PMID- 20137867
OWN - NLM
STAT- MEDLINE
DCOM- 20100929
LR  - 20100913
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 78
IP  - 2
DP  - 2010 Oct 1
TI  - Evaluation of late adverse events in long-term wilms' tumor survivors.
PG  - 370-8
LID - 10.1016/j.ijrobp.2009.08.016 [doi]
AB  - PURPOSE: To evaluate the prevalence and severity of adverse events (AEs) and 
      treatment-related risk factors in long-term Wilms' tumor (WT) survivors, with 
      special attention to radiotherapy. METHODS AND MATERIALS: The single-center study 
      cohort consisted of 185 WT survivors treated between 1966 and 1996, who survived 
      at least 5 years after diagnosis. All survivors were invited to a late-effects 
      clinic for medical assessment of AEs. AEs were graded for severity in a 
      standardized manner. Detailed radiotherapy data enabled us to calculate the 
      equivalent dose in 2 Gy fractions (EQD(2)) to compare radiation doses in a 
      uniform way. Risk factors were evaluated with multivariate logistic regression 
      analysis. RESULTS: Medical follow-up was complete for 98% of survivors (median 
      follow-up, 18.9 years; median attained age, 22.9 years); 123 survivors had 462 
      AEs, of which 392 had Grade 1 or 2 events. Radiotherapy to flank/abdomen 
      increased the risk of any AE (OR, 1.08 Gy(-1) [CI, 1.04-1.13]). Furthermore, 
      radiotherapy to flank/abdomen was associated with orthopedic events (OR, 1.09 
      Gy(-1) [CI, 1.05-1.13]) and second tumors (OR, 1.11 Gy(-1) [CI, 1.03-1.19]). 
      Chest irradiation increased the risk of pulmonary events (OR, 1.14 Gy(-1) [CI, 
      1.06-1.21]). Both flank/abdominal and chest irradiation were associated with 
      cardiovascular events (OR, 1.05 Gy(-1) [CI, 1.00-1.10], OR, 1.06 Gy(-1) [CI, 
      1.01-1.12]) and tissue hypoplasia (OR, 1.17 Gy(-1) [CI, 1.10-1.24], OR 1.10 
      Gy(-1) [CI, 1.03-1.18]). CONCLUSION: The majority of AEs, overall as well as in 
      irradiated survivors, were mild to moderate. Nevertheless, the large amount of 
      AEs emphasizes the importance of follow-up programs for WT survivors.
CI  - 2010 Elsevier Inc. All rights reserved.
FAU - van Dijk, Irma W E M
AU  - van Dijk IW
AD  - Department of Radiation Oncology, Academic Medical Center, Amsterdam, the 
      Netherlands. i.w.vandijk@amc.uva.nl
FAU - Oldenburger, Foppe
AU  - Oldenburger F
FAU - Cardous-Ubbink, Mathilde C
AU  - Cardous-Ubbink MC
FAU - Geenen, Maud M
AU  - Geenen MM
FAU - Heinen, Richard C
AU  - Heinen RC
FAU - de Kraker, Jan
AU  - de Kraker J
FAU - van Leeuwen, Flora E
AU  - van Leeuwen FE
FAU - van der Pal, Helena J H
AU  - van der Pal HJ
FAU - Caron, Huib N
AU  - Caron HN
FAU - Koning, Caro C E
AU  - Koning CC
FAU - Kremer, Leontien C M
AU  - Kremer LC
LA  - eng
PT  - Journal Article
DEP - 20100204
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
RN  - 0 (Anthracyclines)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Anthracyclines/*adverse effects
MH  - Bone and Bones/radiation effects
MH  - Cardiovascular System/drug effects/radiation effects
MH  - Child
MH  - Child, Preschool
MH  - Epidemiologic Factors
MH  - Fertility/radiation effects
MH  - Humans
MH  - Infant
MH  - Kidney/radiation effects
MH  - Kidney Neoplasms/mortality/*radiotherapy
MH  - Lung/radiation effects
MH  - Neoplasms, Radiation-Induced/epidemiology
MH  - Neoplasms, Second Primary/epidemiology
MH  - Radiation Injuries/classification/*epidemiology/mortality
MH  - Radiotherapy Dosage
MH  - Severity of Illness Index
MH  - *Survivors
MH  - Wilms Tumor/mortality/*therapy
MH  - Young Adult
EDAT- 2010/02/09 06:00
MHDA- 2010/09/30 06:00
CRDT- 2010/02/09 06:00
PHST- 2009/04/27 00:00 [received]
PHST- 2009/07/31 00:00 [revised]
PHST- 2009/08/04 00:00 [accepted]
PHST- 2010/02/09 06:00 [entrez]
PHST- 2010/02/09 06:00 [pubmed]
PHST- 2010/09/30 06:00 [medline]
AID - S0360-3016(09)02956-3 [pii]
AID - 10.1016/j.ijrobp.2009.08.016 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2010 Oct 1;78(2):370-8. doi: 
      10.1016/j.ijrobp.2009.08.016. Epub 2010 Feb 4.