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Radiation dose, chemotherapy and risk of osteosarcoma after solid tumours during childhood
Author(s) -
Le Vu Béatrice,
de Vathaire Florent,
Shamsaldin Akhtar,
Hawkins Michael M.,
Grimaud Emmanuel,
Hardiman Claire,
Diallo Ibrahima,
Vassal Gilles,
Bessa Elhadie,
Campbell Sarah,
Panis Xavier,
DalySchveitzer Nicolas,
Lagrange JeanLéon,
Zucker JeanMichel,
Eschwège François,
Chavaudra Jean,
Lemerle Jean
Publication year - 1998
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/(sici)1097-0215(19980729)77:3<370::aid-ijc11>3.0.co;2-c
Subject(s) - osteosarcoma , medicine , sarcoma , cohort , cancer , radiation therapy , chemotherapy , incidence (geometry) , cumulative incidence , bone cancer , cumulative dose , oncology , surgery , pediatrics , pathology , physics , optics
Osteosarcoma is the most frequent second primary cancer occurring during the first 20 years following treatment for a solid cancer in childhood. Using a cohort study of children treated for a solid cancer, we investigated the incidence and etiology of osteosarcoma as a second malignant neoplasm after childhood cancer in a cohort and a case‐control study. We analysed the relationship between the local dose of radiation and the risk of osteosarcoma, taking into account chemotherapy received. A cohort study of 4,400 3‐year survivors of a first solid cancer during childhood diagnosed in France or the United Kingdom, between 1942 and 1986, revealed 32 subsequent osteosarcomas. In a nested case‐control study, we matched 32 cases and 160 controls for sex, type of first cancer, age at first cancer and the duration of follow‐up. Parameters studied were the incidence of osteosarcoma, the cumulative local dose of irradiation and the cumulative dose of chemotherapy received by cases and controls. The risk of a osteosarcoma was found to be a linear function of the local dose of radiation (excess relative risk per gray = 1.8), and was found to increase with the number of moles of electrophilic agents per square meter but not with other drugs. No interaction was noted between radiotherapy and chemotherapy. Bilateral retinoblastoma, Ewing's sarcoma and soft tissue sarcoma were found to render patients susceptible to a higher risk of developing an osteosarcoma as a second malignant neoplasm. We recommend long‐term surveillance of patients who were treated during childhood for bilateral retinoblastoma, Ewing's sarcoma, soft tissue sarcoma, as well as other first cancer treated with radiotherapy plus high doses of chemotherapy, without focusing exclusively on the radiation field. Int. J. Cancer 77:370–377, 1998. © 1998 Wiley‐Liss, Inc.