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Late effects of childhood cancer

Francesca Bagnasco, Silvia Caruso, Anita Andreano, Maria Grazia Valsecchi, Momcilo Jankovic, Andrea Biondi, Lucia Miligi, Claudia Casella, Monica Terenziani, Maura Massimino, Carlotta Sacerdote, Vera Morsellino, Giovanni Erminio, Alberto Garaventa, Maura Faraci, Concetta Micalizzi, Maria Luisa Garrè, Marta Pillon, Giuseppe Basso, Eleonora Biasin, Franca Fagioli, Roberto Rondelli, Andrea Pession, Franco Locatelli, Nicola Santoro, Paolo Indolfi, Giovanna Palumbo, Giovanna Russo, Federico Verzegnassi, Claudio Favre, Marco Zecca, Rossella Mura, Paolo D'Angelo, Carmen Cano, Julianne Byrne, Riccardo Haupt
INTRODUCTION: Advances in paediatric oncology led to the increase in long-term survival, revealing the burden of therapy-related long-term side effects. We evaluated overall and cause-specific mortality in a large cohort of Italian childhood cancer survivors (CCSs) and adolescent cancer survivors identified through the off-therapy registry. MATERIALS AND METHODS: CCSs alive 5 years after cancer diagnosis occurring between 1960 and 1999 were eligible; the last follow-up was between 2011 and 2014...
February 14, 2019: European Journal of Cancer
E Juliana Paré-Blagoev, Kathy Ruble, Camille Bryant, Lisa Jacobson
OBJECTIVE: Schooling after treatment can hold challenges for survivors of childhood cancer and caregivers who may need to act as advocates on their behalf. This study seeks to understand caregiver experiences of survivor's school-related challenges. This understudied area is critical given the 85% survivor rate for those diagnosed with childhood cancer and the disproportionate risk of learning difficulties faced by those with brain tumor or who receive therapy that targets the central nervous system...
February 13, 2019: Psycho-oncology
Anna J Janss, Claire Mazewski, Briana Patterson
Pathologies of pediatric brain tumors are more varied than those diagnosed in adults and survival outcomes more optimistic. Therapies for pediatric brain tumors are also diverse and treatment options are expanding. The growing number of adult survivors of childhood brain tumors is quite diverse. Medical management of these adults requires understanding the tumor diagnosis and location, the modalities used to treat the tumor, the age of the survivor at the time of diagnosis and treatment, any complications of treatment, and, most importantly, the baseline medical condition and neurological function of each adult survivor...
February 9, 2019: Current Treatment Options in Oncology
Matthew J Ehrhardt, Jessica Hochberg, Kari L Bjornard, Tara M Brinkman
Progress in overall survival rates for childhood non-Hodgkin lymphoma (NHL) can be largely attributed to effective development and conduct of a number of international treatment studies. Knowledge gained from these studies has shifted the treatment paradigm from a "one-size fits all" strategy to a histologically dependent approach. More specifically, many now adhere to a risk-stratified approach, prescribing cumulative doses and intensities of chemotherapeutic exposures based upon the aggressiveness of disease...
February 3, 2019: British Journal of Haematology
Taryn Dora Treger, Tanzina Chowdhury, Kathy Pritchard-Jones, Sam Behjati
Wilms tumour is the most common renal malignancy of childhood. The disease is curable in the majority of cases, albeit at considerable cost in terms of late treatment-related effects in some children. However, one in ten children with Wilms tumour will die of their disease despite modern treatment approaches. The genetic changes that underpin Wilms tumour have been defined by studies of familial cases and by unbiased DNA sequencing of tumour genomes. Together, these approaches have defined the landscape of cancer genes that are operative in Wilms tumour, many of which are intricately linked to the control of fetal nephrogenesis...
January 31, 2019: Nature Reviews. Nephrology
Jiaoyang Cai, Jie Yu, Xiaofan Zhu, Shaoyan Hu, Yiping Zhu, Hua Jiang, Chunfu Li, Yongjun Fang, Changda Liang, Xiuli Ju, Xin Tian, Xiaowen Zhai, Jinjin Hao, Qun Hu, Ningling Wang, Hui Jiang, Lirong Sun, Chi Kong Li, Kaili Pan, Minghua Yang, Shuhong Shen, Cheng Cheng, Raul C Ribeiro, Ching-Hon Pui, Jingyan Tang
OBJECTIVES: Before 2003, most children with acute lymphoblastic leukaemia (ALL) abandoned treatment, with only approximately 30% treated in China. With the development of national insurance for underprivileged patients, we assessed the current frequency and causes of treatment abandonment among patients with ALL who were enrolled in the Chinese Children's Cancer Group ALL protocol between 2015 and 2016. METHODS: Demographic, clinical and laboratory data on patients who abandoned treatment, as well as economic and sociocultural data of their families were collected and analysed...
January 31, 2019: Archives of Disease in Childhood
Elizabeth A M Feijen, Wendy M Leisenring, Kayla L Stratton, Kirsten K Ness, Helena J H van der Pal, Elvira C van Dalen, Gregory T Armstrong, Gregory J Aune, Daniel M Green, Melissa M Hudson, Jacqueline Loonen, Kevin C Oeffinger, Leslie L Robison, Yutaka Yasui, Leontien C M Kremer, Eric J Chow
Importance: Anthracyclines are part of many effective pediatric cancer treatment protocols. Most pediatric oncology treatment groups assume that the hematologic toxicity of anthracycline agents is equivalent to their cardiotoxicity; for example, Children's Oncology Group substitution rules consider daunorubicin and epirubicin isoequivalent to doxorubicin, whereas mitoxantrone and idarubicin are considered 4 to 5 times as toxic as doxorubicin. Objective: To determine optimal dose equivalence ratios for late-onset cardiomyopathy between doxorubicin and other anthracyclines or the anthraquinone mitoxantrone...
January 31, 2019: JAMA Oncology
Anne-Lotte L F van der Kooi, Marry M van den Heuvel-Eibrink, Sjoerd A A van den Berg, Wendy van Dorp, Saskia M F Pluijm, Joop S E Laven
PURPOSE: Diminished reproductive function can be a major late effect of childhood cancer treatment. This study evaluates the changes, and occurrence of possible recovery, in gonadal function markers in children treated for cancer. METHODS: Gonadal function markers were measured before (T0), directly after (T1), and 1 year after (T2) end of treatment of childhood cancer. Anti-Müllerian hormone (AMH) was measured in girls and inhibin B in boys and compared to reference populations...
January 31, 2019: Journal of Adolescent and Young Adult Oncology
Nathalie Auger, Caroline Laverdière, Aimina Ayoub, Ernest Lo, Thuy Mai Luu
We sought to determine if neonatal phototherapy is associated with a greater risk of childhood cancer. We conducted a retrospective cohort study of 786,998 infants born in hospitals of Quebec, Canada between 2006 and 2016, with 4,660,868 person-years of follow-up over an 11-year period. The exposures were neonatal phototherapy (32,314 or 4.1% of infants) and untreated jaundice (91,855 or 11.7% of infants). The outcome was hospitalization for solid or hematopoietic childhood tumours between 2 months and 11 years of age...
January 26, 2019: International Journal of Cancer. Journal International du Cancer
Hyewon Shin, Robin Bartlett, Jennie C De Gagne
PROBLEM: Adolescence is a critical developmental period, but little research is available on the quality of life for individuals ages 10-19, especially those who have faced a life-threatening illness. This integrative review examines factors related to quality of life among survivors of a childhood cancer that occurred during adolescence. ELIGIBILITY CRITERIA: The Garrard Matrix Method guided this review of studies that were conducted from 1990 to 2017. Studies were eligible if participants were diagnosed with cancer during adolescence, the studies followed survivorship from cancer diagnosis to treatment completion, and health-related quality of life measures were taken...
January 2019: Journal of Pediatric Nursing
L S Constine, C M Ronckers, C-H Hua, A Olch, L C M Kremer, A Jackson, S M Bentzen
With advances in multimodality therapy, childhood cancer cure rates approach 80%. However, both radiotherapy and chemotherapy can cause debilitating or even fatal late adverse events that are critical to understand, mitigate or prevent. QUANTEC (Quantitative Analysis of Normal Tissue Effects in the Clinic) identified radiation dose constraints for normal tissues in adults and pointed out the uncertainties in those constraints. The range of adverse events seen in children is different from that in adults, in part due to the vulnerability/characteristics of radiation damage to developing tissues, and in part due to the typical body sites affected by childhood cancer that lead to collateral irradiation of somewhat different normal tissues and organs compared with adults...
January 19, 2019: Clinical Oncology: a Journal of the Royal College of Radiologists
Vicky Lehmann, Amanda C Ferrante, Adrien M Winning, Cynthia A Gerhardt
OBJECTIVE: To examine whether adult survivors of childhood cancer perceive a direct impact of potential/confirmed infertility on their romantic relationships/singlehood. METHODS: Open-ended qualitative phone interviews were conducted with 57 adult survivors of childhood cancer and analyzed through thematic content analysis until saturation was reached (N = 30). RESULTS: Interviews revealed three major themes: (1) impact on survivors, (2) impact on partners/romantic relationships, and (3) alternative routes to parenthood...
January 21, 2019: Psycho-oncology
V G Pluimakers, M van Waas, S J C M M Neggers, M M van den Heuvel-Eibrink
Over the past decades, survival rates of childhood cancer have increased considerably from 5 to 30% in the early seventies to current rates exceeding 80%. This is due to the development of effective chemotherapy, surgery, radiotherapy and stem cell transplantation, combined with an optimized stratification of therapy and better supportive care regimens. As a consequence, active surveillance strategies of late sequelae have been developed to improve the quality of survival. Several epidemiological studies have reported an increased incidence of (components of) metabolic syndrome (MetS) and cardiovascular disease in childhood cancer survivors (CCS)...
January 2019: Critical Reviews in Oncology/hematology
Kamakshi Dandu, Prathap Reddy Kallamadi, Suman S Thakur, Ch Mohan Rao
Retinoblastoma is the intraocular malignancy that occurs during early childhood. The current standard of care includes chemotherapy followed by focal consolidative therapies, and enucleation. Unfortunately, these are associated with many side and late effects. New drugs and/or drug combinations need to be developed for safe and effective treatment. This compelling need stimulated efforts to explore drug repurposing for retinoblastoma. While conventional drug development is a lengthy and expensive process, drug repurposing is a faster, alternate approach, where an existing drug, not meant for treating cancer, can be repurposed to treat retinoblastoma...
January 19, 2019: Current Topics in Medicinal Chemistry
Jennifer L Lee, Ana Gutierrez-Colina, Rebecca Williamson Lewis, Karen Wasilewski-Masker, Lillian R Meacham, Ann C Mertens, Jordan Gilleland Marchak
Objective: This study aimed to examine the level and predictors of knowledge of late effects risks from childhood cancer treatment in adolescent and young adult (AYA) survivors. Methods: Seventy-three AYAs, aged 14-21, completed measures of knowledge of late effect risks, executive functioning, and responsibility for health self-management. Sixty-seven parents of these AYA survivors (91.7%) also participated. Results: Survivors demonstrated poor knowledge of their unique risks for treatment-related late effects, with a mean accurate knowledge score of 54...
January 8, 2019: Journal of Pediatric Psychology
Eva Clemens, Marry M van den Heuvel-Eibrink, Renée L Mulder, Leontien C M Kremer, Melissa M Hudson, Roderick Skinner, Louis S Constine, Johnnie K Bass, Claudia E Kuehni, Thorsten Langer, Elvira C van Dalen, Edith Bardi, Nicolas-Xavier Bonne, Penelope R Brock, Beth Brooks, Bruce Carleton, Eric Caron, Kay W Chang, Karen Johnston, Kristin Knight, Paul C Nathan, Etan Orgel, Pinki K Prasad, Jan Rottenberg, Katrin Scheinemann, Andrica C H de Vries, Thomas Walwyn, Annette Weiss, Antoinette Am Zehnhoff-Dinnesen, Richard J Cohn, Wendy Landier
Childhood, adolescent, and young adult (CAYA) cancer survivors treated with platinum-based drugs, head or brain radiotherapy, or both have an increased risk of ototoxicity (hearing loss, tinnitus, or both). To ensure optimal care and reduce consequent problems-such as speech and language, social-emotional development, and learning difficulties-for these CAYA cancer survivors, clinical practice guidelines for monitoring ototoxicity are essential. The implementation of surveillance across clinical settings is hindered by differences in definitions of hearing loss, recommendations for surveillance modalities, and remediation...
January 2019: Lancet Oncology
E A M Lieke Feijen, Anna Font-Gonzalez, Helena J H Van der Pal, Wouter E M Kok, Ronald B Geskus, Cécile M Ronckers, Dorine Bresters, Elvira C van Dalen, Eline van Dulmen-den Broeder, Marleen H van den Berg, Margriet van der Heiden-van der Loo, Marry M van den Heuvel-Eibrink, Flora E van Leeuwen, Jacqueline J Loonen, Sebastian J C M M Neggers, A B Birgitta Versluys, Wim J E Tissing, Leontien C M Kremer
Background Heart failure is one of the most important late effects after treatment for cancer in childhood. The goals of this study were to evaluate the risk of heart failure, temporal changes by treatment periods, and the risk factors for heart failure in childhood cancer survivors ( CCS ). Methods and Results The DCOG-LATER (Dutch Childhood Oncology Group-Long-Term Effects After Childhood Cancer) cohort includes 6,165 5-year CCS diagnosed between 1963 and 2002. Details on prior cancer diagnosis and treatment were collected for this nationwide cohort...
January 8, 2019: Journal of the American Heart Association
Lixian Oh, Hind Hafsi, Pierre Hainaut, Hany Ariffin
PURPOSE OF REVIEW: Childhood blastomas, unlike adult cancers, originate from developing organs in which molecular and cellular features exhibit differentiation arrest and embryonic characteristics. Conventional cancer therapies, which rely on the generalized cytotoxic effect on rapidly dividing cells, may damage delicate organs in young children, leading to multiple late effects. Deep understanding of the biology of embryonal cancers is crucial in reshaping the cancer treatment paradigm for children...
December 24, 2018: Current Opinion in Oncology
Camilla T Clausen, Henrik Hasle, Anna S Holmqvist, Laura Madanat-Harjuoja, Laufey Tryggvadottir, Finn Wesenberg, Andrea Bautz, Jeanette F Winther, Sofie de Fine Licht
BACKGROUND: Hyperthyroidism is a rare disorder which may negatively affect health and quality of life. Its occurrence in childhood cancer survivors has not previously been investigated in detail. MATERIAL AND METHODS: In the hospital registers of the five Nordic countries, 32,944 childhood cancer survivors and 212,675 population comparisons were followed for the diagnosis of hyperthyroidism. Hospitalisation rates, standardised hospitalisation rate ratios and absolute excess risks were calculated with 95% confidence intervals (CI)...
December 26, 2018: Acta Oncologica
Anna S Holmqvist, Yanjun Chen, Jennifer Berano Teh, Canlan Sun, Jillian M Birch, Cor van den Bos, Lisa R Diller, Kimberley Dilley, Jill Ginsberg, Laura T Martin, Rajaram Nagarajan, Paul C Nathan, Joseph P Neglia, Monica Terenziani, David Tishler, Anna T Meadows, Leslie L Robison, Odile Oberlin, Smita Bhatia
BACKGROUND: Survivors of Hodgkin lymphoma (HL) in childhood have an increased risk of subsequent malignant neoplasms (SMNs). Herein, the authors extended the follow-up of a previously reported Late Effects Study Group cohort and identified patients at highest risk for SMNs to create evidence for risk-based screening recommendations. METHODS: The standardized incidence ratio was calculated using rates from the Surveillance, Epidemiology, and End Results program as a reference...
December 17, 2018: Cancer
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