Benign and malignant pulmonary parenchymal findings on chest CT among adult survivors of childhood and young adult cancer with a history of chest radiotherapy Journal Article
| Authors: | Barnea, D.; Tonorezos, E. S.; Khan, A.; Chou, J. F.; Moskowitz, C. S.; Kaplan, R.; Wolden, S. L.; Bryce, Y.; Oeffinger, K. C. |
| Article Title: | Benign and malignant pulmonary parenchymal findings on chest CT among adult survivors of childhood and young adult cancer with a history of chest radiotherapy |
| Abstract: | Purpose: Childhood and young adult cancer survivors exposed to chest radiotherapy are at increased risk of lung cancer. In other high-risk populations, lung cancer screening has been recommended. Data is lacking on prevalence of benign and malignant pulmonary parenchymal abnormalities in this population. Methods: We conducted a retrospective review of pulmonary parenchymal abnormalities in chest CTs performed more than 5 years post-cancer diagnosis in survivors of childhood, adolescent, and young adult cancer. We included survivors exposed to radiotherapy involving the lung field and followed at a high-risk survivorship clinic between November 2005 and May 2016. Treatment exposures and clinical outcomes were abstracted from medical records. Risk factors for chest CT–detected pulmonary nodule were assessed. Results: Five hundred and ninety survivors were included in this analysis: median age at diagnosis, 17.1 years (range, 0.4–39.8); and median time since diagnosis, 22.3 years (range, 1–58.6). At least one chest CT more than 5 years post-diagnosis was performed in 338 survivors (57%). Among these, 193 (57.1%) survivors had at least one pulmonary nodule detected on a total of 1057 chest CTs, resulting in 305 CTs with 448 unique nodules. Follow-up was available for 435 of these nodules; 19 (4.3%) were malignant. Risk factors for first pulmonary nodule were older age at time of CT, CT performed more recently, and splenectomy. Conclusions: Benign pulmonary nodules are very common among long-term survivors of childhood and young adult cancer. Implications for Cancer Survivors: High prevalence of benign pulmonary nodules in cancer survivors exposed to radiotherapy could inform future guidelines on lung cancer screening in this population. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. |
| Keywords: | adolescent; adult; child; preschool child; child, preschool; retrospective studies; young adult; mortality; neoplasm; neoplasms; lung neoplasms; radiotherapy; lung cancer; tomography, x-ray computed; diagnostic imaging; retrospective study; cancer survivor; lung tumor; infant; epidemiology; cancer survivors; adverse event; chest ct; humans; human; male; female; pulmonary nodule; x-ray computed tomography |
| Journal Title: | Journal of Cancer Survivorship |
| Volume: | 18 |
| Issue: | 5 |
| ISSN: | 1932-2259 |
| Publisher: | Springer |
| Date Published: | 2024-10-01 |
| Start Page: | 1657 |
| End Page: | 1664 |
| Language: | English |
| DOI: | 10.1007/s11764-023-01405-1 |
| PUBMED: | 37209240 |
| PROVIDER: | scopus |
| PMCID: | PMC11973493 |
| DOI/URL: | |
| Notes: | Source: Scopus |
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