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01-08-2009 | Original Paper

Case–control study on the therapy of childhood cancer and the occurrence of second malignant neoplasms in Germany

Authors: Peter Kaatsch, Irene Reinisch, Claudia Spix, Frank Berthold, Gritta Janka-Schaub, Andreas Mergenthaler, Jörg Michaelis, Maria Blettner

Published in: Cancer Causes & Control | Issue 6/2009

Abstract

We report on a nested case–control study with 328 cases with second malignant neoplasm (SMN) following childhood cancer and 639 matched controls based on the German Childhood Cancer Registry. In the adjusted overall analysis, the odds ratio (OR) for SMN following any radiotherapy or chemotherapy is 2.1 [95% confidence interval (CI): 1.8–3.3] and 1.8 (95% CI: 0.98–3.1), respectively. The strongest effect is seen for alkylating agents (OR=2.0, 95% CI: 1.2–3.3). The risk of SMN after leukemia is pronounced for antimetabolites (OR=17.2, 95% CI: 1.7–177) and asparaginase (OR=4.3, 95% CI: 1.7–11.0). Following solid tumors, the greatest effect is seen for platinum derivatives (OR=4.1, 95% CI: 1.7–10.1). For anthracyclines, a decreased risk is observed (OR=0.3, 95% CI: 0.1–0.6). Secondary solid tumors are mainly associated with radiotherapy (OR=4.5, 95% CI: 2.5–8.0), especially secondary carcinomas. Secondary acute myeloid leukemia and myelodysplastic syndrome are mainly associated with alkylating agents (OR=8.5, 95% CI: 0.97–74.8), asparaginase (OR=6.8, 95% CI: 2.3–20.6), and platinum derivatives (OR=4.5, 95% CI: 1.5–13.6). The observed risks are in many instances lower than the ones published in previous studies relating to earlier treatment eras of the primary diseases. These differences may be attributed to less toxic but still effective treatment regimes but also to differences in the length of follow-up.

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Title: Case–control study on the therapy of childhood cancer and the occurrence of second malignant neoplasms in Germany
Authors: Peter Kaatsch
Irene Reinisch
Claudia Spix
Frank Berthold
Gritta Janka-Schaub
Andreas Mergenthaler
Jörg Michaelis
Maria Blettner
Publication date: 01-08-2009
Publisher: Springer Netherlands
Published in: Cancer Causes & Control / Issue 6/2009
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-009-9315-1

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