Long-term health status among survivors of childhood cancer: Does sex matter? Journal Article


Authors: Armstrong, G. T.; Sklar, C. A.; Hudson, M. M.; Robison, L. L.
Article Title: Long-term health status among survivors of childhood cancer: Does sex matter?
Abstract: Increasing numbers of children diagnosed with cancer will survive their primary malignancy. Within this growing population of long-term survivors, considerable effort has been put forth to identify treatment-related risks for adverse health-related outcomes, such as exposure to alkylating agents, anthracyclines, radiotherapy, and surgery. Patient sex has been identified as a risk factor for numerous long-term adverse outcomes, with female sex more commonly associated with higher risks. In this article, we review the literature, which generally supports associations between female sex and cognitive dysfunction after cranial irradiation, cardiovascular outcomes, obesity, radiation-associated differences in pubertal timing, development of primary hypothyroidism, breast cancer as a second malignant neoplasm and suggests an increased prevalence for the development of osteonecrosis among females. Results of this review support future investigations to further define sex as a risk factor for other common treatment-specific exposures and outcomes. Additionally, research should focus on understanding the underlying biologic and physiological basis of these sex-specific risks. Historically, evidence from both basic science and clinical research has been used to develop risk-stratified therapy, allowing reduction of toxic therapies to low-risk patients without compromising overall survival. With greater knowledge of sex-specific risks, the potential application of sex-specific therapy designed to avoid poor long-term adverse outcomes may become a viable strategy.
Keywords: body-mass index; acute lymphoblastic-leukemia; hodgkins-disease; central-nervous-system; clinical; growth-hormone deficiency; 2nd malignant neoplasms; heart-failure; acute lymphocytic-leukemia; late anthracycline cardiotoxicity; induced thyroid-cancer
Journal Title: Journal of Clinical Oncology
Volume: 25
Issue: 28
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2007-10-01
Start Page: 4477
End Page: 4489
Language: English
ACCESSION: WOS:000251073300024
DOI: 10.1200/jco.2007.11.2003
PROVIDER: wos
PUBMED: 17906209
Notes: --- - Review - "Source: Wos"
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  1. Charles A Sklar
    319 Sklar