Risk of salivary gland cancer after childhood cancer

A report from the childhood cancer survivor study

Houda Boukheris, Marilyn Stovall, Ethel S. Gilbert, Kayla L. Stratton, Susan A. Smith, Rita Weathers, Sue Hammond, Ann C. Mertens, Sarah S. Donaldson, Gregory Armstrong, Leslie L. Robison, Joseph P. Neglia, Peter D. Inskip

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: To evaluate effects of radiation therapy, chemotherapy, cigarette smoking, and alcohol consumption on the risk of second primary salivary gland cancer (SGC) in the Childhood Cancer Survivor Study (CCSS). Methods and Materials: Standardized incidence ratios (SIR) and excess absolute risks (EAR) of SGC in the CCSS were calculated using incidence rates from Surveillance, Epidemiology, and End Results population-based cancer registries. Radiation dose to the salivary glands was estimated based on medical records. Poisson regression was used to assess risks with respect to radiation dose, chemotherapy, smoking, and alcohol consumption. Results: During the time period of the study, 23 cases of SGC were diagnosed among 14,135 childhood cancer survivors. The mean age at diagnosis of the first primary cancer was 8.3 years, and the mean age at SGC diagnosis was 24.8 years. The incidence of SGC was 39-fold higher in the cohort than in the general population (SIR = 39.4; 95% CI = 25.4-57.8). The EAR was 9.8 per 100,000 person-years. Risk increased linearly with radiation dose (excess relative risk = 0.36/Gy; 95% CI = 0.06-2.5) and remained elevated after 20 years. There was no significant trend of increasing risk with increasing dose of chemotherapeutic agents, pack-years of cigarette smoking, or alcohol intake. Conclusion: Although the cumulative incidence of SGC was low, childhood cancer survivors treated with radiation experienced significantly increased risk for at least 2 decades after exposure, and risk was positively associated with radiation dose. Results underscore the importance of long-term follow up of childhood cancer survivors for the development of new malignancies.

Original languageEnglish (US)
Pages (from-to)776-783
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume85
Issue number3
DOIs
StatePublished - Mar 1 2013
Externally publishedYes

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Salivary Gland Neoplasms
salivary glands
Survivors
cancer
Neoplasms
Radiation
Incidence
incidence
Smoking
dosage
Alcohol Drinking
radiation
alcohols
chemotherapy
Drug Therapy
Salivary Glands
epidemiology
Population
Medical Records
Registries

All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Risk of salivary gland cancer after childhood cancer : A report from the childhood cancer survivor study. / Boukheris, Houda; Stovall, Marilyn; Gilbert, Ethel S.; Stratton, Kayla L.; Smith, Susan A.; Weathers, Rita; Hammond, Sue; Mertens, Ann C.; Donaldson, Sarah S.; Armstrong, Gregory; Robison, Leslie L.; Neglia, Joseph P.; Inskip, Peter D.

In: International Journal of Radiation Oncology Biology Physics, Vol. 85, No. 3, 01.03.2013, p. 776-783.

Research output: Contribution to journalArticle

Boukheris, H, Stovall, M, Gilbert, ES, Stratton, KL, Smith, SA, Weathers, R, Hammond, S, Mertens, AC, Donaldson, SS, Armstrong, G, Robison, LL, Neglia, JP & Inskip, PD 2013, 'Risk of salivary gland cancer after childhood cancer: A report from the childhood cancer survivor study', International Journal of Radiation Oncology Biology Physics, vol. 85, no. 3, pp. 776-783. https://doi.org/10.1016/j.ijrobp.2012.06.006
Boukheris, Houda ; Stovall, Marilyn ; Gilbert, Ethel S. ; Stratton, Kayla L. ; Smith, Susan A. ; Weathers, Rita ; Hammond, Sue ; Mertens, Ann C. ; Donaldson, Sarah S. ; Armstrong, Gregory ; Robison, Leslie L. ; Neglia, Joseph P. ; Inskip, Peter D. / Risk of salivary gland cancer after childhood cancer : A report from the childhood cancer survivor study. In: International Journal of Radiation Oncology Biology Physics. 2013 ; Vol. 85, No. 3. pp. 776-783.
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abstract = "Purpose: To evaluate effects of radiation therapy, chemotherapy, cigarette smoking, and alcohol consumption on the risk of second primary salivary gland cancer (SGC) in the Childhood Cancer Survivor Study (CCSS). Methods and Materials: Standardized incidence ratios (SIR) and excess absolute risks (EAR) of SGC in the CCSS were calculated using incidence rates from Surveillance, Epidemiology, and End Results population-based cancer registries. Radiation dose to the salivary glands was estimated based on medical records. Poisson regression was used to assess risks with respect to radiation dose, chemotherapy, smoking, and alcohol consumption. Results: During the time period of the study, 23 cases of SGC were diagnosed among 14,135 childhood cancer survivors. The mean age at diagnosis of the first primary cancer was 8.3 years, and the mean age at SGC diagnosis was 24.8 years. The incidence of SGC was 39-fold higher in the cohort than in the general population (SIR = 39.4; 95{\%} CI = 25.4-57.8). The EAR was 9.8 per 100,000 person-years. Risk increased linearly with radiation dose (excess relative risk = 0.36/Gy; 95{\%} CI = 0.06-2.5) and remained elevated after 20 years. There was no significant trend of increasing risk with increasing dose of chemotherapeutic agents, pack-years of cigarette smoking, or alcohol intake. Conclusion: Although the cumulative incidence of SGC was low, childhood cancer survivors treated with radiation experienced significantly increased risk for at least 2 decades after exposure, and risk was positively associated with radiation dose. Results underscore the importance of long-term follow up of childhood cancer survivors for the development of new malignancies.",
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T2 - A report from the childhood cancer survivor study

AU - Boukheris, Houda

AU - Stovall, Marilyn

AU - Gilbert, Ethel S.

AU - Stratton, Kayla L.

AU - Smith, Susan A.

AU - Weathers, Rita

AU - Hammond, Sue

AU - Mertens, Ann C.

AU - Donaldson, Sarah S.

AU - Armstrong, Gregory

AU - Robison, Leslie L.

AU - Neglia, Joseph P.

AU - Inskip, Peter D.

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N2 - Purpose: To evaluate effects of radiation therapy, chemotherapy, cigarette smoking, and alcohol consumption on the risk of second primary salivary gland cancer (SGC) in the Childhood Cancer Survivor Study (CCSS). Methods and Materials: Standardized incidence ratios (SIR) and excess absolute risks (EAR) of SGC in the CCSS were calculated using incidence rates from Surveillance, Epidemiology, and End Results population-based cancer registries. Radiation dose to the salivary glands was estimated based on medical records. Poisson regression was used to assess risks with respect to radiation dose, chemotherapy, smoking, and alcohol consumption. Results: During the time period of the study, 23 cases of SGC were diagnosed among 14,135 childhood cancer survivors. The mean age at diagnosis of the first primary cancer was 8.3 years, and the mean age at SGC diagnosis was 24.8 years. The incidence of SGC was 39-fold higher in the cohort than in the general population (SIR = 39.4; 95% CI = 25.4-57.8). The EAR was 9.8 per 100,000 person-years. Risk increased linearly with radiation dose (excess relative risk = 0.36/Gy; 95% CI = 0.06-2.5) and remained elevated after 20 years. There was no significant trend of increasing risk with increasing dose of chemotherapeutic agents, pack-years of cigarette smoking, or alcohol intake. Conclusion: Although the cumulative incidence of SGC was low, childhood cancer survivors treated with radiation experienced significantly increased risk for at least 2 decades after exposure, and risk was positively associated with radiation dose. Results underscore the importance of long-term follow up of childhood cancer survivors for the development of new malignancies.

AB - Purpose: To evaluate effects of radiation therapy, chemotherapy, cigarette smoking, and alcohol consumption on the risk of second primary salivary gland cancer (SGC) in the Childhood Cancer Survivor Study (CCSS). Methods and Materials: Standardized incidence ratios (SIR) and excess absolute risks (EAR) of SGC in the CCSS were calculated using incidence rates from Surveillance, Epidemiology, and End Results population-based cancer registries. Radiation dose to the salivary glands was estimated based on medical records. Poisson regression was used to assess risks with respect to radiation dose, chemotherapy, smoking, and alcohol consumption. Results: During the time period of the study, 23 cases of SGC were diagnosed among 14,135 childhood cancer survivors. The mean age at diagnosis of the first primary cancer was 8.3 years, and the mean age at SGC diagnosis was 24.8 years. The incidence of SGC was 39-fold higher in the cohort than in the general population (SIR = 39.4; 95% CI = 25.4-57.8). The EAR was 9.8 per 100,000 person-years. Risk increased linearly with radiation dose (excess relative risk = 0.36/Gy; 95% CI = 0.06-2.5) and remained elevated after 20 years. There was no significant trend of increasing risk with increasing dose of chemotherapeutic agents, pack-years of cigarette smoking, or alcohol intake. Conclusion: Although the cumulative incidence of SGC was low, childhood cancer survivors treated with radiation experienced significantly increased risk for at least 2 decades after exposure, and risk was positively associated with radiation dose. Results underscore the importance of long-term follow up of childhood cancer survivors for the development of new malignancies.

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