title: Radiation dose and relapse are predictors for development of second malignant solid tumors after cancer in childhood and adolescence: a population-based case-control study in the five Nordic countries.
abstract: The aim of the study was to assess the risk with radiation therapy and chemotherapy of the first cancer in childhood and adolescence for the development of a second malignant solid tumor (SMST). Also, the role of relapse of the primary tumor was studied. It is a nested case-control study within a Nordic cohort of patients less than 20 years of age at first diagnosis 1960-1987. SMSTs were diagnosed in 1960-1991. There were 196 cases and 567 controls. The risk was increased only for radiotherapy given more than five years before the development of the SMST. A significantly increased relative risk of 1.8 was found already at doses below 1 Gy. The risk increased rapidly up to a maximum of 18.3 for doses above 30 Gy. Chemotherapy alone did not increase the risk to develop an SMST. However, in combination with radiotherapy, chemotherapy showed a significant potentiating effect. Relapse was found to be an independent risk factor for development of an SMST, with a higher relative risk for females than for males.
authors.affiliation: Department of Radiation Physics, University Hospital, Lund, Sweden.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Svahn-Tapper
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Garwicz
authors.forename: Harald
authors.initials: H
authors.lastname: Anderson
authors.forename: Akthar
authors.initials: A
authors.lastname: Shamsaldin
authors.forename: Florent
authors.initials: F
authors.lastname: De Vathaire
authors.forename: Jørgen H
authors.initials: JH
authors.lastname: Olsen
authors.forename: Henrik
authors.initials: H
authors.lastname: Døllner
authors.forename: Henrik
authors.initials: H
authors.lastname: Hertz
authors.forename: Gudmundur
authors.initials: G
authors.lastname: Jonmundsson
authors.forename: Frøydis
authors.initials: F
authors.lastname: Langmark
authors.forename: Marjatta
authors.initials: M
authors.lastname: Lanning
authors.forename: Risto
authors.initials: R
authors.lastname: Sankila
authors.forename: Hrafn
authors.initials: H
authors.lastname: Tulinius
authors.forename: Torgil
authors.initials: T
authors.lastname: Möller
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000532:radiotherapy*; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000453:epidemiology; D011879:Radiotherapy Dosage; D012042:Registries; D012307:Risk Factors; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology
chemical_list: D000970:Antineoplastic Agents