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一份来自儿童癌症幸存者研究的报告

原文发布日期：2024-03-01

英文摘要：

摘要翻译：

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一份来自儿童癌症幸存者研究的报告

a report from the Childhood Cancer Survivor Study

原文发布日期：2024-03-01

英文摘要：

Pediatric glioma therapy has evolved to delay or eliminate radiation for low-grade tumors. This study examined these temporal changes in therapy with long-term outcomes in adult survivors of childhood glioma. Among 2,501 5-year survivors of glioma in the Childhood Cancer Survivor Study diagnosed 1970–1999, exposure to radiation decreased over time. Survivors from more recent eras were at lower risk of late mortality (≥5 years from diagnosis), severe/disabling/life-threatening chronic health conditions (CHCs) and subsequent neoplasms (SNs). Adjusting for treatment exposure (surgery only, chemotherapy, or any cranial radiation) attenuated this risk (for example, CHCs (1990s versus 1970s), relative risk (95% confidence interval), 0.63 (0.49–0.80) without adjustment versus 0.93 (0.72–1.20) with adjustment). Compared to surgery alone, radiation was associated with greater than four times the risk of late mortality, CHCs and SNs. Evolving therapy, particularly avoidance of cranial radiation, has improved late outcomes for childhood glioma survivors without increased risk for late recurrence.

摘要翻译：

儿童胶质母细胞瘤（Pediatric glioma）的治疗已发展为通过放疗时间延长或消除低级别肿瘤的治疗手段。本研究探讨了成人存活者中长期随访期疗法的时间变化及其对结果的影响。在1970年至1999年间诊断出的2501例5年存活率较高的儿童胶质母细胞瘤患者中，接受放疗的机会随着时间推移而下降。来自较近期时代的幸存者的慢性健康问题（CHCs）和严重/丧失功能/致命慢性疾病（severe/disabling/life-threatening chronic health conditions, CHCs）、长期放病史（SNs）的风险较低（≥5年存活期）。当调整治疗接触情况时，这些风险被降低（例如，1990年代与20世纪70年代相比，CHCs的相对风险为0.63（95%置信区间：0.49–0.80）未调整，调整后为0.93（0.72–1.20））。与单纯手术治疗相比，放疗的总风险是单纯手术治疗的超过4倍，导致早逝、CHCs和SNs的风险显著增加。随时间推移，治疗手段的发展，尤其是颅内放射治疗的避免，改善了儿童胶质母细胞瘤幸存者的长期结果，而对晚发性复发风险没有增加。