Long-Term Effects of Radiation Exposure among Adult Survivors of Childhood Cancer: Results from the Childhood Cancer Survivor Study

Department of Epidemiology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA.
Radiation Research (Impact Factor: 2.91). 12/2010; 174(6):840-50. DOI: 10.1667/RR1903.1
Source: PubMed


In the last four decades, advances in therapies for primary cancers have improved overall survival for childhood cancer. Currently, almost 80% of children will survive beyond 5 years from diagnosis of their primary malignancy. These improved outcomes have resulted in a growing population of childhood cancer survivors. Radiation therapy, while an essential component of primary treatment for many childhood malignancies, has been associated with risk of long-term adverse outcomes. The Childhood Cancer Survivor Study (CCSS), a retrospective cohort of over 14,000 survivors of childhood cancer diagnosed between 1970 and 1986, has been an important resource to quantify associations between radiation therapy and risk of long-term adverse health and quality of life outcomes. Radiation therapy has been associated with increased risk for late mortality, development of second neoplasms, obesity, and pulmonary, cardiac and thyroid dysfunction as well as an increased overall risk for chronic health conditions. Importantly, the CCSS has provided more precise estimates for a number of dose-response relationships, including those for radiation therapy and development of subsequent malignant neoplasms of the central nervous system, thyroid and breast. Ongoing study of childhood cancer survivors is needed to establish long-term risks and to evaluate the impact of newer techniques such as conformal radiation therapy or proton-beam therapy.

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    • "Anthracycline chemotherapy can lead to dilated cardiomyopathy and heart failure[12]. Mediastinal radiotherapy is associated with heart failure, premature coronary artery disease, pericardial injury, arrhythmias, and valvular abnormalities[13,14]. Determination of left ventricular ejection fraction (LVEF) by two-dimensional (2D) transthoracic echocardiography is the primary modality used to screen for LV systolic dysfunction. "
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    Full-text · Article · Jun 2014 · BMC Cancer
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