Late-occurring stroke among long-term survivors of childhood leukemia and brain tumors: A report from the Childhood Cancer Survivor Study Journal Article

  

Authors:	Bowers, D. C.; Liu, Y.; Leisenring, W.; McNeil, E.; Stovall, M.; Gurney, J. G.; Robison, L. L.; Packer, R. J.; Oeffinger, K. C.
Article Title:	Late-occurring stroke among long-term survivors of childhood leukemia and brain tumors: A report from the Childhood Cancer Survivor Study
Abstract:	Purpose This report examines the incidence of and risk factors for strokes that occur in >= 5-year survivors of childhood leukemia and brain tumors. Patients and Methods The rate of first occurrence of self-reported late-occurring strokes was determined for leukemia survivors (n = 4,828), brain tumor survivors (n = 1,871), and a comparison group of a random sample of cancer survivor siblings (n = 3,846). Relative risks (RRs) and 95% confidence intervals (Cls) of stroke by treatment exposures were examined by multivariate analyses. Results Thirty-seven leukemia survivors and 63 brain tumor survivors reported a late-occurring stroke. The rate of late-occurring stroke for leukemia survivors was 57.9 per 100,000 person-years (95% Cl, 41.2 to 78.7). The BR of stroke for leukemia survivors compared with the sibling comparison group was 6.4 (95% Cl, 3.0 to 13.8, P <.0001). The rate of late-occurring stroke for brain tumor survivors was 267.6 per 100,000 person-years (95% Cl, 206.8 to 339.2). The RR of stroke for brain tumor survivors compared with the sibling comparison group was 29.0 (95% Cl, 13.8 to 60.6; P <.0001). Mean cranial radiation therapy (CRT) dose of >= 30 Gy was associated with an increased risk in both leukemia and brain tumor survivors in a dose-dependent fashion, with the highest risk after doses of >= 50 Gy CRT. Conclusion Survivors of childhood leukemia and brain tumors, particularly those with brain tumors treated with CRT at doses of greater than 30 Gy, are at an increased risk of stroke.
Keywords:	glioma; children; vasculopathy; radiation-therapy; acute lymphoblastic-leukemia; young-adults; sequelae; ischemic-stroke
Journal Title:	Journal of Clinical Oncology
Volume:	24
Issue:	33
ISSN:	0732-183X
Publisher:	American Society of Clinical Oncology
Date Published:	2006-11-20
Start Page:	5277
End Page:	5282
Language:	English
ACCESSION:	WOS:000242342800015
DOI:	10.1200/jco.2006.07.2884
PROVIDER:	wos
PUBMED:	17088567
Notes:	--- - Article; Proceedings Paper - 41st Annual Meeting of the American-Society-of-Clinical-Oncology - MAY 13-17, 2005 - Orlando, FL - "Source: Wos"

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