Ocular late effects in childhood and adolescent cancer survivors: A report from the Childhood Cancer Survivor Study Journal Article
| Authors: | Whelan, K. F.; Stratton, K.; Kawashima, T.; Waterbor, J. W.; Castleberry, R. P.; Stovall, M.; Sklar, C. A.; Packer, R. J.; Mitby, P.; Aitken, C. L.; Blatt, J.; Robison, L. L.; Mertens, A. C. |
| Article Title: | Ocular late effects in childhood and adolescent cancer survivors: A report from the Childhood Cancer Survivor Study |
| Abstract: | Introduction. Approximately 80% of children currently survive 5 years following diagnosis of their cancer. Studies based on limited data have implicated certain cancer therapies in the development of ocular sequelae in these survivors. Procedure. The Childhood Cancer Survivor Study (CCSS) is a retrospective cohort study investigating health outcomes of 5+ year survivors diagnosed and treated between 1970 and 1986 compared to a sibling cohort. The baseline questionnaire included questions about the first occurrence of six ocular conditions. Relative risks (RR) and 95% confidence intervals (CI) were calculated from responses of 14,362 survivors and 3,901 siblings. Results. Five or more years from the diagnosis, survivors were at increased risk of cataracts (RR: 10.8; 95% CI: 6.2-18.9), glaucoma (RR: 2.5; 95% CI: 1.1-5.7), legal blindness (RR: 2.6; 95% CI: 1.7-4.0), double vision (RR: 4.1; 95% CI: 2.7-6.1), and dry eyes (RR: 1.9; 95% CI: 1.6-2.4), when compared to siblings. Dose of radiation to the eye was significantly associated with risk of cataracts, legal blindness, double vision, and dry eyes, in a dose-dependent manner. Risk of cataracts were also associated with radiation 3,000+cGy to the posterior fossa (RR: 8.4; 95% CI: 5.0-14.3), temporal lobe (RR: 9.4; 95% CI: 5.6-15.6), and exposure to prednisone (RR: 2.3; 95% CI: 1.6-3.4). Conclusions. Childhood cancer survivors are at risk of developing late occurring ocular complications, with exposure to glucocorticoids and cranial radiation being important determinants of increased risk. Long-term follow-up is needed to evaluate potential progression of ocular deficits and impact on quality of life. © 2009 Wiley-Liss, Inc. |
| Keywords: | adolescent; adult; child; controlled study; preschool child; child, preschool; middle aged; leukemia; survival rate; retrospective studies; young adult; major clinical study; busulfan; prednisone; clinical trial; mortality; cancer radiotherapy; radiation dose; chemotherapy; brain radiation; outcome assessment; cancer diagnosis; neoplasm; neoplasms; disease association; cohort analysis; dexamethasone; drug effect; radiation injury; retrospective study; risk factor; central nervous system tumor; childhood cancer; hodgkin disease; survivor; cancer survivor; questionnaires; survivors; confidence interval; questionnaire; nonhodgkin lymphoma; kidney tumor; temporal lobe; infant; infant, newborn; neuroblastoma; neoplasms, radiation-induced; multicenter study; newborn; radiation injuries; soft tissue sarcoma; glucocorticoid; cataract; radiation therapy; health; eye disease; glaucoma; sibling; diplopia; dry eye; blindness; drug exposure; eye; glucocorticoids; radiation induced neoplasm; eye diseases; posterior fossa; late effects of cancer therapy; retina disease |
| Journal Title: | Pediatric Blood and Cancer |
| Volume: | 54 |
| Issue: | 1 |
| ISSN: | 1545-5009 |
| Publisher: | Wiley Periodicals, Inc |
| Date Published: | 2010-01-01 |
| Start Page: | 103 |
| End Page: | 109 |
| Language: | English |
| DOI: | 10.1002/pbc.22277 |
| PUBMED: | 19774634 |
| PROVIDER: | scopus |
| PMCID: | PMC2783513 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 20 April 2011" - "CODEN: PBCEA" - "Source: Scopus" |
