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Stroke as a late treatment effect of Hodgkin's Disease: a report from the Childhood Cancer Survivor Study.

Publication ,  Journal Article
Bowers, DC; McNeil, DE; Liu, Y; Yasui, Y; Stovall, M; Gurney, JG; Hudson, MM; Donaldson, SS; Packer, RJ; Mitby, PA; Kasper, CE; Robison, LL ...
Published in: J Clin Oncol
September 20, 2005

PURPOSE: The objectives of this report are to examine the incidence of and risk factors for stroke among childhood Hodgkin's disease (HD) survivors. PATIENTS AND METHODS: The Childhood Cancer Survivor Study is a multi-institutional cohort study of more than 5-year cancer survivors diagnosed between 1970 and 1986 and a sibling comparison group. Incidence rates of stroke among HD survivors (n = 1,926) and siblings (n = 3,846) were calculated and compared. Cox proportional hazards models were used to estimate the hazard ratios, reported as relative risks (RR), of developing stroke between HD survivors and siblings. RESULTS: Nine siblings reported a stroke, for an incidence of 8.00 per 100,000 person-years (95% CI, 3.85 to 14.43 per 100,000 person-years). Twenty-four HD survivors reported a stroke. The incidence of late-occurring stroke among HD survivors was 83.6 per 100,000 person-years (95% CI, 54.5 to 121.7 per 100,000 person-years). The RR of stroke among HD survivors was 4.32 (95% CI, 2.01 to 9.29; P = .0002). All 24 survivors received mantle radiation exposure (median dose, 40 Gy). The incidence of late-occurring stroke among HD survivors treated with mantle radiation was 109.8 per 100,000 person-years (95% CI, 70.8 to 161.1 per 100,000 person-years). The RR of late-occurring stroke among HD survivors treated with mantle radiation was 5.62 (95% CI, 2.59 to 12.25; P < .0001). CONCLUSION: Survivors of childhood HD are at increased risk of stroke. Mantle radiation exposure is strongly associated with subsequent stroke. Potential mechanisms may include carotid artery disease or cardiac valvular disease.

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Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

September 20, 2005

Volume

23

Issue

27

Start / End Page

6508 / 6515

Location

United States

Related Subject Headings

  • Survivors
  • Survival Analysis
  • Stroke
  • Sex Distribution
  • Severity of Illness Index
  • Risk Assessment
  • Retrospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Probability
 

Citation

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Bowers, D. C., McNeil, D. E., Liu, Y., Yasui, Y., Stovall, M., Gurney, J. G., … Oeffinger, K. C. (2005). Stroke as a late treatment effect of Hodgkin's Disease: a report from the Childhood Cancer Survivor Study. J Clin Oncol, 23(27), 6508–6515. https://doi.org/10.1200/JCO.2005.15.107
Bowers, Daniel C., D Elizabeth McNeil, Yan Liu, Yutaka Yasui, Marilyn Stovall, James G. Gurney, Melissa M. Hudson, et al. “Stroke as a late treatment effect of Hodgkin's Disease: a report from the Childhood Cancer Survivor Study.J Clin Oncol 23, no. 27 (September 20, 2005): 6508–15. https://doi.org/10.1200/JCO.2005.15.107.
Bowers DC, McNeil DE, Liu Y, Yasui Y, Stovall M, Gurney JG, et al. Stroke as a late treatment effect of Hodgkin's Disease: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2005 Sep 20;23(27):6508–15.
Bowers, Daniel C., et al. “Stroke as a late treatment effect of Hodgkin's Disease: a report from the Childhood Cancer Survivor Study.J Clin Oncol, vol. 23, no. 27, Sept. 2005, pp. 6508–15. Pubmed, doi:10.1200/JCO.2005.15.107.
Bowers DC, McNeil DE, Liu Y, Yasui Y, Stovall M, Gurney JG, Hudson MM, Donaldson SS, Packer RJ, Mitby PA, Kasper CE, Robison LL, Oeffinger KC. Stroke as a late treatment effect of Hodgkin's Disease: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2005 Sep 20;23(27):6508–6515.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

September 20, 2005

Volume

23

Issue

27

Start / End Page

6508 / 6515

Location

United States

Related Subject Headings

  • Survivors
  • Survival Analysis
  • Stroke
  • Sex Distribution
  • Severity of Illness Index
  • Risk Assessment
  • Retrospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Probability