caa a22 4500 477128890 CHVBK 20180405111658.0 cr unu---uuuuu 170330e19971101xx s 000 0 eng 10.1023/A:1018464328836 doi (NATIONALLICENCE)springer-10.1023/A:1018464328836 Second cancers after medulloblastoma: population-based results from the United States and Sweden [Elektronische Daten] [Alisa Goldstein, Jonathan Yuen, Margaret Tucker] Medulloblastoma, one of the most common central nervous system(CNS)tumors in children, requires aggressive multimodality therapy including surgery, radiation therapy, and occasionally chemotherapy. Given its intensive treatment regimen and improved survival during the past 20 years, it is likely that a cohort of survivors will result who may incur consequences of therapy, including a second cancer. We used population-based data from the United States and Sweden to estimate risks of second neo plasms in patients with histologically confirmed medulloblastoma (n = 1,262).Overall, there was a 5.4-fold excess of second neoplasms (95 percent confidence interval = 3.3-8.4) based on 20 observed and 3.7 expected cancers. The second cancers occurred eight to 432 months after initial diagnosis(median, 73 months) with significantly elevated ratios for all intervals examined except for less than one year after initial diagnosis. Significantly elevated risks were seen for cancers of the salivary glands, cervix uteri, brain and CNS, thyroid gland, and acute lymphoblastic leukemia. Of the 15second cancers with treatment data, seven occurred in the radiation field or within areas of scatter while two others may have been radiation-related. Although based on small numbers of second cancers, the results suggest that as survival increases, some patients with medulloblastoma will have an increased risk of a second cancer, particularly a radiation-related cancer. Thus, as survival improves, late-occurring consequences of diagnosis and treatment will need to be carefully assessed. Identification of patients hypersensitive to radiation therapy, such as those with Gorlin Syndrome, should also be attempted in order to reduce the sequelae from intensive radiation exposure. Chapman and Hall, 1997 Medulloblastoma nationallicence radiation nationallicence second cancers nationallicence survival nationallicence Sweden nationallicence United States nationallicence Goldstein Alisa Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA aut Yuen Jonathan Department of Cancer Epidemiology, University Hospital, Uppsala, Sweden aut Tucker Margaret Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA aut Cancer Causes & Control Kluwer Academic Publishers 8/6(1997-11-01), 865-871 0957-5243 8:6<865 1997 8 10552 https://doi.org/10.1023/A:1018464328836 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1018464328836 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Goldstein Alisa Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA aut NATIONALLICENCE 700 1- Yuen Jonathan Department of Cancer Epidemiology, University Hospital, Uppsala, Sweden aut NATIONALLICENCE 700 1- Tucker Margaret Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA aut NATIONALLICENCE 773 0- Cancer Causes & Control Kluwer Academic Publishers 8/6(1997-11-01), 865-871 0957-5243 8:6<865 1997 8 10552 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer