Long-term morbidity and mortality among survivors of neuroblastoma diagnosed during infancy: A report from the Childhood Cancer Survivor Study Journal Article
| Authors: | Friedman, D. N.; Goodman, P. J.; Leisenring, W. M.; Diller, L. R.; Cohn, S. L.; Howell, R. M.; Smith, S. A.; Tonorezos, E. S.; Wolden, S. L.; Neglia, J. P.; Ness, K. K.; Gibson, T. M.; Nathan, P. C.; Weil, B. R.; Robison, L. L.; Oeffinger, K. C.; Armstrong, G. T.; Sklar, C. A.; Henderson, T. O. |
| Article Title: | Long-term morbidity and mortality among survivors of neuroblastoma diagnosed during infancy: A report from the Childhood Cancer Survivor Study |
| Abstract: | PURPOSETo describe the risk of late mortality, subsequent malignant neoplasms (SMNs), and chronic health conditions (CHCs) in survivors of neuroblastoma diagnosed in infancy by treatment era and exposures.METHODSAmong 5-year survivors of neuroblastoma in the Childhood Cancer Survivor Study diagnosed age < 1 year between 1970 and 1999, we examined the cumulative incidence of late (> 5 years from diagnosis) mortality, SMN, and CHCs (grades 2-5 and 3-5). Multivariable Cox regression models estimated hazard ratios (HRs) and 95% CIs by decade and treatment (surgery-alone v chemotherapy with or without surgery [C ± S] v radiation with or without chemotherapy ± surgery [R ± C ± S]) among survivors and between survivors and 5,051 siblings.RESULTSAmong 1,397 eligible survivors, the 25-year cumulative incidence of late mortality was 2.1% (95% CI, 1.3 to 3.9) with no difference by treatment era. Among 990 participants who completed a baseline survey, fewer survivors received radiation in more recent eras (51.2% 1970s, 20.4% 1980s, and 10.1% 1990s; P <.001). Risk of SMN was elevated only among individuals treated with radiation-containing regimens compared with surgery alone (HR[C ± S], 3.2 [95% CI, 0.9 to 11.6]; HR[R ± C ± S], 5.7 [95% CI, 1.2 to 28.1]). In adjusted models, there was a 50% reduction in risk of grade 3-5 CHCs in the 1990s versus 1970s (HR, 0.5 [95% CI, 0.3 to 0.9]; P =.01); individuals treated with radiation had a 3.6-fold risk for grade 3-5 CHCs (95% CI, 2.1 to 6.2) versus those treated with surgery alone. When compared with siblings, risk of grade 3-5 CHCs for survivors was lowest in the most recent era (HR[1970s], 4.7 [95% CI, 3.4 to 6.5]; HR[1980s], 4.6 [95% CI, 3.3 to 6.4]; HR[1990s], 2.5 [95% CI, 1.7 to 3.9]).CONCLUSIONNeuroblastoma survivors treated during infancy have a relatively low absolute burden of late mortality and SMN. Encouragingly, risk of CHCs has declined in more recent eras with reduced exposure to radiation therapy. © American Society of Clinical Oncology. |
| Keywords: | child; retrospective studies; incidence; morbidity; retrospective study; survivor; cancer survivor; survivors; infant; neuroblastoma; neoplasms, second primary; second cancer; cancer survivors; humans; human |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 41 |
| Issue: | 8 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2023-03-10 |
| Start Page: | 1565 |
| End Page: | 1576 |
| Language: | English |
| DOI: | 10.1200/jco.22.01732 |
| PUBMED: | 36525618 |
| PROVIDER: | scopus |
| PMCID: | PMC10043581 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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