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Sökning: onr:"swepub:oai:lup.lub.lu.se:09ee2b0a-bacc-4e41-861a-b069d499a712" > Life years lost-com...

Life years lost-comparing potentially fatal late complications after radiotherapy for pediatric medulloblastoma on a common scale

Brodin, N. Patrik (författare)
Vogelius, Ivan R. (författare)
Maraldo, Maja V. (författare)
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af Rosenschold, Per Munck (författare)
Aznar, Marianne C. (författare)
Kiil-Berthelsen, Anne (författare)
Nilsson, Per (författare)
Lund University,Lunds universitet,Medicinsk strålningsfysik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medical Radiation Physics, Lund,Section V,Department of Clinical Sciences, Lund,Faculty of Medicine
Björk-Eriksson, Thomas (författare)
Specht, Lena (författare)
Bentzen, Soren M. (författare)
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 (creator_code:org_t)
John Wiley and Sons, 2012
2012
Engelska.
Ingår i: Cancer. - : John Wiley and Sons. - 1097-0142. ; 118:21, s. 5432-5440
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • BACKGROUND: The authors developed a framework for estimating and comparing the risks of various long-term complications on a common scale and applied it to 3 different techniques for craniospinal irradiation in patients with pediatric medulloblastoma. METHODS: Radiation dose-response parameters related to excess hazard ratios for secondary breast, lung, stomach, and thyroid cancer; heart failure, and myocardial infarction were derived from large published clinical series. Combined with age-specific and sex-specific hazards in the US general population, the dose-response analysis yielded excess hazards of complications for a cancer survivor as a function of attained age. After adjusting for competing risks of death, life years lost (LYL) were estimated based on excess hazard and prognosis of a complication for 3-dimensional conformal radiotherapy (3D CRT), volumetric modulated arc therapy (VMAT), and intensity-modulated proton therapy (IMPT). RESULTS: Lung cancer contributed most to the estimated LYL, followed by myocardial infarction, and stomach cancer. The estimates of breast or thyroid cancer incidence were higher than those for lung and stomach cancer incidence, but LYL were lower because of the relatively good prognosis. Estimated LYL ranged between 1.90 years for 3D CRT to 0.28 years for IMPT. In a paired comparison, IMPT was associated with significantly fewer LYL than both photon techniques. CONCLUSIONS: Estimating the risk of late complications is associated with considerable uncertainty, but including prognosis and attained age at an event to obtain the more informative LYL estimate added relatively little to this uncertainty. Cancer 2012. (c) 2012 American Cancer Society.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

Nyckelord

life years lost
radiotherapy
late effects
secondary cancers
risk
modeling

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  • Cancer (Sök värdpublikationen i LIBRIS)

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