EJC paediatric oncology最新文献

{"title":"Potential of non-FDG PET radiotracers for paediatric patients with solid tumours","authors":"Leonor Teles ,&nbsp;Nelleke Tolboom ,&nbsp;Sabine L.A. Plasschaert ,&nbsp;Alex J. Poot ,&nbsp;Arthur J.A.T. Braat ,&nbsp;Max M. van Noesel","doi":"10.1016/j.ejcped.2024.100203","DOIUrl":"10.1016/j.ejcped.2024.100203","url":null,"abstract":"<div><div>Molecular imaging with positron emission tomography (PET) offers significant potential for improving diagnostic accuracy, staging and treatment monitoring in paediatric solid tumours, by using radiopharmaceuticals more specific than [¹⁸F]fluorodeoxyglucose ([¹⁸F]FDG). While non-[¹⁸F]FDG tracers have already improved diagnostic abilities in adult solid cancers such as prostate and neuroendocrine tumours, their use in the paediatric population has been underexplored. This narrative review summarises clinical evidence regarding the use, advantages, and limitations of these more specific PET tracers in paediatric patients. In neuroblastoma, [¹⁸F]mFBG, [¹⁸F]F-DOPA, and SSTR-targeting peptides stand out as the most evolved and promising tracers for the clinical setting, with encouraging results regarding feasibility, safety and detection rates. SSTR-targeting peptides have also consistently outperformed other imaging methods (both conventional and functional) and carry the benefits of theragnostic applications. For brain tumours, amino acid-based tracers in general stand out due to their ability to surpass the blood-brain barrier/blood-tumour barrier (BBB/BTB) and their specific accumulation in malignant tissue. Other paediatric solid tumours, such as sarcoma and bone tumours, suffer from a clear lack of clinical evidence that should be addressed in the near future. The studies performed to date show high accuracy, evident prognostic value, and significant clinical impact of non-[¹⁸F]FDG tracers in paediatric patients with solid tumours. However, prospective studies with longer follow-up times are warranted to provide high-level evidence regarding the impact of these tracers on patient management and prognosis, to consolidate the encouraging results obtained so far. Further research and international collaboration will be essential to overcome current challenges related to low incidence of paediatric solid tumours, logistical barriers and concerns about radiation exposure.</div></div>","PeriodicalId":94314,"journal":{"name":"EJC paediatric oncology","volume":"4 ","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eight-year national multicenter experience on the use of glucarpidase as effective rescue therapy for delayed methotrexate elimination after high-dose methotrexate cycles administered in children with hemato-oncological diseases","authors":"Nicolò Peccatori ,&nbsp;Marta Coppola ,&nbsp;Antonella Colombini ,&nbsp;Daniela Silvestri ,&nbsp;Nicoletta Bertorello ,&nbsp;Valentina Kiren ,&nbsp;Fraia Melchionda ,&nbsp;Rosamaria Mura ,&nbsp;Daniela Onofrillo ,&nbsp;Simona Gobbi ,&nbsp;Raffaele Mattera ,&nbsp;Luciana Vinti ,&nbsp;Tommaso Casini ,&nbsp;Nicola Santoro ,&nbsp;Domenico Sperlì ,&nbsp;Carmelita D’Ippolito ,&nbsp;Valentino Conter ,&nbsp;Andrea Biondi ,&nbsp;Carmelo Rizzari","doi":"10.1016/j.ejcped.2024.100202","DOIUrl":"10.1016/j.ejcped.2024.100202","url":null,"abstract":"<div><h3>Background</h3><div>High-dose methotrexate (HDMTX) for cancer treatment can be complicated by delayed methotrexate elimination (DME) and associated acute kidney injury (AKI). This study evaluated glucarpidase for the treatment of DME and HDMTX-AKI in pediatric hemato-oncology patients.</div></div><div><h3>Methods</h3><div>This multicenter, retrospective study reviewed the medical records of pediatric patients (1–18 years) with ALL or NHL who were given glucarpidase as rescue therapy for DME or HDMTX-AKI at 13 Italian AIEOP centers between January 1, 2015, and June 30, 2023. Patients also received uniform supportive therapy, per study protocols and guidelines, to prevent and treat AKI.</div></div><div><h3>Results</h3><div>Data were available for 42/44 patients given glucarpidase, following i.v. HDMTX as monotherapy (non-high risk ALL [non-HR ALL], n=24), or within combined intensive chemotherapy blocks (HR-ALL, n=13; NHL, n=5). Median time to glucarpidase infusion was 53 hours (range 32–72). Most patients required glucarpidase during the first cycle of HDMTX. Glucarpidase led to a rapid decrease in plasma MTX levels (median 72.53 %; range 12.62–94.57 %). Median time for complete elimination of MTX and its metabolites was 216 hours (range 120–672). Recovery of renal function (return of serum creatinine to ≤1.5 times baseline value) took a median 18 days (range 4–72). Of the 22/42 patients (52 %) re-challenged with HDMTX (at 40–100 % of recommended dose), none experienced DME and all completed per-protocol number of HDMTX cycles.</div></div><div><h3>Conclusions</h3><div>Our experience shows that glucarpidase is effective and well tolerated for the treatment of DME and HDMTX-AKI in pediatric patients with hemato-oncologic diseases.</div></div>","PeriodicalId":94314,"journal":{"name":"EJC paediatric oncology","volume":"5 ","pages":"Article 100202"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New insights into hematopoietic cell transplantation in ALL: Who should be transplanted, when, and how","authors":"Daisuke Tomizawa ,&nbsp;Evgenios Goussetis","doi":"10.1016/j.ejcped.2024.100200","DOIUrl":"10.1016/j.ejcped.2024.100200","url":null,"abstract":"<div><div>Advancements in multi-agent chemotherapy through clinical trials conducted by multi-institutional collaborative groups worldwide, along with risk stratification using molecular genetic features and treatment responses, including minimal residual disease, have significantly improved outcomes for children and adolescents with acute lymphoblastic leukemia (ALL) over the past half-century. However, for a certain number of high-risk patients, including those with relapsed or refractory disease, for whom existing chemotherapy alone is insufficient for cure, allogeneic hematopoietic cell transplantation (HCT) has provided a potential opportunity for leukemia cure. For these patients, the appropriate selection of donor and stem cell source, conditioning regimen, timing of transplantation, and comprehensive supportive care, including effective graft-versus-host disease prophylaxis, are prerequisites for successful HCT. While HCT from a human leukocyte antigen (HLA)-matched sibling has traditionally been the preferred option, less than 25 % of patients currently have such a donor in developed countries. Consequently, alternative donor HCT options, such as those from matched unrelated donors identified through high-resolution HLA typing, unrelated cord blood donors, and more recently, haploidentical donors using post-transplant cyclophosphamide or TCRαβ+/CD19+ cell-depleted grafts, are providing broader access to HCT for patients lacking matched sibling donors. Nonetheless, HCT carries the risk of various acute and late toxicities. In particular, the use of myeloablative conditioning with total body irradiation, a standard in pediatric ALL, is associated with significant long-term sequelae. As our understanding of the pathophysiology of the disease improves and novel molecular targeted therapies and immunotherapies are developed, the indication for HCT in pediatric ALL is becoming more selective, leading to a gradual decrease in the number of transplants performed. However, further optimization and evolution of allogeneic HCT are needed to both maximize its anti-leukemia effects and minimize transplant-related complications, as there remain cases that undoubtedly require HCT for the cure of leukemia.</div></div>","PeriodicalId":94314,"journal":{"name":"EJC paediatric oncology","volume":"4 ","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients’, parents’, and survivors’ perspective about AI applications in pediatric oncology","authors":"Hyseni Bocolli Albina,&nbsp;Schneider Carina,&nbsp;Bastos Pais Teresa,&nbsp;Willi Michaela,&nbsp;Brunmair Mattias","doi":"10.1016/j.ejcped.2024.100201","DOIUrl":"10.1016/j.ejcped.2024.100201","url":null,"abstract":"<div><div>Patients, parents and survivors of childhood cancer are those who represent the critical link between the clinical and technical research spheres. Thus, UNICA4EU worked towards a patient- centric approach to integrate AI in the care pathways for childhood cancer, with evidence-based patient advocacy at its core to build trust while protecting and guaranteeing patients’ fundamental rights <span><span>[1]</span></span>.</div><div>The task “Increase Knowledge and Transparency about AI among patients, parents and survivors” was led by CCI Europe as the biggest pan-European childhood cancer parents’ and survivors’ organization which represents childhood cancer parents´ and survivors´ groups and other childhood cancer organizations and reunites 63 member-organizations in 34 countries <span><span>[2]</span></span>.</div><div>To investigate the knowledge base of AI application in pediatric oncology among those who are affected, a survey was conducted. The survey translated into nine European languages, gathered responses from 332 individuals. To delve deeper into the survey findings, discussions were held with a diverse focus group, including four parents of childhood cancer former patients (survivors), three childhood cancer survivors, and one bereaved parent, each representing different backgrounds, age groups, and countries.</div><div>Insights and outcomes of this study produced a report for guiding the multi-stakeholder board of the project when defining the governance structures reg. data sharing, ownership, protection, access and usage.</div><div>Perspective of parents, patients and survivors of pediatric cancer regarding AI applications in Pediatric Oncology focused in six areas of interest including: data anonymization and data protection, data ownership, data withdrawal, ethical concerns of use of data, data types and, additionally, informed consents. This paper summarizes the respective results, along concluding policy recommendations.</div></div>","PeriodicalId":94314,"journal":{"name":"EJC paediatric oncology","volume":"4 ","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142586831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing pediatric oncology clinical trials through patient reported outcomes (PROs)","authors":"David Riedl ,&nbsp;Niclas Hubel ,&nbsp;Annalena Endres ,&nbsp;Chiara Vetrano ,&nbsp;Andreas Meryk ,&nbsp;Roman Crazzolara","doi":"10.1016/j.ejcped.2024.100199","DOIUrl":"10.1016/j.ejcped.2024.100199","url":null,"abstract":"<div><div>Survival rates of children with cancer have significantly increased over the last decades in high income countries. However, cancer survivors often face significant long-term adverse effects on physical, psychosocial, and neurocognitive health. The use of Patient-Reported Outcomes (PROs) in clinical trials may help to further optimize treatment regimens to minimize acute and late adverse events. Despite clear recommendations of regulatory agencies, the use of PROs in pediatric clinical trials remains limited. In this article, we discuss the rationale to assess PROs in pediatric clinical trials with a specific highlight on electronic PRO (ePRO) assessment. In addition, we underscore the importance of recent international guideline developments such as the <em>Setting International Standards in Analyzing Patient-Reported Outcomes and Quality of Life Endpoints Data</em> (SISAQOL-IMI) and the <em>CONsolidated Standards of Reporting Trials – Patient-Reported Outcomes</em> (CONSORT-PRO) to improve the robustness of PRO data assessment in pediatric oncology, thus facilitating better patient care and more accurate assessments of treatment effects. Best practice examples for the use of modern technologies in ePRO assessments are presented and potential barriers and challenges are discussed. We conclude that – despite some challenges and barriers – the routine assessment of (e)PROs in pediatric clinical trials has the potential to substantially improve the quality of the trials and facilitate the usability of outcome data. We call for a joint effort to take proactive steps to incorporate PROs into clinical trials in pediatric oncology, thus giving children a voice.</div></div>","PeriodicalId":94314,"journal":{"name":"EJC paediatric oncology","volume":"4 ","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A practical guide to apply AI in childhood cancer: Data collection and AI model implementation","authors":"Shuping Wen ,&nbsp;Stefan Theobald ,&nbsp;Pilar Gangas ,&nbsp;Karina C. Borja Jiménez ,&nbsp;Johannes H.M. Merks ,&nbsp;Reineke A. Schoot ,&nbsp;Marcel Meyerheim ,&nbsp;Norbert Graf ,&nbsp;on behalf of UNICA4EU","doi":"10.1016/j.ejcped.2024.100197","DOIUrl":"10.1016/j.ejcped.2024.100197","url":null,"abstract":"<div><div>Childhood cancer is a leading cause of death in children, and the increasing availability of digital healthcare data, coupled with rapid progress in artificial intelligence (AI), brings a transformative opportunity to revolutionise its diagnosis, treatment and ultimately improve patient outcomes by leveraging diverse data resources. However, the effective application of AI in childhood cancer requires strict adherence to regulatory and best practice guidelines for patient data preparation and AI model development. Currently, there is a lack of such regulatory and methodological guidance specifically tailored for the paediatric community. This review seeks to address this gap. Beginning with an overview of existing regulatory frameworks, it examines the types of data currently in use or with potential use in developing AI applications for childhood cancer. This encompasses data from traditional sources, such as patient data and electronic health records (EHRs), as well as emerging sources like social media data and social determinants of health. This review also outlines the rules and criteria for collecting, processing, and sharing these data. Informed consent and re-consent are required for data collection and re-use, and data quality, privacy, and security as well as data standardisation, harmonisation and interoperability are important for data processing. Additionally, this review clarifies the essential requirements and methodologies for developing AI models in childhood cancer and healthcare. It also emphasises the importance of AI being trustworthy, protecting privacy, and being accountable and validated in clinical settings. By systematically addressing these key components, this review aims to provide comprehensive knowledge and practical tools for the reliable application and implementation of AI in paediatric cancer to enhance AI acceptance and promote its widespread integration within the childhood cancer community. This, in turn, will lead to improved diagnosis, treatment and outcomes for children with cancer.</div></div>","PeriodicalId":94314,"journal":{"name":"EJC paediatric oncology","volume":"4 ","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of methylome analysis on the diagnosis and treatment of CNS tumours in children and adolescents: A population-based study in Greece","authors":"Maria Filippidou ,&nbsp;Stavros Glentis ,&nbsp;Ilona Binenbaum ,&nbsp;Martin Sill ,&nbsp;Kleoniki Roka ,&nbsp;Antonia Vlachou ,&nbsp;Georgia Avgerinou ,&nbsp;Jonas Ecker ,&nbsp;Florian Selt ,&nbsp;Martin Hasselblatt ,&nbsp;Mirjam Blattner-Johnson ,&nbsp;Kathrin Schramm ,&nbsp;Clio Trougkou ,&nbsp;Dimitrios Doganis ,&nbsp;Nikolaos Katzilakis ,&nbsp;Vita Ridola ,&nbsp;Evgenia Papakonstantinou ,&nbsp;Vassilios Papadakis ,&nbsp;Emmanouel Hatzipantelis ,&nbsp;Eleftheria Kokkinou ,&nbsp;Antonis Kattamis","doi":"10.1016/j.ejcped.2024.100198","DOIUrl":"10.1016/j.ejcped.2024.100198","url":null,"abstract":"<div><h3>Background</h3><div>The recently published WHO classification of central nervous system (CNS) tumours recognizes DNA methylation profiling as a desirable and, for some diagnoses, essential diagnostic tool adjunctive to conventional histopathology. DNA methylation profiling is not routinely available in many countries, including Greece.</div></div><div><h3>Methods</h3><div>In this collaborative study, we report the DNA methylation results in a series of children and adolescents with CNS tumours in Greece (2018–2023). In total, 130 tumour samples were analyzed using the latest applicable version of the Heidelberg brain tumour classifier.</div></div><div><h3>Results</h3><div>Upon initial analysis, 80 % (104/130) achieved calibrated scores (Cs) ≥ 0.9 and matched an established methylation class family/subclass. Among them, methylation results confirmed (90/104, 86.5 %), refined (50/104, 48 %) or changed (10/104, 9.6 %) the histological diagnosis. Only four results were regarded as non-contributing (4/104, 3.9 %). Twenty-six tumour samples received Cs &lt; 0.9. Despite low scores, methylation results supported the initial diagnosis with lower confidence in 38.5 % (10/26) and established the diagnosis in two tumours with non-conclusive histopathology. Additional t-distributed stochastic neighbour embedding (t-SNE) analysis allowed the possible classification of twelve tumours. Nine more samples reached high Cs using the newer brain tumour classifiers, since available. Samples co-tested in Greece demonstrated excellent test reproducibility, supporting the analysis' local implementation. Methylome profiling impacted the clinical management of 40 % of patients, modifying stratification, prognosis, or treatment approach.</div></div><div><h3>Conclusions</h3><div>This study supports the need to integrate methylome analysis into routine diagnostics in our country and highlights the importance of collaboration between European pediatric oncology centres.</div></div>","PeriodicalId":94314,"journal":{"name":"EJC paediatric oncology","volume":"4 ","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life of toddlers during and after cancer treatment","authors":"Elin Irestorm ,&nbsp;Raphaele R.L. van Litsenburg ,&nbsp;Heleen Maurice-Stam ,&nbsp;Kelly L.A. van Bindsbergen ,&nbsp;Annelies M.C. Mavinkurve-Groothuis ,&nbsp;Marita Partanen ,&nbsp;Martha Grootenhuis","doi":"10.1016/j.ejcped.2024.100194","DOIUrl":"10.1016/j.ejcped.2024.100194","url":null,"abstract":"<div><h3>Background</h3><div>There is a knowledge gap regarding health-related quality of life (HRQOL) in childhood cancer patients below 2 years of age. The aim of this study was therefore to compare HRQOL of young children during and after treatment for cancer, to healthy controls, and to investigate effects of biopsychosocial factors.</div></div><div><h3>Procedure</h3><div>The study is based on data from an online monitoring program. Parent-proxy reports of HRQOL in 205 children aged 12–24 months were compared to 108 healthy children. The parents filled out the TNO-AZL Preschool Quality of Life questionnaire for young children, which consists of 12 subscales, in addition to a parental distress thermometer.</div></div><div><h3>Results</h3><div>Participants undergoing treatment had less favorable HRQOL than children after treatment for eight of the subscales. They also had less favorable HRQOL than healthy children for seven scales, while the only significant difference between children off treatment and healthy controls was for motor functioning. For ten subscales, there were significant relationships between biopsychosocial variables and HRQOL outcomes. Parental distress and treatment with immunotherapy were the variables most frequently associated with lower HRQOL.</div></div><div><h3>Conclusions</h3><div>Parental distress should be considered when monitoring young childhood cancer patients. Treatment with immunotherapy is likely to be a marker of disease severity and might represent other underlying factors affecting HRQOL. The association between immunotherapy and HRQOL therefore needs more research. While there was a significant difference depending on treatment status, it cannot be concluded that this represents an improvement in HRQOL after end of treatment.</div></div>","PeriodicalId":94314,"journal":{"name":"EJC paediatric oncology","volume":"4 ","pages":"Article 100194"},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General context and relevant public datasets available for improving pathways in Paediatric Cancer applying Artificial Intelligence. A review","authors":"Gustavo Hernández-Peñaloza ,&nbsp;Silvia Uribe ,&nbsp;Francisco Moreno García ,&nbsp;Norbert Graf ,&nbsp;Federico Álvarez","doi":"10.1016/j.ejcped.2024.100196","DOIUrl":"10.1016/j.ejcped.2024.100196","url":null,"abstract":"<div><div>Due to the promise of transforming healthcare and medicine that Artificial Intelligence (AI) has posed, the number of applications has increased exponentially. These applications range from screening and disease diagnosis to prognosis, treatment planning, and follow-up. In complex topics such as childhood cancer, these techniques are being expanded with the ambition of improving the quality of care by allowing healthcare professionals to make more informed decisions. However, the adequate application of such techniques heavily depends on the data, which creates a set of challenges including collection, bias, and scarcity among others. Furthermore, ethical, legal, and regulatory frameworks increase even more the difficulties to develop AI-powered solutions. In this paper, we present an exhaustive literature review to identify and analyse public datasets targeting two common childhood cancer types, such as neuroblastoma and nephroblastoma. Moreover, the complex context for the development of AI- based software solutions is outlined. It includes the description of the most relevant techniques to address problems associated with data sharing and training. Finally, a set of code snippets is provided to perform exploratory analysis for the available data.</div></div>","PeriodicalId":94314,"journal":{"name":"EJC paediatric oncology","volume":"4 ","pages":"Article 100196"},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of severe esophageal stricture among childhood cancer survivors – A population-based case-cohort study within the Adult Life after Childhood Cancer in Scandinavia (ALiCCS)","authors":"Helena K. Hansen ,&nbsp;Peter H. Asdahl ,&nbsp;Jane Christensen ,&nbsp;Camilla Pedersen ,&nbsp;Anja Krøyer ,&nbsp;Celina S. Pontoppidan ,&nbsp;Anna S. Holmqvist ,&nbsp;Lars Hjorth ,&nbsp;Thomas Wiebe ,&nbsp;Thorgerdur Gudmundsdottir ,&nbsp;Sofie de fine Licht ,&nbsp;Yasmin Lassen-Ramshad ,&nbsp;Klaus Seiersen ,&nbsp;Morten Jørgensen ,&nbsp;Michael RT Laursen ,&nbsp;Hilde Øfstaas ,&nbsp;Päivi M. Lähteenmäki ,&nbsp;Susan A. Smith ,&nbsp;Rebecca Howell ,&nbsp;Catherine Rechnitzer ,&nbsp;Line Kenborg","doi":"10.1016/j.ejcped.2024.100195","DOIUrl":"10.1016/j.ejcped.2024.100195","url":null,"abstract":"<div><h3>Purpose</h3><div>Due to limited data on treatment-related risk factors associated with esophageal stricture in childhood cancer survivors, this study aimed to assess such factors in long-term survivors.</div></div><div><h3>Methods</h3><div>A case-cohort study was conducted involving 36 cases of five-year childhood cancer survivors with esophageal stricture and a sub-cohort of 540 survivors diagnosed with cancer in 1970–2007 as identified within the Nordic ‘Adult Life after Childhood Cancer in Scandinavia’ program. Individualized treatment details were retrieved from medical records. Radiation doses to each body region and average dose to the esophagus were reconstructed for patients that received radiotherapy. We used a modified Cox proportional hazard model to evaluate associations between esophageal stricture and risk factors by calculating incidence rate ratio (IRR), with 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>An increased rate of esophageal stricture was found in survivors who received total body irradiation (IRR=13.7, 95 %CI 4.6–41.1), chest- and neck-directed radiotherapy (IRR=23.5, 95 %CI 8.5−64.7) and doses of ≥12 Gy to the esophagus (IRR=26.8, 95 % CI=9.0–80.3) compared to non-irradiated survivors. Treatment with chemotherapy was also associated with esophageal stricture (IRR=8.4, 95 % CI=2.9–24.4). Notably, leukemia survivors faced an elevated rate (IRR=3.8, 95 % CI 1.8–8.1) compared with survivors of CNS and other solid tumors.</div></div><div><h3>Conclusions</h3><div>Our findings indicate an increased risk of esophageal stricture among childhood cancer survivors, with both neck- and chest-directed radiotherapy and chemotherapy as important risk factors.</div></div>","PeriodicalId":94314,"journal":{"name":"EJC paediatric oncology","volume":"4 ","pages":"Article 100195"},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}