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Risk of secondary neoplasms after external-beam radiation therapy treatment of pediatric low-grade gliomas: a SEER analysis, 1973-2015.

Publication ,  Journal Article
Rodrigues, AJ; Jin, MC; Wu, A; Bhambhvani, HP; Li, G; Grant, GA
Published in: J Neurosurg Pediatr
September 1, 2021

OBJECTIVE: Although past studies have associated external-beam radiation therapy (EBRT) with higher incidences of secondary neoplasms (SNs), its effect on SN development from pediatric low-grade gliomas (LGGs), defined as WHO grade I and II gliomas of astrocytic or oligodendrocytic origin, is not well understood. Utilizing a national cancer registry, the authors sought to characterize the risk of SN development after EBRT treatment of pediatric LGG. METHODS: A total of 1245 pediatric patient (aged 0-17 years) records from 1973 to 2015 were assembled from the Surveillance, Epidemiology, and End Results (SEER) database. Univariable and multivariable subdistribution hazard regression models were used to evaluate the prognostic impact of demographic, tumor, and treatment-related covariates. Propensity score matching was used to balance baseline characteristics. Cumulative incidence analyses measured the time to, and rate of, SN development, stratified by receipt of EBRT and controlled for competing mortality risk. The Fine and Gray semiparametric model was used to estimate future SN risk in EBRT- and non-EBRT-treated pediatric patients. RESULTS: In this study, 366 patients received EBRT and 879 did not. Forty-six patients developed SNs after an LGG diagnosis, and 27 of these patients received EBRT (OR 3.61, 95% CI 1.90-6.95; p < 0.001). For patients alive 30 years from the initial LGG diagnosis, the absolute risk of SN development in the EBRT-treated cohort was 12.61% (95% CI 8.31-13.00) compared with 4.99% (95% CI 4.38-12.23) in the non-EBRT-treated cohort (p = 0.013). Cumulative incidence curves that were adjusted for competing events still demonstrated higher rates of SN development in the EBRT-treated patients with LGGs. After matching across available covariates and again adjusting for the competing risk of mortality, a clear association between EBRT and SN development remained (subhazard ratio 2.26, 95% CI 1.21-4.20; p = 0.010). CONCLUSIONS: Radiation therapy was associated with an increased risk of future SNs for pediatric patients surviving LGGs. These data suggest that the long-term implications of EBRT should be considered when making treatment decisions for this patient population.

Duke Scholars

Published In

J Neurosurg Pediatr

DOI

EISSN

1933-0715

Publication Date

September 1, 2021

Volume

28

Issue

3

Start / End Page

306 / 314

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • 3213 Paediatrics
  • 3209 Neurosciences
  • 1114 Paediatrics and Reproductive Medicine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Rodrigues, A. J., Jin, M. C., Wu, A., Bhambhvani, H. P., Li, G., & Grant, G. A. (2021). Risk of secondary neoplasms after external-beam radiation therapy treatment of pediatric low-grade gliomas: a SEER analysis, 1973-2015. J Neurosurg Pediatr, 28(3), 306–314. https://doi.org/10.3171/2021.1.PEDS20859
Rodrigues, Adrian J., Michael C. Jin, Adela Wu, Hriday P. Bhambhvani, Gordon Li, and Gerald A. Grant. “Risk of secondary neoplasms after external-beam radiation therapy treatment of pediatric low-grade gliomas: a SEER analysis, 1973-2015.J Neurosurg Pediatr 28, no. 3 (September 1, 2021): 306–14. https://doi.org/10.3171/2021.1.PEDS20859.
Rodrigues AJ, Jin MC, Wu A, Bhambhvani HP, Li G, Grant GA. Risk of secondary neoplasms after external-beam radiation therapy treatment of pediatric low-grade gliomas: a SEER analysis, 1973-2015. J Neurosurg Pediatr. 2021 Sep 1;28(3):306–14.
Rodrigues, Adrian J., et al. “Risk of secondary neoplasms after external-beam radiation therapy treatment of pediatric low-grade gliomas: a SEER analysis, 1973-2015.J Neurosurg Pediatr, vol. 28, no. 3, Sept. 2021, pp. 306–14. Pubmed, doi:10.3171/2021.1.PEDS20859.
Rodrigues AJ, Jin MC, Wu A, Bhambhvani HP, Li G, Grant GA. Risk of secondary neoplasms after external-beam radiation therapy treatment of pediatric low-grade gliomas: a SEER analysis, 1973-2015. J Neurosurg Pediatr. 2021 Sep 1;28(3):306–314.

Published In

J Neurosurg Pediatr

DOI

EISSN

1933-0715

Publication Date

September 1, 2021

Volume

28

Issue

3

Start / End Page

306 / 314

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • 3213 Paediatrics
  • 3209 Neurosciences
  • 1114 Paediatrics and Reproductive Medicine