TY - JOUR
T1 - Late-occurring stroke among long-term survivors of childhood leukemia and brain tumors
T2 - A report from the childhood cancer survivor study
AU - Bowers, Daniel C.
AU - Liu, Yan
AU - Leisenring, Wendy
AU - McNeil, Elizabeth
AU - Stovall, Marilyn
AU - Gurney, James G.
AU - Robison, Leslie L.
AU - Packer, Roger J.
AU - Oeffinger, Kevin C.
PY - 2006/11/20
Y1 - 2006/11/20
N2 - Purpose: This report examines the incidence of and risk factors for strokes that occur in ≥ 5-year survivors of childhood leukemia and brain tumors. Patients and Methods: The rate of first occurrence of self-reported late-occurring strokes was determined for leukemia survivors (n = 4,828), brain tumor survivors (n = 1,871), and a comparison group of a random sample of cancer survivor siblings (n = 3,846). Relative risks (RRs) and 95% confidence intervals (CIs) of stroke by treatment exposures were examined by multivariate analyses. Results: Thirty-seven leukemia survivors and 63 brain tumor survivors reported a late-occurring stroke. The rate of late-occurring stroke for leukemia survivors was 57.9 per 100,000 person-years (95% CI, 41.2 to 78.7). The RR of stroke for leukemia survivors compared with the sibling comparison group was 6.4 (95% CI, 3.0 to 13.8; P < .0001). The rate of late-occurring stroke for brain tumor survivors was 267.6 per 100,000 person-years (95% CI, 206.8 to 339.2). The RR of stroke for brain tumor survivors compared with the sibling comparison group was 29.0 (95% CI, 13.8 to 60.6; P < .0001). Mean cranial radiation therapy (CRT) dose of ≥ 30 Gy was associated with an increased risk in both leukemia and brain tumor survivors in a dose-dependent fashion, with the highest risk after doses of ≥ 50 Gy CRT. Conclusion: Survivors of childhood leukemia and brain tumors, particularly those with brain tumors treated with CRT at doses of greater than 30 Gy, are at an increased risk of stroke.
AB - Purpose: This report examines the incidence of and risk factors for strokes that occur in ≥ 5-year survivors of childhood leukemia and brain tumors. Patients and Methods: The rate of first occurrence of self-reported late-occurring strokes was determined for leukemia survivors (n = 4,828), brain tumor survivors (n = 1,871), and a comparison group of a random sample of cancer survivor siblings (n = 3,846). Relative risks (RRs) and 95% confidence intervals (CIs) of stroke by treatment exposures were examined by multivariate analyses. Results: Thirty-seven leukemia survivors and 63 brain tumor survivors reported a late-occurring stroke. The rate of late-occurring stroke for leukemia survivors was 57.9 per 100,000 person-years (95% CI, 41.2 to 78.7). The RR of stroke for leukemia survivors compared with the sibling comparison group was 6.4 (95% CI, 3.0 to 13.8; P < .0001). The rate of late-occurring stroke for brain tumor survivors was 267.6 per 100,000 person-years (95% CI, 206.8 to 339.2). The RR of stroke for brain tumor survivors compared with the sibling comparison group was 29.0 (95% CI, 13.8 to 60.6; P < .0001). Mean cranial radiation therapy (CRT) dose of ≥ 30 Gy was associated with an increased risk in both leukemia and brain tumor survivors in a dose-dependent fashion, with the highest risk after doses of ≥ 50 Gy CRT. Conclusion: Survivors of childhood leukemia and brain tumors, particularly those with brain tumors treated with CRT at doses of greater than 30 Gy, are at an increased risk of stroke.
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U2 - 10.1200/JCO.2006.07.2884
DO - 10.1200/JCO.2006.07.2884
M3 - Article
C2 - 17088567
AN - SCOPUS:33847769663
SN - 0732-183X
VL - 24
SP - 5277
EP - 5282
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 33
ER -