≥ 40 Gy had risks that were two-fold, eight-fold, 52-fold, 568-fold, and 479-fold, respectively, the risks experienced by those whose meningeal tissue was unexposed. The risk of meningioma among individuals receiving 1 to 39,40 to 69, and at least 70 mg/m2 of intrathecal methotrexate was 15-fold, 11-fold, and 36-fold, respectively, the risk experienced by those unexposed. The standardized incidence ratio for gliomas was 10.8 (95% CI, 8.5 to 13.6). The risk of glioma/primitive neuroectodermal tumors increased linearly with dose of radiation, and those who had CNS tissue exposed to at least 40 Gy experienced a risk four-fold that experienced by those who had CNS tissue unexposed. Conclusion The largest-ever study, to our knowledge, of CNS tumors in survivors of childhood cancer indicates that the risk of meningioma increases rapidly with increased dose of radiation to meningeal tissue and with increased dose of intrathecal methotrexate.

Behavioral and Social Outcomes in Adolescent Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

2007 ◽  
Vol 25 (24) ◽  
pp. 3649-3656 ◽  
Author(s):  
Kris Ann P. Schultz ◽  
Kirsten K. Ness ◽  
John Whitton ◽  
Christopher Recklitis ◽  
Brad Zebrack ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
Attention Deficit ◽  
Childhood Cancer Survivor ◽  
Social Outcomes ◽  
Cns Tumors ◽  
Antisocial Behaviors ◽  
Childhood Cancer Survivor Study ◽  
Survivors Of Childhood Cancer

Purpose Adolescents, regardless of medical history, may face behavioral and social challenges. Cancer and related treatments represent additional challenges for teens navigating the transition from childhood to adulthood. This study was conducted to evaluate behavioral and social outcomes of adolescent childhood cancer survivors using data from the Childhood Cancer Survivor Study. Patients and Methods We evaluated 2,979 survivors and 649 siblings of cancer survivors to determine the incidence of difficulty in six behavioral and social domains (depression/anxiety, headstrong, attention deficit, peer conflict/social withdrawal, antisocial behaviors, and social competence). Outcomes were determined by calculating parent-reported scores to questions from the behavior problem index. Results Survivors and siblings were similar in age at the time of interview (mean: 14.8, survivors; 14.9, siblings; range, 12 to 17 years). Overall, multivariate analyses showed that survivors were 1.5 times (99% CI, 1.1 to 2.1) more likely than siblings to have symptoms of depression/anxiety and 1.7 times (99% CI, 1.3 to 2.2) more likely to have antisocial behaviors. Scores in the depression/anxiety, attention deficit, and antisocial domains were significantly elevated in adolescents treated for leukemia or CNS tumors when compared with siblings. In addition, survivors of neuroblastoma had difficulty in the depression/anxiety and antisocial domains. Treatments with cranial radiation and/or intrathecal methotrexate were specific risk factors. Conclusion Adolescent survivors of childhood cancer, especially those with a history of leukemia, CNS tumors, or neuroblastoma, may be at increased risk for adverse behavioral and social outcomes. Increased surveillance of this population, in combination with development of interventional strategies, should be a priority.

scholarly journals Fatigue and Sleep Disturbance in Adult Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study (CCSS)

SLEEP ◽  
2008 ◽  
Vol 31 (2) ◽  
pp. 271-281 ◽  
Author(s):  
Daniel A. Mulrooney ◽  
Kirsten K. Ness ◽  
Joseph P. Neglia ◽  
John A. Whitton ◽  
Daniel M. Green ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
Adult Survivors ◽  
Childhood Cancer Survivor ◽  
Childhood Cancer Survivor Study ◽  
Survivors Of Childhood Cancer

scholarly journals Mortality After Breast Cancer Among Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

2019 ◽  
Vol 37 (24) ◽  
pp. 2120-2130 ◽  
Author(s):  
Chaya S. Moskowitz ◽  
Joanne F. Chou ◽  
Joseph P. Neglia ◽  
Ann H. Partridge ◽  
Rebecca M. Howell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
De Novo ◽  
Childhood Cancer Survivors ◽  
Childhood Cancer Survivor ◽  
Malignant Neoplasms ◽  
Childhood Cancer Survivor Study ◽  
Survivors Of Childhood Cancer

PURPOSE Female survivors of childhood cancer have a high risk of subsequent breast cancer. We describe the ensuing risk for mortality and additional breast cancers. PATIENTS AND METHODS Female participants in the Childhood Cancer Survivor Study, a cohort of 5-year survivors of cancer diagnosed between 1970 and 1986 before age 21 years, and subsequently diagnosed with breast cancer (n = 274; median age at breast cancer diagnosis, 38 years; range, 20 to 58 years) were matched to a control group (n = 1,095) with de novo breast cancer. Hazard ratios (HRs) and 95% CIs were estimated from cause-specific proportional hazards models. RESULTS Ninety-two childhood cancer survivors died, 49 as a result of breast cancer. Overall survival after breast cancer was 73% by 10 years. Subsequent risk of death as a result of any cause was higher among childhood cancer survivors than among controls (HR, 2.2; 95% CI, 1.7 to 3.0) and remained elevated after adjusting for breast cancer treatment (HR, 2.4; 95% CI, 1.7 to 3.2). Although breast cancer–specific mortality was modestly elevated among childhood cancer survivors (HR, 1.3; 95% CI, 0.9 to 2.0), survivors were five times more likely to die as a result of other health-related causes, including other subsequent malignant neoplasms and cardiovascular or pulmonary disease (HR, 5.5; 95% CI, 3.4 to 9.0). The cumulative incidence of a second asynchronous breast cancer also was elevated significantly compared with controls ( P < .001). CONCLUSION Mortality after breast cancer was higher in childhood cancer survivors than in women with de novo breast cancer. This increased mortality reflects the burden of comorbidity and highlights the need for risk-reducing interventions.

scholarly journals Impact of exercise on psychological burden in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

Cancer ◽  
2019 ◽  
Vol 125 (17) ◽  
pp. 3059-3067 ◽  
Author(s):  
Emily S. Tonorezos ◽  
Jennifer S. Ford ◽  
Linwei Wang ◽  
Kirsten K. Ness ◽  
Yutaka Yasui ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Cancer Survivor ◽  
Adult Survivors ◽  
Childhood Cancer Survivor ◽  
Psychological Burden ◽  
Childhood Cancer Survivor Study ◽  
Survivors Of Childhood Cancer

scholarly journals Behavioral, Social, and Emotional Symptom Comorbidities and Profiles in Adolescent Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

2016 ◽  
Vol 34 (28) ◽  
pp. 3417-3425 ◽  
Author(s):  
Tara M. Brinkman ◽  
Chenghong Li ◽  
Kathryn Vannatta ◽  
Jordan G. Marchak ◽  
Jin-Shei Lai ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Cancer Survivor ◽  
Late Effects ◽  
Externalizing Symptoms ◽  
Attention Problems ◽  
Childhood Cancer Survivor ◽  
Symptom Profiles ◽  
Increased Risk ◽  
Childhood Cancer Survivor Study ◽  
Survivors Of Childhood Cancer

Purpose In the general population, psychological symptoms frequently co-occur; however, profiles of symptom comorbidities have not been examined among adolescent survivors of childhood cancer. Patients and Methods Parents of 3,893 5-year survivors of childhood cancer who were treated between 1970 and 1999 and who were assessed in adolescence (age 12 to 17 years) completed the Behavior Problems Index. Age- and sex-standardized z scores were calculated for symptom domains by using the Childhood Cancer Survivor Study sibling cohort. Latent profile analysis identified profiles of comorbid symptoms, and multivariable multinomial logistic regression modeling examined associations between cancer treatment exposures and physical late effects and identified symptom profiles. Odds ratios (ORs) and 95% CIs for latent class membership were estimated and analyses were stratified by cranial radiation therapy (CRT; CRT or no CRT). Results Four symptoms profiles were identified: no significant symptoms (CRT, 63%; no CRT, 70%); elevated anxiety and/or depression, social withdrawal, and attention problems (internalizing; CRT, 31%; no CRT, 16%); elevated headstrong behavior and attention problems (externalizing; CRT, no observed; no CRT, 9%); and elevated internalizing and externalizing symptoms (global symptoms; CRT, 6%; no CRT, 5%). Treatment with ≥ 30 Gy CRT conferred greater risk of internalizing (OR, 1.7; 95% CI, 1.0 to 2.8) and global symptoms (OR, 3.2; 95% CI, 1.2 to 8.4). Among the no CRT group, corticosteroid treatment was associated with externalizing symptoms (OR, 1.9; 95% CI, 1.2 to 2.8) and ≥ 4.3 g/m2 intravenous methotrexate exposure was associated with global symptoms (OR, 1.5; 95% CI, 0.9 to 2.4). Treatment late effects, including obesity, cancer-related pain, and sensory impairments, were significantly associated with increased risk of comorbid symptoms. Conclusion Behavioral, emotional, and social symptoms frequently co-occur in adolescent survivors of childhood cancer and are associated with treatment exposures and physical late effects. Assessment and consideration of symptom profiles are essential for directing appropriate mental health treatment for adolescent survivors.

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